24/11/2025
MRI âAbnormalitiesâ Do not Equal Injury â Hereâs What the Research Really ShowsâŚ.
Following on from my recent post about running and arthritis, hereâs another important myth-buster that every athlete, patient, and clinician should understand.
A large review by Culvenor et al. (2018) looked at 63 studies and over 5,300 knee MRIs in people with no knee pain or injury. What they found is incredibly important:
Almost 20% of people under 40 with zero symptoms had âchangesâ on MRI
Almost 50% of people over 40 with zero symptoms had âchangesâ on MRI
And what were these âchangesâ?
Things like: Meniscal tears, Cartilage defects, Bone bruising, Bone spurs, Degeneration as
well as other findings often labelled as âwear and tearâ
In other words⌠Perfectly healthy, pain-free knees often look âabnormalâ on scans.
đ Why does this matter?
Because too many people are told that:
â âYour MRI shows damage.â
â âYou must stop running.â
â âYou need surgery.â
â âThis explains your pain.â
But the science is clear:
MRI findings only matter if they match your symptoms.
If youâre not in painâand not limited in daily lifeâthese findings are usually completely normal, harmless, and often just part of the body adapting and ageing.
Think of it this way:
Just like we get grey hairs and wrinkles on the outside, we get them on the inside too.
Imaging simply makes it easier to âseeâ them.
đââď¸đŹ What this doesnât mean
This doesnât mean MRIs are useless. Theyâre a powerful tool when used correctlyâtypically after a thorough clinical assessment, when symptoms and history indicate that imaging will change management.
But it does mean:
â A finding on MRI does not automatically explain pain
â A finding does not predict the future
â A finding does not mean you should reduce activity
â A finding does not mean you are damaged
đ§ The real take-home message
If youâre pain-free, active, and functioning well, then an MRI âabnormalityâ is often nothing more than internal grey hair and likely something you shouldnât overly worry about.
If you do have pain, the goal is not to chase scan results, but to treat you â your movement, load tolerance, goals, worries, and the patterns behind your symptoms.