Abstract
The management of rotator cuff pathology has developed over hundreds of years. In this article, we take a journey from the early days, in order to understand how we have reached our modern-day practice. Initially our understanding of rotator cuff pathology was based on cadaveric anatomical findings and this has enhanced over the years by the development of radiological and surgical techniques. We discuss the historical debates over the pathogenesis of cuff dysfunction. This work describes the landmark publications by several clinicians who have made important contributions to our understanding of rotator cuff pathology and its management. We follow the trends of surgical management of rotator cuff tears, traditionally performed via an open technique, to an exponential rise in arthroscopic surgery in recent years. As new techniques emerge, a review of the historical rise and fall of techniques is a reminder for us to remain vigilant of surgical indications and rigorous outcome analysis.