Do You Really Need Surgery for a Shoulder Tear? | Howard Luks | EP#438
Most joint and tendon pain in adults stems from lack of support, training, and proper loading rather than injury. Imaging often reveals age-related changes like labral tears that are normal findings over age 40-45 and don't necessarily require surgery, despite what social media doctors claim.
Summary
Howard Luks discusses the common misconception that joint and tendon pain results from specific injuries or minor incidents. He explains that tendons and joints are designed to function only when properly supported, trained, moved, and loaded—without these factors, they deteriorate and fail. A major point of the discussion centers on how imaging results are frequently overestimated in their clinical significance. Luks notes that labral tears are nearly universal in people over 40-45 years old and become increasingly common with age, with complete tendon ruptures becoming the norm in the fifth, sixth, seventh decades and beyond. Importantly, he emphasizes that existing labral tears do not heal and will persist for life, using an analogy of worn jeans with holes to illustrate this is a normal degenerative finding rather than a pathological problem requiring intervention. The discussion also addresses misinformation spread on social media, where some doctors claim to cure arthritis and eliminate chronic pain permanently—claims Luks identifies as false. He mentions recent work on plyometrics, suggesting this training modality is underrated, and notes that training approaches must evolve with age, particularly because falls become a significant health risk for older adults.
Key Insights
- Most joint and tendon pain in adults is not related to specific injury but rather to lack of proper support, training, movement, and loading of the structures
- Almost everyone over age 40-45 has some degree of labral tear, and complete tendon ruptures become the norm in the fifth, sixth, and seventh decades of life
- Existing labral tears will not heal and persist for life, comparable to permanent wear in aged clothing rather than an acute pathological problem
- Claims by social media doctors that they can cure arthritis and eliminate chronic knee pain forever are simply not true
- Training approach must change with age because falls become a significant health risk factor for older adults
Topics
Transcript
[0:00] Most joint or tendon pain in adults is not related to injury. You didn't just "have a bad night's sleep." That milk wasn't too heavy when you took it out of the fridge. Our tendons and joints are designed in such a way that if they are not supported, trained, moved, or loaded, they will fail you. What do we most often find when talking about normal joints that we tend to overestimate based on imaging results? Almost everyone over the [0:31] age of 40-45 has some degree of labral tear. As you get older, in your fifth, sixth, seventh decade of life and beyond, complete ruptures of one or more tendons become the norm. This labrum tear will…
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