Could Disruption of the Shoulder Superior Capsule Be the “Essential Lesion” of Rotator Cuff Disease? Possibly, but Questions Remain…

Rotator cuff disease remains a complex clinical problem with significant variation in pathology, clinical presentation, and management options. Functionally, humeral head depression is critical in restoring or maintaining arm elevation, and the shoulder superior capsule serves in this important function. Could disruption of the shoulder superior capsule be the "essential lesion" of rotator cuff disease? Possibly, but many questions remain unanswered, and substantial scientific evidence is required before we can assert with certainty that disruption of the superior capsule with resultant superior instability of the humeral head is the essential lesion of rotator cuff disease.