🦴 Rotator cuff "tears" are nearly universal after age 40.

In a population-based Finnish study (n=602), 99% had ≥1 MRI abnormality — including 96% of asymptomatic shoulders. Even full-thickness tears were usually silent, and adjusted analyses eliminated differences between painful and painless shoulders .

Lesson? After 40, imaging abnormalities are common — causality is not.

Treat function. Treat symptoms. Treat patients — not scans.