Do You Actually Need an MRI?
Most people think the hardest part of getting an MRI is the insurance company.
Let me clear that up… sometimes it’s insurance.
but most of the time, you simply don’t need the MRI in the first place.
In military medicine especially, MRIs get ordered like candy.
Hurt knee? MRI.
Stubbed toe? MRI.
Shoulder feels tight after the gym? MRI.
Because the system is “free,” the MRI becomes the easy button.
But when everyone gets one, the system collapses.
Appointments take months. Access suffers. And the people who truly need advanced imaging get stuck waiting.
What’s the solution? Knowing who actually needs an MRI and, perhaps more importantly, who does not.
Red Flags: When You Do Need an MRI Quickly
If you have any of these, do not pass go and do not wait 3 months hoping it magically improves:
A big injury with a loud pop followed by rapid swelling (knee)
A shoulder dislocation
Suspected ACL, MCL, or significant tendon tear
Acute weakness or inability to bear weight
Neuro symptoms (numbness, tingling, loss of function) after trauma
These are the situations where an MRI is important for the plan.
When the diagnosis impacts surgery vs no surgery, timing matters.
Future-you will thank present-you for not playing tough.
When You Do Not Need an MRI
Most aches and pains do NOT need immediate imaging.
Examples:
Gradual-onset pain without a specific injury
Shoulder soreness from lifting
Knee irritation after increasing training volume
Finger, toe, or rib pain from minor bumps
A stable knee or shoulder with no swelling, full motion, and normal strength
Start with:
6–12 weeks of physical therapy
Anti-inflammatories
Load management
Quality sleep (yes, it matters)
Compression, ice/heat, and mobility work
If you follow the plan… Your pain usually follows suit.
The Hidden Problem With “Just Get an MRI”
MRIs find things.
They almost always find things.
Here’s the truth:
MRI findings do NOT equal a problem.
A small tear might not be the source of your knee pain.
A bulging disc might be totally asymptomatic.
A labral tear could be from a decade ago.
Everyone has a SLAP tear.
The danger?
Patients (and sometimes providers) fixate on the imaging instead of the person.
I’ve had patients undergo surgery based solely on an MRI finding…
and their pain didn’t improve at all.
Because the MRI wasn’t showing the real issue.
So What Should You Do Instead?
Before jumping to imaging, ask yourself:
Was there a major traumatic moment?
Do I have swelling or instability?
Am I getting worse despite doing the basics?
Has it been more than 6–12 weeks with no improvement?
Am I actually behaving and following the plan, or sending it still in training everyday?
If the answer is yes to any of these, imaging might help.
If not… you’re probably better off fixing your training, recovery, mobility, and strength.
Final Thoughts
MRIs are powerful tools… when used correctly.
But they aren’t the first step, the magic answer, or the shortcut to a diagnosis.
Most injuries improve with:
Smart rehab
Consistency
Recovery
Patience
Strength training
And a willingness to actually listen to your body
Save the MRI for when it will change your treatment plan, not when it will only feed your anxiety.
Your body communicates long before it quits on you.
Before you push the “easy button,” give it a chance to heal the way it’s designed to.
____
Dr. Megan Lisset Jimenez
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