Aaron McEneaney

Are Most Rotator Cuff Tears Actually Tears? This topic is far, far more complicated than most think... and it's certainly far more complicated than the discussion in most office visits portrays. 1/ If you have a rotator cuff tear on an MRI report, almost everything you have been told about it is more wrong than right. A short thread on what the cuff actually is, why most "tears" aren't what you think, and why surgery is rarely the right first step.

In our latest paper we make a case for treatment pluralism. This reflects the state of the evidence and hopefully allows us to move beyond toxic debates about treatments that rarely lead to progress but in fact regress to name calling and tribalism. jospt.org/doi/10.2519/jo…

Low back injury risk in deadlifting is not explained by spinal posture alone. A more precise framework integrates load management, movement variability, dynamic trunk control, and individual adaptation. doi.org/10.3390/sports…

𝗣𝗮𝘁𝗶𝗲𝗻𝘁𝘀 𝗪𝗶𝘁𝗵 𝗖𝗵𝗿𝗼𝗻𝗶𝗰 𝗟𝗼𝘄 𝗕𝗮𝗰𝗸 𝗣𝗮𝗶𝗻 𝗪𝗶𝘁𝗵𝗼𝘂𝘁 𝗔𝗱𝘃𝗮𝗻𝗰𝗲𝗱 𝗗𝗶𝘀𝗸 𝗗𝗲𝗴𝗲𝗻𝗲𝗿𝗮𝘁𝗶𝗼𝗻 𝗘𝘅𝗵𝗶𝗯𝗶𝘁 𝗚𝘂𝘁 𝗠𝗶𝗰𝗿𝗼𝗯𝗶𝗼𝗺𝗲 𝗗𝘆𝘀𝗯𝗶𝗼𝘀𝗶𝘀 onlinelibrary.wiley.com/doi/10.1002/js…

Did you miss this popular #BJSMBlog? 🙋‍♀️ Strong for Life Part 1: Understanding Sarcopenia 💪 How does muscle loss affect ageing? 🤔 ➡️ bit.ly/46f3gj3

Keeping the abdomen relaxed versus contracted during Pilates improves disability slightly and may improve other outcomes in CLBP sciencedirect.com/science/articl… Picture: pilatesjournal.com/articles/stop-…

Hot off the press! Our NUDG-ED trial now published in #CMAJ Read the paper here: lnkd.in/gxJjWSbg

Hot off the Press 🔥 𝗥𝗲𝗰𝗲𝗻𝘁 𝗵𝗶𝗴𝗵𝗹𝗶𝗴𝗵𝘁𝘀 𝗶𝗻 𝗹𝗼𝘄 𝗯𝗮𝗰𝗸 𝗽𝗮𝗶𝗻 𝗿𝗲𝘀𝗲𝗮𝗿𝗰𝗵, 𝗣𝗮𝗿𝘁 𝗜𝗜: 𝗣𝗿𝗲𝘃𝗲𝗻𝘁𝗶𝗼𝗻 𝗮𝗻𝗱 𝗺𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁 sciencedirect.com/science/articl…

Just published 🔥 The Suspected Cauda Equina Syndrome Score (SuCESS) pubmed.ncbi.nlm.nih.gov/41763246/

If your goal is fat loss, the gym bros have been misleading you. Lifting weights is essential for health, but if you believe it is the best way to lose fat, especially visceral (belly) fat, you have fallen for a marketing myth. The Evidence (The STRRIDE Trial & Beyond): One of the most comprehensive studies on this (Duke University) compared aerobic training, resistance training, and a combination. The results were clear: 🔸Aerobic Training led to significantly more fat loss and a greater reduction in visceral fat than weight training. 🔸Resistance Training is great for building lean mass, but it had zero significant impact on decreasing fat mass or total body weight when used alone. 🔸Visceral Fat: Runners consistently show lower levels of internal organ fat, which is the most dangerous type for metabolic health. The Harsh Reality: You can "chase the pump" for years and still carry a stubborn belly. Why is it so? Because the calorie expenditure of a heavy lifting session is often overcompensated for by increased appetite and decreased movement throughout the rest of the day. Meanwhile, regular runners/cardio enthusiasts: ✔Burn more calories per minute of effort. ✔Experience better lipid oxidation (fat burning). ✔Accumulate significantly less visceral fat as they age. Why won’t the fitness industry tell you this? 🔸"Lift heavy to get shredded" is a sexier sell. It sells supplements, gym memberships, and expensive coaching programs. 🔸"Go for a 45-minute run 4 times a week" is free, simple, and effective, but it doesn’t move product. Reality Check: ✅Strength Training: Builds the "engine" (muscle) and preserves bone density. ✅Running/Cardio: Actually burns the "fuel" (fat). If fat loss is your #1 goal: 1. Prioritize Zone 2 & Aerobic sessions. This is your primary fat-loss tool. 2. Use Weights as the Support. 2–3 days a week is enough to maintain muscle while the cardio does the heavy lifting for fat loss. Bottom Line: The "Cardio kills gains" era is over. If you are skipping the track and wondering why your waistline is not budging despite hitting PRs on the bench press...You are playing the wrong game. Dr Sudhir Kumar X:@hyderabaddoctor (Disclaimer: Information provided here is general in nature. Discuss individual exercise regimen with your fitness trainer and physician.)

The irony I find myself returning to is that MRI technology has not made us better diagnosticians. It has, in many cases, made us worse ones, because the image is so concrete and the language of the report so authoritative that it takes deliberate effort to resist anchoring to it. When the MRI arrives before the history is fully taken, the finding shapes what questions get asked and which ones don't. Bias abounds throughout the encounter. The encounter organizes itself around what the scanner found rather than what the patient experienced, and that is very difficult to undo once it has happened. Don't look at the scans first... the basics matter. Take a history... confirm it with an exam, then see if the MRI findings make sense in the same context.

As I prepare to read another stat lumbar MR from ED

The Association between Gut Microbiota and Osteoarthritis: Does the Disease Begin in the Gut? pmc.ncbi.nlm.nih.gov/articles/PMC88… “Instead of solely focusing on bone and cartilage, medical practitioners should be twice as vigilant about the patient’s metabolic status.”

📢📢New paper: JUST PUBLISHED Treating musculoskeletal conditions with a bit of exercise and manual therapy: are you kidding me? It’s time for us to evolve again tandfonline.com/doi/full/10.10… 🔓

Modern Hip Replacements Are Lasting Longer Than Many People Think Hip replacements are lasting longer than many people expect. Large registry data shows most are still functioning well at 10 years.Many continue to perform at 20 years and beyond. This matters because expectations around implant lifespan often influence decision making. But longevity is only one part of the equation. The other is what happens while someone is living with ongoing hip limitation. Because reduced activity over time can lead to: ✅deconditioning ✅compensatory movement ✅reduced quality of life For some people, rehabilitation is enough. For others, the joint remains the limiting factor.

MRI–CT correlation: when “atypical” is actually typical A focal vertebral body lesion on MRI. Low on T1. Bright on T2. This pattern raises concern on MRI. Metastasis, myeloma, chordoma. All reasonable. What is next? CT as a problem-solving tool. Axial CT images showed the polka-dot appearance. Coronal CT images showed the corduroy sign. Classic for vertebral hemangioma. Reporting tip: If CT shows classic trabecular thickening (polka-dot/corduroy), confidently diagnose hemangioma despite atypical MRI signal. Wisdom: Not every T1 dark, T2 bright vertebral lesion is malignant. Sometimes the answer is already there. Just in another modality. — Pearls, pitfalls and wisdom from my reporting list

A study ahead of its time. @PerHolmich

Thread to blog: Understanding Spondylolisthesis: The Five Types (Not Just the Grades) – A Clear, Evidence-Based Overview retlouping331888347.wordpress.com/2026/03/23/und…

Quick guide for the BAMIC (Muscle Injury Classification) in practice. 1) Grade the injury. 2) Define the location. 3) Predict recovery. Save it for your reference. #MSKRadiology #SportsMedicine #MRI #ReturnToPlay #BAMIC

An MRI of a joint is a static image of the current state of your ligaments, tendons, cartilage, and muscles. The patient and physician then have to determine what is clinically relevant based on your history and physical exam. Not everything seen on an MRI is pathologic.