Rotator Cuff Injuries in the Elite Athlete

Abstract

Rotator cuff injuries in the elite athlete pose a unique challenge for the treating surgeon. As a common cause of dysfunction in throwing and contact athletes, careful evaluation and treatment is required to maintain an elite level of play. The etiology of rotator cuff injuries ranges from acute trauma to chronic overuse and can manifest as contusions, tendinopathies, and tears. The management of rotator cuff injuries can vary depending on a number of factors, including type of injury, severity, and performance limitations. Furthermore management of the overhead athlete may be complicated by in-season or postseason nuances. Nonoperative management remains the first line of treatment for high-level throwers, as outcomes of rotator cuff repair have not been comparable to that of non-throwing athletes. Currently, after failure of nonoperative measures, debridement is recommended over repair for most partial- and full-thickness tears for athletes who plan to return to competitive throwing.