Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally

CF 385: Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally

Today we’re going to talk about Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally But first, here’s that sweet sweet bumper music  

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com Things you should do. 

• Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon.
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You have found yourself smack dab in the middle of Episode #385 Now if you missed last week’s episode, we talked about Motor Weakness In Cervical Radiculopathy & Exercise And Dementia. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Well, as you might guess, things have been crazy. I recently returned from about 6 days out in Los Angeles where I was taking a prep class for the QME exam that’s coming up this Spring. What is a QME you might ask.

Well let me clear that up for you, friend. It stands for Qualified Medical Evaluator and once I’m a QME, I’ll fly out to California every 4-5 weeks or so and spend a couple of days doing impairment ratings exams on injured workers. Then fly home and do all the reports.  For the QME exam, it’s about a 50/50 pass/fail rate on that deal and I plan on passing that dude the first time around. Ain’t nobody got time to do it again. Of course, I will if I need to but I don’t plan on it, man. 

Outside of that, we’ve been getting this new associate up and running and y’all, she’s just a gem. Plain and simple. I’m really proud of her. She’s smart, she’s good with patients, she’s a good adjuster, and she just gets it. You show her once and she’s got it. Lots of times better than I got it! We are working hard on our PVA. I see patients around 8-9 times lifetime. And that’s with having VA and PI patients that are compelled to come in. That’s terrible and we are underserving by strictly looking at pain.  We are transitioning into pain relief followed by the functional movement screen, and then into maintenance. We believe this will better serve the patient but will also see our PVA go from around 8-9 up to about 15 or so.

I can live with that. And our assoicate is all over it as well.  I’m the one that is FMS certified but made intense notes and through the help of AI, have created a way of training her up on FMS and now, she does it better than I ever did. Plus, she has the time to do it whereas, I just don’t.  So, we have all that. Through our new nurse prac, we are bringing in peptides and getting that all up and rolling so again…..lots and lots of action here with your ol uncle Jeffro. Trust that

I’m not falling behind on the podcasts because I don’t care. I am just trying to balance this crazy life.  Becomeing a QME is no joke. It Ain’t easy my friends.  Wiith that, let’s jump in on that research. 

Item #1

Our first one today is called, “Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging” by Ibounig et al and published in Jama Internal Medicine in February of 2026 and check out the shizzle on that shucker!! Remember, the citations can be found at chiropracticforward.com under this episode.  Ibounig T, Järvinen TLN, Raatikainen S, et al. Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA Intern Med. Published online February 16, 2026. doi:10.1001/jamainternmed.2025.7903

Why They Did It Shoulder pain is a common musculoskeletal complaint often attributed to rotator cuff (RC) abnormalities. Diagnostic imaging is frequently used, but the association between RC abnormalities and shoulder symptoms remains uncertain. Objective  To determine the prevalence of RC abnormalities in a general population sample and their association with shoulder symptoms.

How They Did It Population-based cross-sectional study in a nationally representative random sample of adults aged 41 to 76 years who underwent standardized clinical assessment and MRIs of the shoulders conducted from February 2023 to April 2024 in Finland. 

Main Outcomes and Measures  RC tendon status was classified on MRI as normal, tendinopathic, partial-thickness tear (PTT), or full-thickness tear (FTT).  Shoulder symptoms were defined as pain or dysfunction in the preceding week.  The prevalence of RC abnormalities was compared across age groups and between symptomatic and asymptomatic shoulders, adjusting for demographic factors, concurrent MRI findings, and clinical examination.

What They Found

• Among 602 participants, RC abnormalities on MRI were found in 595: 25% tendinopathy, 62% partial thickness tears, and 11% full thickness tears. 
• The prevalence and severity of abnormalities increased with age but did not differ between sexes. 
• RC abnormalities were present in 96% of asymptomatic shoulders (1039 of 1076) and 98% of symptomatic shoulders (126 of 128). 
• Only full thickness tears were more prevalent in symptomatic shoulders (14.6%) than in asymptomatic shoulders (6.5%), but this difference diminished after adjustment 

Wrap It Up

In this population-based study, rotator cuff abnormalities were nearly universal after age 40 years and showed poor concordance with shoulder symptoms.  These findings suggest that rotator cuff abnormalities often represent normal age-related changes rather than disease and call into question the clinical value of routine imaging for atraumatic shoulder pain.

Item #2 The last one this week is one of those that continues to make me uncool amidst the rising popularity and money that has gone into its acceptance and legalizations.  It’s called, “Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders” by Young-Wolff et all and published in JAMA Health Forum in February of 2026 and it’s smokin up the place.  Young-Wolff KC, Cortez CA, Alexeeff SE, et al. Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders. JAMA Health Forum. 2026;7(2):e256839. doi:10.1001/jamahealthforum.2025.6839

Why They Did It As cannabis becomes more accessible and socially accepted, concerns have grown about its potential implications for adolescent mental health. While prior research has linked adolescent cannabis use to psychiatric symptoms, few large, population-based, longitudinal studies have examined associations with clinically diagnosed psychiatric disorders.

Objective  To evaluate whether adolescent cannabis use is associated with an increased risk of incident psychotic, bipolar, depressive, and anxiety disorders during adolescence and young adulthood.

How They Did It This cohort study included adolescents aged 13 to 17  Adolescents were followed up through age 25 years or until December 31, 2023. 

Main Outcomes and Measures  Incident clinician-diagnosed psychotic, bipolar, depressive, and anxiety disorders, which were identified through electronic health records using International Classification of Disease codes.  Cox proportional hazards regression models were used to measure the strength of associations between adolescent cannabis use and incident psychiatric diagnoses, with adjustments for sex, race and ethnicity, neighborhood deprivation index, insurance type, and time-varying alcohol and other substance use.

What They Found Of 463,396 adolescents included in the sample At baseline, 26,345 adolescents (5.7%) self-reported past-year cannabis use.  Past-year cannabis use was associated with an increased risk of incident psychotic, bipolar, depressive, and anxiety disorders.  The strength of the associations between cannabis use and incident depressive and anxiety disorders decreased as adolescents aged This pattern was similar but slightly attenuated after additional adjustment for past psychiatric conditions

Wrap It Up This cohort study found that adolescent cannabis use was associated with increased risk of incident psychiatric disorders, particularly psychotic and bipolar disorders.  These results could inform the development of clinical and educational interventions for parents, adolescents, and clinicians, as well as protective policies to prevent or delay adolescent cannabis use in the context of expanding cannabis legalization. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!  

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

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