Rotator cuff injury in contact athletes.

The causes and incidence of rotator cuff injuries in patients under the age of 40 has not been clearly established. The present study focuses on a group of 10 male contact athletes with rotator cuff injuries related to trauma sustained during football (ages from 24 to 36 years). Symptoms included pain and dysfunction in all 10 patients and a positive shrug sign in 8 of 10. The diagnoses for these patients were two isolated contusions, five partial-thickness tears, and three full-thickness tears. Surgery was performed on all patients after nonoperative treatment failed. Three partial-thickness tears were arthroscopically debrided. One full-thickness and two partial-thickness tears were repaired using the arthroscopically assisted miniarthrotomy technique. An open repair was performed in two patients. Two isolated rotator cuff contusions were arthroscopically debrided. The average followup was 21 months. Nine of 10 athletes returned to active participation in football, 7 of these at their preinjury levels. The diagnosis of rotator cuff injury should be considered in a contact athlete who has persistent shoulder pain, impingement signs, weakness, and a positive shrug sign. Arthroscopic debridement of the subacromial space followed by debridement or repair of rotator cuff tears, as clinically indicated, resulted in a marked improvement in function and rapid return to sport for these patients.