根據一大型文獻回顧性研究
旋轉肌撕裂傷有以下五大因子：
年齡(>60歲)、身體質量指數、慣用手、高血壓、吸煙。
而根據另一大型統合分析
與有症狀的旋轉肌撕裂傷相關危險因子有：
糖尿病、高血壓、較高身體質量指數 (BMI) 和吸菸
另外
需要舉手過頭的活動之運動和職業
導致旋轉肌撕裂的發生率較高
患者年齡較輕
且經常與關節唇病變(labral pathology)相關
以下是教科書中針對相關危險因子的整理：
一、內在因素
與年齡相關的退化性變化：細胞數減少、纖維變薄和破裂，以及營養不良性鈣化
代謝變化：肉芽組織積聚
血管變化：關節側與滑液囊側撕裂頻率不同—>可能與血管分佈差異有關
二、外在因素
經典的肩峰下夾擠症候群
肩關節不穩定（通常是前方不穩）
內夾擠症候群(internal impingement)
前方不穩定
後關節囊攣縮
肱骨後旋減少
張力過大
投擲技術不良
肩胛肌不平衡
三、創傷因素
單一創傷性傷害
重複性微創傷
肩袖的過度張力負荷
According to a large-scale literature review, there are five major factors associated with rotator cuff tears: age (>60 years), body mass index (BMI), dominant hand, hypertension, and smoking.
Additionally, based on another meta-analysis, the risk factors associated with symptomatic rotator cuff tears include diabetes, hypertension, higher body mass index (BMI), and smoking.
Furthermore, activities and occupations that require overhead arm movements are associated with a higher incidence of rotator cuff tears, particularly in younger patients, and are often related to labral pathology.
The following is a summary of the relevant risk factors from the textbook:
a. Intrinsic factors
Age-related degenerative changes: decreased cellularity, fascicular thinning and disruption, and dystrophic calcification
Metabolic changes: accumulation of granulation tissue
Vascular changes: relative frequency of articular-sided versus bursal-sided partial-thickness tears may potentially be related to this difference in vascularity
b. Extrinsic factors
Classic subacromial impingement
Shoulder instability (typically anterior)
Internal impingement
Anterior instability
Posterior capsular contracture
Decreased humeral retroversion
Tension overload
Poor throwing mechanics
Scapular muscle imbalance
c. Traumatic factors
Single traumatic injury
Repetitive microtrauma
Excessive tensile load of the cuff
References:
Systematic review on risk factors of rotator cuff tears
What Factors Are Associated with Symptomatic Rotator Cuff Tears: A Meta-analysis.
https://pubmed.ncbi.nlm.nih.gov/34424222/
Rotator Cuff Disorders: Basic Science and Clinical Medicine
By Nicola Maffulli, John P Furia
Rotator cuff tear: A detailed update
https://www.sciencedirect.com/science/article/pii/S2214687314000739
