Role of Psychosocial Factors on Recovery from Knee and Shoulder Pain

By Vennela Thumula, Te-Chun Liu, Randall Lea, M.D.

September 18, 2025 Related Topics: Behavioral Health, Physical Medicine, Worker Outcomes

Behavioral health is increasingly recognized as a key factor in workers’ compensation recovery. Psychosocial risks—like fear of movement, poor coping skills, and low mood—can significantly affect outcomes for knee and shoulder injuries.

Building on WCRI’s earlier findings of recovery from low back injuries, this new study extends the scope to include common musculoskeletal conditions.

The study examines a large sample of patients with knee and shoulder pain using data from Focus on Therapeutic Outcomes (FOTO) collected from 2021 to 2024. The dataset for the study includes approximately 65,000 episodes each of knee and shoulder physical therapy. Among these, more than 8,000 shoulder and 5,000 knee episodes were covered under workers’ compensation. The large sample enables a robust examination of differences in psychosocial risks and functional outcomes by payor type.

Psychosocial Factors and Functional Outcomes Following Physical Therapy. Vennela Thumula, Te-Chun Liu, and Randall D. Lea. September 2025. WC-25-43.

Copyright: WCRI

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Research Questions:

  • How prevalent are psychosocial risk factors in knee and shoulder patients receiving physical therapy, particularly among workers’ compensation cases?
  • Does the prevalence of these risk factors vary across different payor types (including private insurance) and patient groups?
  • Do injured workers with and without psychosocial risk factors recover differently? How large is any difference? And do these relationships differ between workers’ compensation and other payors?

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