Q: I was very active in sports during my high school and college years. I never hurt myself and always felt proud of that fact. But now it turns out I have a rotator cuff tear in both shoulders and didn't even know it. Could these have been there all this time or is this a new development?

A: Wine may improve with age but research shows the shoulder doesn't. In fact, there's a direct relationship between increasing age and the number of rotator cuff tears. At age 50, just slightly more than one in 10 adults has a rotator cuff tear seen on MRIs. By age 80, this has increased to five out of 10 (or half of all adults).

That seems high, but many of those people are asymptomatic (i.e., have no pain or other symptoms). They don't complain of any pain and don't report any problems. The damage is found when MRIs are done for something else, or as in the case of scientific studies, the MRIs show these types of injuries when imaging is done for research purposes.

For those adults over the age of 66, shoulder pain on one side is actually a sign of rotator cuff tears in both shoulders. And that's not all. Studies show that where there's a rotator cuff tear, there's likely a tear of the biceps tendon where it attaches to the labrum (rim of cartilage around the socket).

You may have sustained these injuries during your earlier, more active years. But it's more likely these lesions have occurred as a result of the aging process. Degenerative changes in the soft tissues may put some people at an increased risk for rotator cuff and labral tears. Research is ongoing to find risk factors that might help us identify who the more susceptible individuals might be and how to prevent these types of injuries in the first place.

Reference: Amy E. Abbot, MD, et al. Arthroscopic Treatment of Concomitant Superior Labral Anterior Posterior (SLAP) Lesions and Rotator Cuff Tears in Patients Over the Age of 45 Years. In The American Journal of Sports Medicine. July 2009. Vol. 37. No. 7. Pp. 1358-1362.