The 2026 FIMAGE study provides a definitive look at the prevalence of rotator cuff findings in the general population. Data from 602 adults showed that 98.7% have at least one abnormality. Supraspinatus findings were present in 98% of participants, while 62% showed partial-thickness tears.

Perhaps most striking is the "Adjustment Reality." When researchers adjusted for clinical tests, the difference in full-thickness tear prevalence between symptomatic and asymptomatic shoulders was a mere 0.8%. We simply cannot distinguish clinically meaningful abnormalities from incidental findings using MRI alone.

For rehab professionals, the mandate is clear: Normalize the image. Treat findings like skin wrinkles—expected markers of age rather than sources of pathology. Focus on clinical correlation, strength, and function rather than the "tear" on the screen.