Changes in Pain-Related Fear Predict Shoulder Disability in Rotator Cuff Tendinopathy With Resistance…

ObservationalThe Journal of orthopaedic and sports physical therapy· Aug 2026

Changes in Pain-Related Fear Predict Shoulder Disability in Rotator Cuff Tendinopathy With Resistance Exercise.

Courtney K Mears, Matthew D Heindel, Rebecca E Abeles … Lori A Michener

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Shoulder & ElbowObservationalQ1IF 4.7

Treatment responders showed larger drops in work-related fear-avoidance beliefs than nonresponders.

Changes in Pain-Related Fear Predict Shoulder Disability in Rotator Cuff Tendinopathy With Resistance Exercise.

Courtney K Mears … Lori A Michener

The Journal of orthopaedic and sports physical therapy · Aug 2026 · Q1 in General Medicine

Purpose

To determine the trajectory of (1) change in pain-related fear and catastrophizing factors, (2) changes in pain-related fear and catastrophizing by treatment satisfaction groups, and (3) the relationship between pain-related fear trajectories, and catastrophizing factors and shoulder disability during an 8-week resistance exercise program.

Methods

Prospective longitudinal observational study.

4.2

Results

4.2

pt

Satisfied patients' fear-avoidance-about-work scores fell about 4 points more than unsatisfied patients'.

More results

All pain-related fear and catastrophizing measures changed over time during resistance exercise ( P < .01) but differed by Patient Acceptable Symptom State-defined responder and nonresponder groups.

For TSK-11, nonresponders had less of a decrease (-0.1) than responders (-3.2 pt) (mean difference, 3.1 pt; 95% CI: -5.9, -0.3; P = .03).

More results

Reduced shoulder disability was related to less pain-related fear and catastrophizing ( P < .01), and differed by responder group.

Nonresponders had no relationship between change in pain-related fear and catastrophizing and disability ( P >.05); responders had an overall negative relationship ( P < .04).

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Conclusion · 1 of 3

Pain-related fear and catastrophizing changed over time for individuals with rotator cuff tendinopathy, and changes varied by participant.

Conclusion · 2 of 3

Those who were not satisfied at 8 weeks had higher levels of pain-related fear and catastrophizing, while those who were satisfied had reduced pain-related fear and catastrophizing.

Conclusion · 3 of 3

Less pain-related fear and catastrophizing was related to decreased disability. J Orthop Sports Phys Ther 2026;56(8):546-554. Epub 9 Jun 2026. doi:10.2519/jospt.2026.13563 .

Changes in Pain-Related Fear Predict Shoulder Disability in Rotator Cuff Tendinopathy With Resistance Exercise.

Changes in Pain-Related Fear Predict Shoulder Disability in Rotator Cuff Tendinopathy With Resistance Exercise.

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