A study published in the Journal of ISAKOS, Joint Disorders & Orthopaedic Sports Medicine in Nov. 2019, adds to a growing body of evidence that MRI scans are often misleading. Twenty-six elite volleyball players with no symptoms of injury received an MRI on their dominant shoulder. The MRIs showed an abnormality in every athlete, even though none had symptoms that kept them from competing.
Earlier studies in which baseball pitchers and tennis players received MRIs of their dominant shoulders had similar findings. Researchers estimate that almost 100% of MRIs on elite overhead athletes will show abnormalities, even when they have no symptoms. The bottom line: MRIs do not measure pain or function and can lead to unnecessary treatment.
The study concluded that a person's symptoms might not match their MRI findings. In other words, some athletes will have tears found on an MRI but have no symptoms. Others may have symptoms, but no tears are seen on their MRI. Researchers emphasized the importance of making management decisions based on more than just an MRI alone.
Researchers recommend that surgery should only be considered for shoulder pain, rotator cuff injuries, labral tears, and symptoms involving overuse after conservative treatments, including physical therapy, have been exhausted. Physical therapists are movement experts who treat people of all ages and abilities through movement, hands-on care, exercise, and patient education.
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Reviewed by Rick Clark, PT, DScPT, board-certified clinical specialist in sports physical therapy.