Pole Meets Science #3: Imaging for shoulder pain

When your shoulder is hurting and not improving, the instinct to want a scan is understandable. A scan feels like an answer, something that explains what’s wrong and points toward a solution. The reality of what imaging does and doesn’t tell you is considerably more complicated than that.

This edition of Pole Meets Science looks at a 2025 opinion article examining when imaging for shoulder pain is and isn’t helpful, including the perspectives of various clinicians, researchers, educators, physiotherapists, physicians and nurses working within the musculoskeletal field.

Study snapshot

Title: Shoulder pain: to image or not to image?
Authors: Brindisino et al. (2025)
Study link: Read full article here

Study design

This is an opinion article where experts share their professional viewpoint on a topic, rather than an experimental study.

What they did

The authors reviewed current evidence and clinical guidelines to explore when imaging is and isn’t useful for people with shoulder pain.

What they found

Not all shoulder pain needs imaging. Scans don’t always match symptoms and the same image might even be interpreted differently by different clinicians. Rotator cuff tendon tears, for example, are often seen in people with no pain who continue to perform at a high level. This is why clinical reasoning (considering pain patterns, history, movement and function) should guide decisions.

There are, however, clear situations where imaging is important. These include after trauma such as a fall, when a fracture, infection or cancer is suspected or when symptoms are not improving as expected or are worsening. In these cases, imaging can provide valuable structural detail that guides surgical decisions or rehabilitation choices.

The authors also highlighted the risks of unnecessary imaging. Beyond exposure to radiation, scans can lead to long waiting times, unnecessary procedures such as injections or surgery and reinforce unhelpful beliefs that the shoulder is ‘damaged’. Being told that there is a tear, degeneration or abnormality doesn’t always reflect functional reality and those findings without clinical context can create unnecessary fear and avoidance, which can negatively affect recovery.

The key message is that imaging should be used thoughtfully.

Study limitations

As an opinion paper, it doesn’t provide new information. The recommendations are general, meaning they may not address the unique demands of sports such as pole dancing. The focus is on healthcare decision-making, rather than athlete-specific contexts.

What this means for pole dancers

Shoulder pain is the most common injury amongst pole dancers. This paper highlights that:

• A scan isn’t needed in most cases. A thorough history, clinical assessment and presentation pattern provides more accurate information and guides rehab more effectively. Our rotator cuff related shoulder pain guide goes into detail about diagnosis and worth a read.
• A physiotherapy assessment can identify strength, range of motion and control deficits, compensatory movement patterns and how different structures work together. This is far more useful from a return to training and rehab perspective than a radiological report.
• A scan isn’t a diagnosis and doesn’t always equal answers or show the whole picture. Just because it picked up something, it doesn’t mean that’s what causes pain or limits performance. It could just as well be an incidental finding. Context is important.
• Imaging may be required if your pain is persistent, unexplained or linked to a traumatic event, such as a fall.

Our takeaway

If you’re having shoulder pain, see a physio. Chances are you won’t need a scan but some advice and rehab. Your physio will reason whether a scan is need and what type is most appropriate. If you’ve had a scan and it shows changes, discuss the results with your physio in context and focus on what you can do rather than only focusing on what the results show. When used wisely, scans can be a helpful tool, but they are not the full picture.

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Have you been through the experience of having a scan for shoulder pain? Did the findings match what you expected or what you were feeling? It’s a common experience in the pole community and worth talking about openly. Share it in the forum. And if you know someone who’d find this useful, spread the word!

If you’re managing shoulder pain and want a pole-specific clinical assessment, a virtual physiotherapy session with Polisthenics is the right starting point. We can tell you whether imaging is likely to add anything useful for your specific situation.

We offer virtual physiotherapy, strength coaching and personalised training programs tailored to pole dancers whether you’re injured, want to avoid getting injured or want to get stronger and achieve your pole goals.

💻 Book your appointment or message us here or on Instagram @polisthenics!

References

Brindisino, F, Salamh, P, Cook, C, Lewis, J, Palese, A, Guerra, G, Bonavita, J and Rossettini, J. (2025). ‘Shoulder pain: to image or not to image?’, Frontiers in Rehabilitation Sciences, 6. Available at: https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2025.1624056/full (Accessed 02 September 2025).