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Letters to the Editor to:

Scientific Articles:
H. Mike Kim, Sharlene A. Teefey, Ari Zelig, Leesa M. Galatz, Jay D. Keener, and Ken Yamaguchi
Shoulder Strength in Asymptomatic Individuals with Intact Compared with Torn Rotator Cuffs
J Bone Joint Surg Am 2009; 91: 289-296 [Abstract] [Full text] [PDF]
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[Read Letter to the Editor] Is the Asymptomatic Shoulder Asymptomatic?
Jerrold M. Gorski, MD   (17 February 2009)

Is the Asymptomatic Shoulder Asymptomatic? 17 February 2009
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Jerrold M. Gorski, MD,
Orthopedic Surgeon
Winthrop University Hospital, Mineola, NY

Send letter to journal:
Re: Is the Asymptomatic Shoulder Asymptomatic?

jgorskimd{at}hotmail.com Jerrold M. Gorski, MD

To the Editor:

I was encouraged to write after reading the final question posed by Dr Cofield in his JBJS web Commentary on the article by Kim et al. (1) "I would pose a final philosophical question: Is a person who has a painless rotator cuff tear that is causing weakness really asymptomatic"?

The answer to this pointed question, I believe, lies beyond both philosophy and the simple confusion of symptoms and physical findings. I have observed that the asymptomatic shoulder commonly presents as symptomatic "neck" pain (2, 3). My hope is that further research will prove that the asymptomatic shoulder underlies some chronic neck pain syndromes in which evidence is lacking like whiplash, trapezius spasm, trigger points, fibromyalgia, and thoracic outlet syndrome. I am hopeful that the normative data established by these authors will help their ongoing scientific analysis of the mysterious and highly prevalent asymptomatic shoulder. I hope they address two additional questions in future reports: why does the rotator cuff tear with presumably decreasing usage with age and why is the shoulder asymptomatic?

The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the author, or a member of his immediate family, is affiliated or associated.

References

1. Kim HM, Teefey SA, Zelig A, Galatz LM, Keener JD, Yamaguchi K. Shoulder Strength in Asymptomatic Individuals with Intact Compared with Torn Rotator Cuffs. J Bone Joint Surg Am 2009;91:289-296 2. Gorski JM, Schwartz H. Shoulder Impingement Presenting as Neck Pain. J Bone Joint Surg 85-American 2003;4:635-638.

3. Gorski JM. A New Pain in the Neck. Bulletin of the AAOS, Aug, 2007 27-29.