99% of adults over 40 have shoulder "abnormalities" on an MRI, study finds

Original Article ↗ Hacker News Discussion ↗

What “abnormality” means when 99% have it

  • Many argue that if 99% of people over 40 show MRI “abnormalities,” these findings are better understood as age-related changes or normal variation, not defects needing repair.
  • Others say “abnormal” should be defined against an ideal healthy baseline (including age-adjusted baselines), not “what most people have,” noting that common ≠ healthy (e.g., herpes, widespread obesity).
  • Several note that many distinct deviations can each be rare at a specific location even if “something” is present almost everywhere.

Limits of MRI and risk of overdiagnosis

  • Multiple comments say MRI findings in shoulders and spines often don’t correlate with pain or function; people can have tears, herniations, or malformations and be totally asymptomatic.
  • Examples include incidental Chiari I malformations and degenerative spine changes that are now reframed as “age-related” rather than pathologic.
  • Concern: imaging can create “nocebo” effects, making patients anxious about harmless findings. Some doctors explicitly warn patients that MRIs will almost always find “something.”
  • Ties to criticism of over-prescription of surgery (e.g., shoulder impingement) where placebo-surgery trials show similar outcomes.

Activity, exercise, and wear-and-tear

  • Debate over gym/athletic effects:
    • Some expect heavy training (boxing, gymnastics, “gym rats”) to increase structural damage.
    • Others emphasize that strength training, if not overdone, reduces everyday injury risk and preserves function.
  • General agreement that loss of shoulder mobility with age is common and that regular, full‑range resistance training and mobility work are protective.

Posture, ergonomics, and lifestyle

  • Multiple anecdotes link long-term computer/mouse use, hunched posture, and unilateral loading (kids, dogs, one‑sided tasks) to chronic shoulder and neck issues.
  • One detailed story describes severe, progressive right-sided problems from decades of mouse use; alternative pointing devices (e.g., tablet + stylus) reportedly helped another commenter.
  • Standing desks, split keyboards, and minimizing mouse use are mentioned as helpful by some.

Sleep, nerves, and related issues

  • Side sleeping and GERD spur discussion of specialized pillows, bed elevation, and temperature-control devices; results are mixed.
  • Several note that shoulder pain can actually stem from cervical spine nerve issues (radiculopathy), reinforcing that imaging findings at the shoulder may be misleading without clinical context.

Statistics, “normal,” and design analogies

  • Commenters compare “normal” anatomy to cockpit design for the “average pilot,” arguing that a single average or binary normal/abnormal label is often useless; meaningful ranges and individual fit matter far more.