Can Your Shoulder Be Fixed Without Surgery?
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The answer you want to hear: yes.
The answer you don’t want to hear: you still need to get treatment.
Not every shoulder injury requires surgery, but ignoring it will not fix it either. Some injuries do need a surgical evaluation. Evaluation does not mean operation. It simply means getting the right information so you can make a smart decision.
You should consider seeing a specialist if:
You have dislocated your shoulder
You have a complete rotator cuff tear
You have finished 3 to 6 months of dedicated rehab with no real progress. This means ACTUAL physical therapy with a program not just going to the gym randomly with no goal/help.
The Most Common Causes of Shoulder Pain (That Often Do Not Need Surgery)
Rotator Cuff Tendinitis
Scapular Dyskinesia (abnormal movement of the shoulder blade)
SLAP Tears / Biceps Tendinitis
These are some of the most frequent reasons I see athletes, especially jiu jitsu athletes and the military population, with shoulder pain. The good news? They are treatable without surgery in most cases.
The foundation of treatment is physical therapy, especially focused on posture, strength, shoulder blade control, and mechanics.
Yes, I have heard it before: “I do not have time for PT.”
To that I say: “the shoulder pain will take longer to improve and it might become a chronic injury.”
Rotator Cuff Tendinitis
The rotator cuff includes four small muscles that stabilize and rotate the shoulder:
SITS — Supraspinatus, Infraspinatus, Teres Minor, Subscapularis.
Tendinitis happens when these tendons get irritated from repetitive stress, poor posture, and overload (think too much overhead pressing, hard rolling, or bad desk setup).
If there is no full tear, this is usually treated effectively with:
Targeted shoulder and scapular strengthening
Mobility work
Dry needling or manual therapy if needed
Scapular Dyskinesia
This refers to abnormal movement of the shoulder blade, often overlooked in shoulder evaluations. If your scapula is not rotating or stabilizing properly, your shoulder joint ends up doing too much work, leading to pain.
Common signs:
Shoulder fatigue or burning with overhead work
Pain on the shoulder blade in the back of the shoulder
Pain during pressing or pulling movements
"Winged" scapula or asymmetry during motion
Fixing scapular dyskinesia often means retraining the brain-body connection. PT focuses on:
Neuromuscular control of the scapula
Strengthening the serratus anterior, traps, and rhomboids
Postural and breathing mechanics
Biceps Tendinitis / SLAP Tears
Your biceps tendon crosses the front of your shoulder and attaches at the top of the labrum. Over time, or with sudden pulls (like posting your arm out during a fall or getting yanked in a grip fight), this area can become irritated or even partially torn.
Common symptoms:
Sharp pain in the front of the shoulder
Pain with pulling or overhead motions
Clicking or catching during rotation
Treatment depends on the cause. Most cases improve with:
Load modification
Soft tissue release
Strengthening and stabilizing the shoulder and scapular muscles
In more stubborn cases, we may discuss injections, advanced imaging, or surgical options, but only after exhausting high-quality conservative care.
Takeaway
If you are dealing with shoulder pain, do not jump to the worst-case scenario.
Surgery is rarely the first step and often not needed at all.
Rehab, movement retraining, and lifestyle adjustments are powerful tools when done right and consistently.
See you next round,
Dr. Megan Lisset Jimenez
Connect with Me:
Instagram: @drjiujitsu
LinkedIn: Dr. Megan Lisset Jimenez
Website: www.drjiujitsu.com
