A combined anatomic, experimental, and clinical study asking whether rotator cuff tears come from wear and aging or from trauma. Lindblom examined 36 cadaver specimens plus operative tissue, loaded isolated supraspinatus tendons to failure, and reviewed a clinical arthrography series. The central question: is cuff rupture a wear disease, or is a distinct trauma the chief cause?
This is one of the early attempts to settle the wear-versus-trauma debate in rotator cuff disease, and its answer holds up in a modern mental model: cuff tears are multifactorial. The practical rule is that a tear needs a susceptible tendon (age-related sclerosis) plus, in most patients, a discrete traumatic event. Neither alone reliably tears a young, healthy tendon.
The biomechanics are worth remembering. Pulling the cuff along its fibers fails the muscle, not the tendon; only load applied across the insertion with the arm abducted or externally rotated tears the supraspinatus. That is the injury position to ask about when you take a history.
Lindblom also flagged that degeneration at tear margins is likely a consequence of the tear, so degenerative-looking edges do not prove a purely atraumatic cause. Finally, his observation that tears progress in stages fits the frequency of partial-thickness tears you see today.
A combined anatomic, experimental, and clinical study asking whether rotator cuff tears come from wear and aging or from trauma. Lindblom examined 36 cadaver specimens plus operative tissue, loaded isolated supraspinatus tendons to failure, and reviewed a clinical arthrography series. The central question: is cuff rupture a wear disease, or is a distinct trauma the chief cause?
This is one of the early attempts to settle the wear-versus-trauma debate in rotator cuff disease, and its answer holds up in a modern mental model: cuff tears are multifactorial. The practical rule is that a tear needs a susceptible tendon (age-related sclerosis) plus, in most patients, a discrete traumatic event. Neither alone reliably tears a young, healthy tendon.
The biomechanics are worth remembering. Pulling the cuff along its fibers fails the muscle, not the tendon; only load applied across the insertion with the arm abducted or externally rotated tears the supraspinatus. That is the injury position to ask about when you take a history.
Lindblom also flagged that degeneration at tear margins is likely a consequence of the tear, so degenerative-looking edges do not prove a purely atraumatic cause. Finally, his observation that tears progress in stages fits the frequency of partial-thickness tears you see today.