How to Determine

• 1). Go see your doctor and get his input before making any decisions of your own. Keep in mind that the symptoms for shoulder impingement--which is treated without surgery--is the same for many rotator cuff tears. In order for your doctor to diagnose you, you may need to have an arthogram or an MRI. Generally, a severe rotator cuff tear will need surgery. Consider getting a second medical opinion.
  
  
• 2). Determine what your end goal is. If your pain is severe and restoring shoulder strength is secondary, you may want to stick to rehabilitation. According to the website for the American Academy of Orthopedic Surgeons, "surgeons may recommend nonsurgical treatment for patients who are most bothered by pain, rather than weakness, because strength does not tend to improve without surgery."
  
  
• 3). Weigh pros and cons of surgery. Are you willing to undergo anesthesia? Do you have the down time required for a successful surgery? Can you afford it? You may need additional surgeries. The medical website for the University of Washington says that "it is important to recognize that surgery cannot improve the basic quality of the tendon tissue. Repair of poor-quality tissue is often followed by recurrent tears."
  
  
• 4). Go for surgery if you can get surgery within a month of being injured, you have already tried rehabilitating your injury, you are in optimal health or need to restore function and are aware and motivated to do necessary rehabilitation afterward.