#64: Is measuring strength useful? With Tim Cook

Rotator cuff-related shoulder pain often leads clinicians to prioritize strength testing, yet this practice frequently lacks a clear causal link to patient outcomes. Strength deficits are often a consequence of pain-induced inhibition rather than a primary cause of the condition. While maximal isometric dynamometry provides objective, trackable data, it primarily measures pain tolerance rather than absolute force production. Clinicians should view strength testing as a tool for patient engagement and expectation violation—demonstrating that movement is safe—rather than a diagnostic necessity for every case. Relying on isolated strength metrics risks falling into the trap of treating the test rather than the patient’s functional goals. Ultimately, rehabilitation should focus on meaningful movement and patient confidence, ensuring that strength training serves as a functional means to recovery rather than an end in itself.