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Shoulder pain can be confusing and frustrating. It might come on suddenly after lifting something heavy, or it may slowly build over months without a clear cause. When people search online or talk to friends, they often hear a mix of stories, advice, and warnings–many of which may not actually be true.

These myths can lead people to avoid movement, delay getting help, or rush into treatments they might not need. In reality, most shoulder pain responds very well to conservative care, especially a targeted physical therapy program that focuses on strength, mobility, and healthy movement patterns. Understanding what is myth and what is fact is a key step toward getting better.

Below are some of the most common myths about shoulder pain, and the truth behind them.

Myth 1: “If my shoulder hurts, I should stop using my arm and rest completely”

Many people think complete rest is the safest choice for shoulder pain. While it may seem logical, full rest for too long can actually make the problem worse. When you stop using the shoulder, the muscles around the joint weaken and the joint can become stiffer. That can lead to even more pain and loss of function over time.

In most cases, the better approach is smart activity, not total rest. This means:

• Avoiding movements that clearly flare up the pain
• Staying active within a comfortable range
• Using specific exercises to improve strength and motion

A physical therapist can help you find the right balance–protecting irritated tissues while keeping the shoulder and surrounding muscles as strong and mobile as possible.

Myth 2: “If I have shoulder pain, there must be a tear or serious damage causing it”

Many people assume that shoulder pain automatically means a torn rotator cuff or major structural damage. The truth is that shoulder pain is often related to irritation, overload, or sensitivity of the tissues, not necessarily a large tear. In fact, imaging studies show that many people with rotator cuff “tears” on MRI have no pain at all.

• Pain does not always equal damage
• Imaging findings (like “degeneration” or “partial tear”) are common as we age and do not always explain symptoms
• Focusing too much on scary–sounding MRI words can increase fear and make pain feel worse

Physical therapy looks at how your shoulder moves, which muscles are weak or tight, and how your posture or daily habits might be contributing. The goal is to improve how the shoulder functions, not just what it looks like on a scan.

Myth 3: “I need an MRI or X–ray before starting physical therapy”

Another common belief is that imaging is necessary before starting physical therapy, or that imaging will “identify the problem” and solve everything. In reality, for most common shoulder conditions, a careful exam and movement assessment by a physical therapist or another qualified provider is more important than a scan.

Imaging may be helpful if:

• You had significant trauma, like a fall or accident
• There are red flags for a fracture, infection, or other serious condition
• Symptoms are not improving after a solid trial of conservative care

For typical rotator cuff–related pain, impingement–type pain, or mild to moderate stiffness, guidelines often recommend starting with conservative treatment–like physical therapy–before ordering imaging. This approach can save time, reduce unnecessary costs, and avoid finding “incidental” findings that are not actually causing your pain.

Myth 4: “Shoulder pain means I will probably need surgery”

Hearing the word “tear” or feeling persistent pain leads many people to assume that surgery is inevitable. For most people, that is not true. Many common diagnoses–including rotator cuff–related pain, tendinopathy, impingement–related pain, and even some partial–thickness tears–respond very well to non–surgical care like physical therapy.

Surgery may be considered when:

• There is a large traumatic tear with major loss of function
• There is significant instability or repeated dislocations
• You have tried a solid course of physical therapy and other conservative treatments without enough improvement

Even in cases where surgery is ultimately needed, pre– and post–operative physical therapy are critical to restoring strength, motion, and function. For most people, however, a well–designed physical therapy program alone is enough to get back to daily life, work, and sports without an operation.

Myth 5: “If I'm older and my shoulder hurts, it's just 'wear and tear' and nothing can be done about it”

Age–related changes in the shoulder–like mild arthritis or tendon wear–are very common. But common does not mean hopeless. Shoulder pain in older adults is not just about aging; it often has to do with strength, posture, movement habits, and how the shoulder and shoulder blade work together.

• People in their 50s, 60s, and beyond can make significant gains in strength, mobility, and pain relief with the right exercises
• Even with arthritis or degenerative changes, improving muscle support around the joint can reduce pain and improve function
• You are rarely “too old” to benefit from a targeted shoulder rehab program

The goal of physical therapy in these cases is to help you do more with less pain, not to make your shoulder look “perfect” on a scan. Improved function–reaching, lifting, dressing, sleeping–is a meaningful and realistic outcome at any age.

Bringing It All Together: Facts, Not Fear

Myths about shoulder pain can create fear, confusion, and unnecessary delays in getting the right help. The truth is that most shoulder conditions are treatable, and many patients respond very well to non–surgical care–especially when you have a clear plan and the guidance of a skilled physical therapist.

If you're dealing with shoulder pain–whether it started suddenly or has been bothering you for months–there is something you can do about it. You don't need to wait for it to get “bad enough,” and you don't have to figure it out alone. Contact our physical therapy clinic today to schedule an appointment. Together, we can sort through the myths, find the real source of your shoulder pain, and build a personalized plan to help you move with confidence, strength, and less pain.

References and Further Reading

1. Patient characteristics and clinical management of patients with shoulder pain in U.S. primary care settings


2. Durable Shoulder Pain Relief and Avoidance of Surgery Up To 5 Years Following 60-Day PNS Treatment


3. Shoulder Pain and Physical Therapy: A Review of Current Evidence


4. Shoulder Pain and Impairment: A British Journal of Sports Medicine Analysis


5. Prevalence and Impact of Shoulder Disorders in Rheumatology Patients


6. Evidence–Based Clinical Practice Guidelines for Physical Therapy in Shoulder Pain


7. Global Perspectives on Musculoskeletal Pain: A The Lancet Review


8. Cochrane Review: Conservative vs Surgical Management of Shoulder Conditions


9. Shoulder Pain: The Evidence Behind Imaging and Treatment Decisions