Aetiology of work-related disorders of the rotator cuff tendons: Research and theory

Abstract

This paper examines evidence and theories from epidemiological and biomechanical research regarding the work-relatedness of shoulder disorders affecting the rotator cuff tendons, often referred to as rotator cuff syndrome, one of the few more clearly defined musculoskeletal disorders of the shoulder region. Recent epidemiological studies and prior reviews were found to be generally consistent in their findings and conclusions regarding problems with repetitive work and elevated shoulder posture. However, most studies tended to employ fairly gross assessments of exposure. In considering more specific methods for assessing exposure, this paper identifies studies of shoulder biomechanics, tendon cell biology and animal models of tendinosis that are relevant to the design and development of exposure assessment methodologies specifically relevant to rotator cuff pathology. The authors concur with others regarding the need for more specific assessments of associations between disorders and exposures, in order to progress to the point where researchers can provide exposure-dose-response information for physical workplace factors in relation to musculoskeletal disorders. The paper concludes by listing several theoretical issues pertaining to the biomechanics of the shoulder that need to be addressed by the research community.