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Some very interesting reading 👏 #Repost @hamishthephysio with @get_repost ・・・ 30 days of shoulders with @thestrengththerapist. Here’s my contribution. ・・・ Imaging results with @hamishthephysio Changes seen on imaging can be very worrying for shoulder pain clients. While imaging definitely has its place and time in many cases, it’s important to also understand that ‘pathology’ changes are often seen in asymptomatic shoulders also. Sher et al 1995 did an MRI study of 96 asymptomatic individuals aged between 19-88 years (average age 53 years). The dominant shoulder of each participant was scanned 34%! had cuff tears. (15% full thickness) Kong et al 2018 looked at the structural evolution of nonoperatively treated high-grade partial-thickness tears of the supraspinatus tendon. They assessed partial thickness rotator cuff tears > 1 yr MRI follow up. 81 patients 25% ruptures decreased in size, 59% were unchanged and only 16% increased in size! Another ultrasound study by Girish G et al found abnormalities in 96% of a sample of 51 asymptomatic male subjects. Subacromial-subdeltoid bursa (78%), tendinosis of the supraspinatus (39%) and ACJ osteoarthritis (65%) were most prevalent. Also some research backing conservative Mx of cuff tears. Moosmayer et al 2017 followed up 49 non operatively treated full thickness tears after 8 years. 41/49 83% reported good or excellent function. Interestingly most tears also had modest tear size progression. So after all that! A reminder to treat the wo(man) not the scan. 👍 People diagnosed with rotator cuff tears should be preety ‘cuffed’ about this!😜 #30daysofshoulders Refs: Girish G, et al Ultrasound of the shoulder: Asymptomatic findings in men. AJR 2011;197:W713-W719. Sher JS, et al Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 1995; 77:10-15. Kong BY, et al Structural Evolution of Nonoperatively Treated High-Grade Partial-Thickness Tears of the Supraspinatus Tendon. Am J Sports Med. 2018 Moosmayer et al The natural course of nonoperatively treated rotator cuff tears: an 8.8-year follow-up of tear anatomy and clinical outcome in 49 patients. Journal of Shoulder and Elbow

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