Published March 6, 2026
Most Older Adults Have Rotator Cuff Abnormalities, but Few Show Symptoms
Rotator cuff abnormalities are present in most individuals over 40 years of age, but routine imaging may not identify symptomatic vs asymptomatic shoulders, found a study published in JAMA Internal Medicine.
The research examined a nationally representative sample of 602 adults aged 41 to 76 years in Finland who had undergone clinical assessment and magnetic resonance imaging (MRI) of their shoulders from February 2023 through April 2024. Approximately 99% of the individuals had rotator cuff abnormalities, with 25% having tendinopathy, 62% having partial-thickness tears, and 11% having full-thickness tears. But only 18% of participants reported current shoulder symptoms. And although rotator cuff abnormalities were present in 98% of symptomatic shoulders, they were also present in 96% of asymptomatic shoulders. Severity appeared to increase with age.
The finding that rotator cuff abnormalities were nearly universal after age 40 years but demonstrated poor concordance with shoulder pain and dysfunction suggests that they may often represent normal age-related changes rather than disease, the researchers said. They added that it calls into question the clinical value of using MRI for atraumatic shoulder pain, given the inability to distinguish between clinically meaningful abnormalities and incidental results.