Clinics in Shoulder and Elbow · Published 2026-05-12 · DOI 10.5397/cise.2025.01438
Sina Ramtin, Prakash Jayakumar, David C. Ring, Melissa Tonn
Background When an adult with rotator cuff tendinopathy reports feeling or hearing a pop along with new pain, both the clinician and the patient may inaccurately and unhelpfully expect (framing heuristic) an injury and consider it a compensable work claim. Methods We retrospectively reviewed medical records of 118 people that filed work claims for new shoulder pain where aspects of their care or recovery trajectory triggered a peer review. We collected data on age, sex, reports of hearing or feeling a pop (25%; 29 of 118 patients), and reports of new numbness or tingling (11%; 13 of 118 patients). Five (4%) patients had a possible acute rotator cuff rupture (relatively large defect with good muscle) and 11 (11%) had a long head of biceps rupture, age indeterminate. Results Accounting for confounding variables using logistic regression, possibly acute rotator cuff defects and age-indeterminate long head of biceps ruptures were associated with older age (odds ratio [OR], 1.10; 95% CI, 1.02–1.18) and the presence of a degenerative rotator cuff defect (OR, 6.0; 95% CI, 1.5–24) but not with sensation of a “pop.” Conclusions Based on this evidence, among people claiming injury at work, when a “pop” is reported the clinician should not expect new pathophysiology. Level of evidence III.
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Ramtin, S., Jayakumar, P., Ring, D., et al. (2026). The limited diagnostic value of “feeling a pop” for identifying acute tendon rupture in workers’ compensation shoulder claims. Clinics in Shoulder and Elbow. https://doi.org/10.5397/cise.2025.01438