title: The effect of rotator cuff tear size on shoulder strength and range of motion.
abstract: METHODS
  Prospective cohort study.
  
  
  OBJECTIVE
  To determine the effect of rotator cuff tear size on shoulder strength and range of motion.
  
  
  BACKGROUND
  Patients with rotator cuff pathology typically present with weakness and motion loss in various motions. The extent to which the presence of a rotator cuff tear and the size of the tear affect strength and range of motion is not well understood.
  
  
  METHODS
  Sixty-one patients scheduled for surgery, with a diagnosis of a rotator cuff tear and/or subacromial impingement, underwent examination for shoulder pain, function, range of motion, and strength. The extent of rotator cuff pathology was documented during subsequent surgery (presence of tear, tear size, tear thickness).
  
  
  RESULTS
  There were 10 massive tears, 15 large tears, 13 medium tears, 12 small tears, and 11 rotator cuffs without a tear. Patients had marked weakness in abduction strength at 90 degrees and 10 degrees of abduction, in external rotation strength at 90 degrees, and in the "full can test" (all, P<.0001). Marked range of motion losses in shoulder flexion and external rotation at 0 degrees and 90 degrees abduction (all, P<.001) were also observed. Abduction strength deficit at 10 degrees was affected by rotator cuff tear size (P<.0001). Twenty of 25 patients with large or massive tears had deficits greater than 50%, compared with only 1 of 11 patients with no tear, 2 of 12 patients with a small tear, and 5 of 13 patients with a medium tear (P<.0001). Other strength and range of motion deficits or indices of pain and function were unaffected by tear size.
  
  
  CONCLUSIONS
  Weakness of greater than 50% relative to the contralateral side in shoulder abduction at 10 degrees of abduction was indicative of a large or massive rotator cuff tear.
authors.affiliation: Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, NY 10021, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: McCabe
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Nicholas
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Montgomery
authors.forename: John J
authors.initials: JJ
authors.lastname: Finneran
authors.forename: Malachy P
authors.initials: MP
authors.lastname: McHugh
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology*; D010146:Pain; D016059:Range of Motion, Articular; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index