Common Shoulder MRI Findings (And What They Really Mean)

If you have shoulder pain and your doctor orders an MRI, the report can feel overwhelming. Terms like tendinosis, labral tear, or impingement often sound far more serious than they actually are. The reality is that many shoulder MRI findings are common, age-related, and not always the source of your pain.

This article breaks down the most common shoulder MRI findings, explains what the “big words” mean, and—most importantly—clarifies when you should be concerned and when you shouldn’t.

1. Rotator Cuff Tendinosis or Tendinopathy

What it means:
Tendinosis refers to degenerative changes in a tendon, not an acute tear. Think of it as wear-and-tear rather than an injury.

Common MRI language:

• Tendinosis

• Tendinopathy

• Thickening of the tendon

• Increased signal within the tendon

Important to know:
This is extremely common, especially in people over 30–40 years old, athletes, lifters, and anyone with repetitive overhead activity. Many people with zero pain have this finding on MRI.

Usually not an emergency.

2. Partial Thickness Rotator Cuff Tear

What it means:
A partial tear means some fibers are damaged, but the tendon is still intact. It is not a complete rupture.

Common MRI language:

• Partial thickness tear

• Articular-sided tear

• Bursal-sided tear

• Intrasubstance tear

Important to know:
Partial tears often respond very well to rehab, strengthening, and movement correction. Surgery is rarely the first step unless symptoms are severe and persistent.

Often manageable without surgery.

3. Full Thickness Rotator Cuff Tear

What it means:
A full thickness tear means the tendon is torn all the way through.

Important distinction:
Not all full thickness tears cause pain or dysfunction. Some are chronic, degenerative, and well-compensated by surrounding muscles.

When this matters more:

• Sudden traumatic injury

• Significant weakness

• Loss of ability to raise the arm

• Rapid onset after a fall or accident

This is one finding that may require further evaluation, depending on symptoms.

4. Labral Tears (SLAP Tears)

What it means:
The labrum is a cartilage ring that deepens the shoulder socket. A SLAP tear involves the top portion of the labrum.

Common MRI language:

• SLAP tear

• Labral fraying

• Superior labral tear

Important to know:
Labral “tears” are very common and frequently seen in people with no pain at all—especially overhead athletes and adults over 35.

MRI often over-diagnoses labral pathology.

Symptoms matter more than the picture.

5. Shoulder Impingement / Subacromial Bursitis

What it means:
This refers to irritation or inflammation in the space where the rotator cuff tendons pass under the shoulder blade.

Common MRI language:

• Subacromial bursitis

• Impingement

• Inflammation of the bursa

Important to know:
This is often related to poor shoulder mechanics, posture, or movement patterns, not structural damage.

Highly responsive to conservative care.

6. AC Joint Arthritis

What it means:
The AC joint (top of the shoulder) commonly shows arthritic changes, even in younger active adults.

Common MRI language:

• Degenerative changes

• Osteoarthritis

• Joint space narrowing

• Bone spurs

Important to know:
Arthritis on MRI does not automatically equal pain. Many people live symptom-free with these findings.

When to Worry (Red Flags)

You should take MRI findings more seriously if you have:

• Sudden loss of strength

• Inability to lift the arm

• Trauma (fall, accident, collision)

• Rapidly worsening pain

• Night pain that does not improve

• Progressive weakness or numbness

In these cases, further evaluation is appropriate.

When Not to Worry

You likely don’t need to panic if:

• Pain came on gradually

• MRI findings sound scary but function is mostly intact

• Symptoms improve with movement or rehab

• You were told you have “degenerative changes”

• Pain fluctuates rather than steadily worsens

MRIs show structure—not function. Pain is often driven by movement quality, load tolerance, and neuromuscular control, not just tissue appearance.

The Big Takeaway

An MRI is a piece of the puzzle, not the diagnosis.

Many shoulder MRI findings are:

• Common

• Age-related

• Treatable without surgery

• Poor predictors of pain on their own

A thorough physical exam, movement assessment, and symptom history matter far more than the imaging report alone.

If your shoulder hurts, the goal isn’t just to “fix the picture”—it’s to restore strength, mobility, and confidence in movement.

Need clarity on your shoulder MRI?

A qualified provider should explain what your MRI means in the context of how you move, function, and feel, not just what the report says.