I was able to talk last week at the Missouri Self-Insurer's Association 22nd Annual Conference. My talk concerned the issue of causation in rotator cuff tears. Not everyone knows that the tendons of the rotator cuff tend to tear over time, and that up to 50% of people in their 50's may have a tear in the rotator cuff. This makes it difficult to determine with certainty if a work injury caused the tear or if it was a pre-existing condition. Many thanks to Pat Venditti, MSIA president, for extending the invitation to speak.