The gayser sign is a patognomic symptom of massive rotator cuff tears, that means very large rotator cuff tears. How do they rise? In every human body articulation, so in the shoulder too, there is a “lubrificant” liquid, known as “sinovial liquid”. The sinovial liquid is in a special bag, called ” capsule”, with a spheric form. Rotator cuff tendoms are 4 tendoms lyng on the capsule. above the rotator cuff tendoms there is the acromion-clavicular articolation. acromio-clavicular articulation has its capsule too, with a cube form. when rotator cuff tear rises, the spheric Capsule breaks too and the humeral head goes up because of deltoid muscle action and damages inferior surface of cubic acromion-clavicle capsule: the two articulations become one, and the sinovial liquid fills everything. When superior surface of acromio-clavicle capsule breaks too, there is a “funnel effect”: sinovial liquid is pushed above the acromio-clavicula articulations and can’t come back, like a gayser. Obviously it should be an important mistake try to suck sinovial liquid: there should be a new liquid movement. For this reason the right terapheutic decision is to treat the real problem, that is rotatot cuff tear.