ArticleAnnals of biomedical engineering2026
Inter-rotator Cuff Muscle Force Sharing Mitigates Superior Posterior Cuff Tendon Strain in U-Shaped Supraspinatus Tears.
Article in Annals of biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeU-shaped supraspinatus (SSP) tears predispose the rotator cuff (RC) to strain-related failure, yet most biomechanical studies evaluate the SSP in isolation, overlooking inter-muscle force sharing. We investigated how coordinated RC loading affects strain magnitude and distribution in U-shaped SSP tears. We hypothesized that isolated SSP loading would increase posterior cuff strain, whereas coordinated RC loading would redistribute strain and reduce localized overload.
methodsEight fresh-frozen cadaveric shoulders with standardized U-shaped SSP tears were tested at 45° glenohumeral abduction. Surface strains were measured using three-dimensional DIC during loading of the SSP (whole, anterior/posterior regions) under two conditions: (1) coordinated loading of SSP, infraspinatus (ISP), and subscapularis (SSC), and (2) SSP-only loading with ISP and SSC unloaded. Major strains were quantified at the SSC, coracohumeral ligament, SSP, and superior/inferior ISP tendons. Normalized strain ratios assessed load sharing. Paired t-tests compared conditions.
resultsSSP-only loading increased strain within the superior ISP region, whereas coordinated loading redistributed strain inferiorly. During whole SSP loading, combined cuff loading reduced superior ISP strain (2.91% vs. 3.48%, p < 0.01) and increased inferior ISP strain (4.26% vs. 3.02%, p < 0.05). Similar superior-to-inferior redistribution occurred during anterior loading. During posterior loading, coordinated loading reduced strains in both ISP regions, particularly the superior ISP (1.64% vs. 3.27%, p < 0.01). Strain ratios confirmed a shift toward superior posterior cuff dominance with SSP-only loading.
conclusionCombined loading of the SSP, ISP, and SSC was associated with reduced superior strain concentration in U-shaped tears and a more balanced load transmission compared with SSP-only loading. These findings suggest that inter-rotator cuff load sharing may influence regional strain patterns and provide a biomechanical rationale for future studies evaluating surgical and rehabilitation strategies.
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