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

kylestlb8 minutes ago

Best thing a doctor ever told me was "you CAN get imaging done, but I'd like to warn you that there is a near-certainty we'd find something wrong with your shoulder and your back".

mghackerlady2 hours ago

If 99% of adults have an abnormality, it ceases to be abnormal regardless of its effects

crazygringo26 minutes ago

On the one hand, that's the point of the article. That it ceases to be a useful diagnostic indicator.

On the other hand, if there are 100 places in the shoulder where you can have an abnormality, and most people have just one or a couple but the other 98-99 are normal, then each one individually really is abnormal.

So it's complicated, and then it becomes important to figure out which abnormalities are medically relevant, in which combinations, etc.

kstrauser11 minutes ago

I went to a doctor for something unrelated and ended up getting an MRI that happened to show my upper spine. The neurologist read it and determined that I have a Chiari I malformation[0]. I have no symptoms from this whatsoever. I never have. It's unlikely that I ever will. If it weren't for the MRI, I'd never have known.

Doctors use to think that the degree of it that I have meant I'd have problems with it. After all, people who came in with the symptoms and then had an MRI or CT scan tended to show that level of herniation. Thus, it was assumed, that level of herniation was considered a diagnostic indicator. And then MRIs became cheaper and more accessible, and patients had them for all sorts of other reasons — like I did. Doctors discovered that the degree of "malformation" I have is very common among asymptomatic adults. In fact, you're many times more likely to be perfect fine with it than to experience symptoms.

Well, huh. That doesn't sound like much of a malformation anymore. Or at least, by itself it doesn't mean anything, other than that perhaps you're more likely to have problems than otherwise. On its own? It's more of a normal variation.

[0] https://en.wikipedia.org/wiki/Chiari_malformation

Insanityan hour ago

That's actually what the article points out. But I do think the language of normal vs abnormal obfuscates some of the intent. It's a 'deviation from healthy baseline' that they're talking about, and there are multiple such deviations in the grouped 'anomalies'.

From the article:

The language in particular should change given that “abnormalities” are ubiquitous—thus normal—and shouldn’t be described in terms that indicate a need for repair, like “tear.”

ameliusan hour ago

99% of adults have abnormal faces, they all look different!

mghackerladyan hour ago

Ok, in that case it's safe to say that the normal is highly variant but generally follows a pattern. People generally have a nose in the center of their face so that'd be normal, but one on the forehead would be abnormal unless everyone suddenly also had forehead noses

iso1631an hour ago

Relevant history from the US Airforce in the 1940s when they tried to build a cockpit for the average pilot and failed

I find this an interesting take on the story

https://polkas.github.io/posts/cursedim/

amelius21 minutes ago

This is also a good argument why "opinionated" designs like from Apple are a bad idea. The average user does not exist. Stop trying to turn us into one!

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jaccola32 minutes ago

I would hate to be one of the ~80 million people in the world who have identical faces

leni536an hour ago

Except that one guy.

newscluesan hour ago

Everyone is abnormal compared to yourself.

pinkmuffinerean hour ago

Dude I know exactly who you're talking about, that guy without a unique face! Weird as hell that he's the only one...

brandall10an hour ago

Right, it's clearly aging related deterioration. It's like saying facial wrinkles are an abnormality.

dijitan hour ago

I think the conclusion they're eluding to in the article is that: "if MRI says 99% of people have abnormalities, MRI is not trustworthy".

diydspan hour ago

Yes in one sense, but it also points to the insufficency of "normalness". See also: The Average Soldier.

hinkleyan hour ago

There’s a famous case study in design about the Average Pilot - they were making airplanes than nobody could fly well because nobody was average enough in all physical dimensions to be comfortable in the aircraft. They had to design for ranges that the equipment could adjust through.

Even then when I was a kid I knew a guy who wanted to join the air force and he had a growth spurt that made him too tall.

alistairSHan hour ago

More of the history of "avenge pilots" here: https://99percentinvisible.org/episode/on-average/

francisofasciian hour ago

only if the abnormality is in the same spot

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ratelimitsteve15 minutes ago

if they all have the same abnormality yeah but if they all have different abnormalities then they're still abnormalities.

CGMthrowawayan hour ago

Abnominal (not abdominal)

kingkawnan hour ago

Not if they are all different and produce negative effects

ciesan hour ago

Dunno man. When enough people overweight, 1-2 alcoholic drink become healthy (alcohol is a blood thinner): this happened, but as we know now it's not true.

Qeman hour ago

> alcohol is a blood thinner

Source?

hinkleyan hour ago

Alcohol reduces clotting factors in the blood. This is known.

Doctors mostly tell you not to drink because it’ll fuck with the anesthesia math and bad anesthesia doses can kill you just as dead as a surgical mistake and probably moreso. But it’ll also make you bleed more.

If you need courage to show up to surgery they’ll give you a prescription for a single dose of a benzo. Which is better than liquid courage anyway.

ASalazarMXan hour ago

"1% of adults over 40 have abnormally normal shoulders"

tptacek8 minutes ago

Closely related to a huge problem in American health care --- overprescription, particularly of surgical procedure. There's evidence that some widespread classes of surgical intervention --- shoulder "impingement" in particular --- have outcomes no better than placebos in controlled trials where people literally get placebo incisions.

laurexan hour ago

Given that most commenters do not seem to have read the article perhaps the headline could be more explicit about 'MRIs find "abnormalities" but they seem to have no relationship to actual health problems"

kbelder2 hours ago

Who's the freak without an abnormality?

int27h-tsr29 minutes ago

A statistical error. All humans are slightly asymmetrical. Most shoulder problems begin at foot and/or hip though.

malfist3 minutes ago

My labrum was torn from multiple shoulder dislocations. I don't think that began at my foot or hip.

kylestlb8 minutes ago

Steph Curry

skizm2 minutes ago

He’s getting old, but not over 40 yet.

diydspan hour ago

Im guessing certain gym rats who also dont desk/computer work?

elzbardicoan hour ago

I would strongly bet against gym rats not having some shoulder abnormality. If anything, I'd expect them to have more issues with their tendons and ligaments.

b65e8bee43c2ed020 minutes ago

yeah. and joints, especially. I lost some wrist mobility during my boxing years and it never came back, even though I was in my early 20's when I had quit.

deadbabe8 minutes ago

Why didn’t you wrap up

laughing_manan hour ago

More likely someone who's been in a coma for the last ten years.

bogzzan hour ago

Oh hey it's me, I'm the conformist. Stop picking on me.

racl101an hour ago

Most of my shoulder issues are sleep related since I sleep on my side. Getting a body pillow system, was costly but kinda worth it. Helps with shoulder and GERD. Only issue is that it's kinda warm and I like to sleep cool.

mgiampapaan hour ago

The issue with those inclined pillows with the arm hole in them is that they can be a really hard angle for a side sleeper to be at. It makes my back and hips hurt way worse than my shoulder.

dralleyan hour ago

Any recommendations? I have GERD and generally sleep on my back, which helps but isn't perfect.

lordofgibbons14 minutes ago

You can try raising the head part of the bed by 5 - 6 or so inches using wood blocks. The doctor recommended it to me.

It's not perfect, but has really helped me!

ASalazarMXan hour ago

> was costly but kinda worth it

This doesn't inspire confidence, but I guess any improvement that mitigates pain is nice.

But seriously, the article addressesd that

> The authors argue that the findings suggest clinicians should rethink MRI findings, changing not just how they’re used, but also how they’re explained to patients. The language in particular should change given that “abnormalities” are ubiquitous—thus normal—and shouldn’t be described in terms that indicate a need for repair, like “tear.”

cactusplant7374an hour ago

Cervical radiculopathy can cause shoulder pain. I have experienced this quite a bit and it's probably also because of my sleeping style. I wouldn't get an MRI unless I was planning to have surgery.

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nickjjan hour ago

Do they define if this relates to anything noticeable in your day to day?

For example, I can put my right hand above my shoulder and left hand near my lower back and easily connect both hands behind my back with fully interlocked fingers by converging in the middle. They reach to the other hand's palm.

But I can only barely touch my fingers with both hands if I switch it up so my left hand is up top.

I have no pain or day to day mobility issues but something is lopsided. Is that what they consider abnormal?

zihotki25 minutes ago

Limited range of motion on one side could cause some deviations in scapulohumeral rhythm, so your force application won't be optimal and may cause injuries, or even cause uneveness and side effects in gait cycle. And with time it tends to get worse since the body would be trying to adopt to execute the function. But suboptimal force application eventually would cause joint injuries if a convex (humerus) is rolling without gliding or vice versa or doing it in suboptimal rhythm.

That's my personal take, not a doctor, study kinesiology as a hobby.

All such minor mobility issues could be addressed by body conditioning excercises including simple isolated mobility drills to learn range of motion of joints.

SoftTalker26 minutes ago

I'd consider it abnormal that you can do that; I can't get my fingertips within a foot of each other doing that.

I'm nearly 60 but I don't know if I could ever do that. You have good mobility IMO.

garbawarb26 minutes ago

Interesting. What happens at 40 to make MRIs no longer accurate?

radicalbytean hour ago

I have three kids and they've messed up my dominant schoulder (left).

darth_avocado44 minutes ago

I have three dogs and they’ve messed up my dominant shoulder, back and leg

p00dlesan hour ago

From walking around holding them with your left arm when they were babies, or from something else?

radicalbyte41 minutes ago

Walking/carrying at all crazy hours once they were >30kg. Holding 40kg of sick kid around is fun. Ours all refused to sit in the stroller very early which is what made it so much worse (our oldest was two, the other two refused point blank the second they could walk).

dhaivatan hour ago

not OP but - walking, carrying, holding, being pulled in random directions, catching kids when they jump at you from unexpected places, kids using your arms to practice tug-of-war/rock-climbing, pushing (empty) stroller with one hand, and carrying kid with other....

Glyptodonan hour ago

I don't know what causes it, but even without major issues I think a lot of people continually loose range of motion in the shoulder as they age. So this doesn't surprise me.

daringrain32781an hour ago

Reading this title made me sit up in my chair.

baxtran hour ago

What about the other 1%? I feel for them.

0x1ch33 minutes ago

Just hit my mid twenties. Want to say I started having some shoulder issues around 20 years old. Although correlation =! causation, I largely think this is because of my lifelong computer usage and PC gaming. It doesn't bother me all the time, but every few months something will change up and it comes back. Surprisingly, my wrists and hands are completely fine, no carpal tunnel or anything similar.

SoftTalker28 minutes ago

Yes, sitting slightly hunched up with your hands in front of you on a keyboard for 8-10 hours a day will screw up your shoulder mobility over time.

abe942 hours ago

lysace34 minutes ago

Evolution never really bothered with the wellbeing of 40+ year olds.

deadbabe3 minutes ago

Oddly enough, I think now it will. Because there is a whole generation of people having kids later, some first time parents even in their 40s. Naturally this should mean they produce offspring that over time is also able to easily reproduce in their 40s. Teen pregnancy is way down, and late pregnancies are replacing it.

downrightmike34 minutes ago

100% of all things that do not asexually reproduce are mutants

tiahura2 hours ago

Even though they never have any neck pain, many shoulder issues are actually caused by pinched nerves in the cervical spine.

TacticalCoderan hour ago

[flagged]

Flavius2 hours ago

You call it "abnormality", I call it evolution. We are not the same.

dylan6042 hours ago

How many generations of constant bent over posture staring at a device before that's just built into the species?

plufz2 hours ago

Im not sure people with bad posture get more offspring than others. :)

dylan604an hour ago

The pickins are getting slim though. I don't know anyone in their 20s that doesn't sit hunched over staring at a screen for a large portion of their day while stipulating I don't know any where near all 20 somethings. Just one person's observations

mgiampapaan hour ago

If I learned anything at Buy N Large University, AR screens in eyeware may be huge.

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