Physical Therapist Suspects Labral Tear and Rotator Cuff Issues - Is Imaging Necessary?
I am a 28-year-old experiencing cervical radiculopathy, alongside persistent, unresolved problems with my right shoulder that have been overlooked for years. These issues were initially thought to be linked to neurological or hormonal factors, but all tests have returned normal results. Recently, a physical therapist assessed my situation and indicated that my labrum might be torn, at the very least. However, I have yet to undergo any imaging or a thorough evaluation by a physician. My main inquiry is whether it is common practice to continue physical therapy under these circumstances, or if imaging should be prioritized. If imaging is deemed necessary, what kind would be most appropriate? To provide more context: I had significant brain fog, which I initially focused on. A spinal specialist determined that this was likely caused by tight muscles in the front of my neck, potentially exerting pressure at the base of my skull. Other than the radiculopathy attributed to a muscle strain, my spine was otherwise pathology-free, aside from mild hypolordosis, possibly related to muscle spasms in my neck. While I accept this diagnosis, I am inclined to believe that these issues are a result of an unaddressed shoulder injury I suffered roughly five years ago. After my neck strain, my shoulder problems resurfaced, but the brain fog and neck tightness have dramatically improved. I am concerned about the potential for thoracic outlet syndrome given the color changes in my arm, weaknesses, and my previous shoulder injury. Thank you for any insights you may have!
Answers (1)
2/11/2026, 12:50:35 AM
OpenHealth AI
Main Points: Imaging may be necessary to assess potential labral tear and rotator cuff issues, especially given your history and ongoing symptoms. It's common to evaluate these concerns further before continuing physical therapy, particularly if symptoms change or worsen.
Explanation: You've experienced a long-standing shoulder issue, which may be related to your previous injury. Your physical therapist's suspicion of a labral tear or rotator cuff problem is a valid concern, especially with symptoms like cervical radiculopathy, arm color changes, and weakness. Imaging is important here because it can provide detailed information about soft tissues like tendons and cartilage, helping confirm any injuries that could be causing your symptoms.
Without imaging, such as an MRI (which is often preferred for joint and soft tissue evaluation), it’s challenging to develop an effective treatment plan. Continuing physical therapy might provide temporary relief, but without knowing the precise nature of your shoulder issue, you might not be addressing the root cause.
Next Steps:
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Consider Imaging: Discuss with your physician the option of getting an MRI of your shoulder. This will help to confirm or rule out a labral tear or rotator cuff tear and guide further treatment.
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Monitor Symptoms: Keep a detailed record of your symptoms, noting any changes or worsening. This information can be useful for your healthcare provider.
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Physical Therapy Evaluation: If you do continue physical therapy, make sure to communicate openly with your therapist about your symptoms. They may want to adjust your regimen based on findings from imaging.
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Evaluate All Symptoms: Given your past issues with neck tightness and brain fog, ensure your healthcare providers consider all symptoms holistically during your evaluations.
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Stay Proactive: If you notice new symptoms, such as increased weakness, ongoing color changes, or worsening pain, seek further evaluation promptly.
Please take care, and don’t hesitate to reach out for further clarification or support as you navigate this process.
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