Risk factors for rotator cuff tendinopathy
Secondly, most of the included studies were either
cross-sectional studies or cohort studies with diverse
populations, although the majority of the included stu-
dies examined the working population (13/16). Pooled
analysis showed age above 50 years and work with the
shoulder above 90° were associated with increased risk
of symptomatic rotator cuff tendinopathy among the
working population, and diabetes was associated with
increased risk of symptomatic rotator cuff tendinopa-
thy among the general and working population. More
prospective studies are required to identify the exact
risk factors for rotator cuff tendinopathy in the general
population and athletes of overhead sports. Thirdly,
inconsistency in the method of tendinopathy diagnoses
may explain the large between-study heterogeneity.
In the present systematic review, we included only
symptomatic patients with rotator cuff tendinopathy
diagnosed by clinical tests or conventional imaging,
which have been adopted in previous studies in order
to identify those with rotator cuff tendinopathy (3, 19,
20). The majority of the included studies used clinical
diagnostic tests to determine the diagnosis of rotator
cuff tendinopathy. Future studies should combine the
use of clinical diagnostic testing and imaging to con-
firm the diagnosis of rotator cuff tendinopathy. Finally,
among the 22 potential risk factors that were identi-
fied, only 5 factors were explored with meta-analysis.
This may be due to the small number of studies and
the fact that the studies were largely heterogeneous;
therefore, conducting a meta-analysis was impossible.
Further high-quality prospective studies in regard to
risk factors for rotator cuff tendinopathy are required.
In conclusion, this study demonstrates that there is
evidence indicating that age above 50 years and diabe-
tes are associated with increased risk of symptomatic
rotator cuff tendinopathy. In addition, overhead shoul-
der activities above 90° were associated with increased
risk of symptomatic rotator cuff tendinopathy. Further
high-quality prospective studies are required to identify
the exact risk factors for rotator cuff tendinopathy.
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