Meyer GA, Ward SR.
Persistent muscle atrophy in the chronically torn rotator cuff is a significant
obstacle for treatment and recovery. Large atrophic changes are predictive of
poor surgical and nonsurgical outcomes and frequently fail to resolve even
following functional restoration of loading and rehabilitation. New insights into
the processes of muscle atrophy and recovery gained through studies in
developmental biology combined with the novel tools and strategies emerging in
regenerative medicine provide new avenues to combat the vexing problem of muscle
atrophy in the rotator cuff. Moving these treatment strategies forward likely
will involve the combination of surgery, biologic/cellular agents, and physical
interventions, as increasing experimental evidence points to the beneficial
interaction between biologic therapies and physiologic stresses. Thus, the
physical therapy profession is poised to play a significant role in defining the
success of these combinatorial therapies. This perspective article will provide
an overview of the developmental biology and regenerative medicine strategies
currently under investigation to combat muscle atrophy and how they may integrate
into the current and future practice of physical therapy.
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