Do You Really Need Shoulder Surgery for a Rotator Cuff Tear?

If you’ve been told you have a rotator cuff tear and the only option is surgery, or that you’ll never be able to lift weights or stay active — let’s pump the brakes.

So many people hear this and feel stuck between living in pain or giving up what they love.

But the truth is, not every rotator cuff tear actually needs surgery.

What Exactly Is the Rotator Cuff?

The rotator cuff is a group of four small muscles and tendons in your shoulder that help you lift, rotate, and stabilize your arm. These muscles are active every time you reach overhead, push a weight, swing a racket, or even carry groceries.

Because we use our shoulders constantly, the rotator cuff can develop wear and tear over time. MRIs often show partial tears, fraying, or tendon changes.

But here’s the key: changes on imaging don’t always mean pain.

Rotator Cuff Tears Don’t Always Equal Pain

Here’s something surprising: MRIs often show rotator cuff tears, even in people who don’t have shoulder pain at all.

Research has found that many adults, especially as we age, have partial tears but no symptoms:

• 20–30% of people in their 60s

• Over 50% of people in their 80s

(Tempelhof et al., 1999; Yamamoto et al., 2010)

That means just because an MRI shows a tear doesn’t mean that’s what’s causing your pain.

At 901 Physical Therapy here in Memphis, we see this all the time — people told surgery was their only option, only to discover that their pain came from weakness, stiffness, or movement patterns, not the tear itself.

Myth vs. Fact: Shoulder Surgery and Rotator Cuff Tears

Myth: If you have a rotator cuff tear, surgery is the only way forward.

Fact: Many people with partial tears regain full, pain-free function through physical therapy alone.

Myth: If you skip surgery, your shoulder will only get worse.

Fact: In many cases, addressing strength, flexibility, and mechanics actually improves shoulder function, and avoids unnecessary surgery.

Myth: Imaging results always explain pain.

Fact: MRIs show structure, not sensitivity. Pain is influenced by muscles, joints, mechanics, and even the nervous system.

Why Surgery Isn’t Always the First Answer

Don’t get me wrong, sometimes surgery is the right path. But even if surgery is needed, you’ll still have to do months of physical therapy afterwards to regain shoulder strength and function.

That’s why starting PT before surgery often makes sense.

We focus on:

• Improving shoulder and upper-back strength

• Restoring flexibility and mobility

• Fixing mechanics that overload the joint

• Reducing pain so you can move with confidence

By addressing these things early, many people avoid surgery altogether.

And for those who do end up needing it, they recover faster and stronger because their shoulder is already prepared.

A Local Perspective

Shoulder pain is one of the most common issues we treat at our Memphis clinic.

Whether it’s someone who loves lifting weights, an active grandparent who wants to keep playing with their grandkids, or a weekend tennis player, we see the same pattern:

• Imaging shows a “tear”

• Fear sets in

• Activity stops or surgery feels like the only choice

But once we address strength, mechanics, and confidence, people are often surprised at how much better they feel, without going under the knife.

The Bottom Line

An MRI showing a rotator cuff tear doesn’t automatically mean you need surgery or that you have to stop lifting and doing what you love. With the right plan, many of our patients get back to pain-free movement without going under the knife.

At 901 Physical Therapy, we specialize in helping adults understand their options, build strength, and take control of shoulder pain.

👉 Book a free discovery call today to learn how we can help you get back to lifting, training, and living without fear.

References:

• Tempelhof S, Rupp S, Seil R. “Age-related prevalence of rotator cuff tears in asymptomatic shoulders.” J Shoulder Elbow Surg. 1999 Jul-Aug;8(4):296-9.

• Yamamoto A, Takagishi K, Kobayashi T, et al. “Prevalence and risk factors of a rotator cuff tear in the general population.” J Shoulder Elbow Surg. 2010 Jan;19(1):116-20.