{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:51:01Z","timestamp":1792050661065,"version":"4.4.0"},"reference-count":98,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"4","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["JOSPT Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>OBJECTIVE: To describe the association between psychosocial factors and pain and function\/disability in people with rotator cuff (RC) disorders.<\/jats:p>\n                  <jats:p>DESIGN: Etiology systematic review.<\/jats:p>\n                  <jats:p>LITERATURE SEARCH: Systematic searches were conducted in CINAHL, EMBASE, MEDLINE, PsycINFO, and Scopus databases from inception to November 2025. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed.<\/jats:p>\n                  <jats:p>STUDY SELECTION CRITERIA: Studies were eligible if they included adults with RC disorders and examined associations between psychosocial factors and pain and\/or functional outcomes.<\/jats:p>\n                  <jats:p>DATA SYNTHESIS: Study quality was assessed using the Joanna Briggs Institute critical appraisal tool. Due to study heterogeneity, results were presented descriptively.<\/jats:p>\n                  <jats:p>RESULTS: Thirty-eight observational studies (n = 4845; 2024 males, 2170 females, 651 sex not reported) were included. Over 70% of studies were of medium-high methodological quality. Pain catastrophizing ( r = \u22120.50 to 0.62, \u03b2 = \u22120.54 to 0.50) and sleep ( r = \u22120.59 to 0.54, \u03b2 = \u22120.41) had moderate-to-strong associations with functional outcomes. Fear-avoidance had weak-to-strong associations with function ( r = \u22120.61 to 0.24, \u03b2 = \u22120.59 to \u22120.27, odds ratio [OR] = 1.39). Moderate evidence supported associations between fear-avoidance, sleep disturbance, pain catastrophizing, and functional outcomes. Poorer mental health had a moderate-to-strong association with pain severity ( r = \u22120.52 to \u22120.48) and impaired function ( r = \u22120.61 to 0.75); the strength of evidence was limited. Weak-to-strong associations with limited strength of evidence were observed between remaining psychosocial factors and pain.<\/jats:p>\n                  <jats:p>CONCLUSION: Pain catastrophizing and sleep disturbance demonstrated moderate-to-strong associations with functional impairment in people with RC disorders. Fear-avoidance beliefs had heterogenous associations with function. Poor emotional health was associated with greater pain severity and functional impairment. JOSPT Open 2026;4(4):420-441. 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