📌 Learn more about Dr. Ivan Wong and Island Orthopaedics at https://www.drivanwong.com or https://www.islandorthopaedics.ky

Your MRI says rotator cuff tear. That single phrase can mean three completely different things for your shoulder. One patient can heal with monitoring. Another needs a closer look right away. A third has a tear that isn't even causing the pain.

In this episode, I'm going to break down the exact words to search for in your MRI report and show you how to tell which of these three situations actually applies to your shoulder.

⏱️ TIMESTAMPS
0:00 You’ll Find This Video When Your MRI Says “Rotator Cuff Tear”
1:06 When a rotator cuff tear can be monitored without surgery
2:00 Words to find in your report: partial vs full thickness
3:22 Why partial does not always mean minor
5:53 When a tear deserves a closer, faster look
7:35 What retraction tells a surgeon about healing
8:56 Why atrophy and fatty infiltration change everything
9:34 The two lists to make before your next appointment
10:56 When the tear on your MRI is not your real pain source

❓ QUESTIONS ANSWERED

Does every rotator cuff tear on an MRI need surgery?
No. Many partial thickness tears with good strength, little retraction, and no muscle atrophy can be safely monitored with a structured rehab program.

What MRI words mean a rotator cuff tear needs urgent attention?
Look for full thickness, meaningful retraction, muscle atrophy, or fatty infiltration, especially after a sudden injury with new weakness. Those findings together suggest the tendon and muscle may keep losing function if you wait.

Can a rotator cuff tear show up on MRI and not be the cause of shoulder pain?
Yes. An MRI shows anatomy, not pain. A tear can be a long standing finding while stiffness, another structure, or a different movement pattern is actually driving the symptoms.

📱 RESOURCES
Website: https://www.drivanwong.com
Practice: https://www.islandorthopaedics.ky
Instagram: https://www.instagram.com/drivanwongmd/
LinkedIn: https://www.linkedin.com/in/ivan-wong-415b8515

🔔 If this changed how you think about your shoulder, subscribe for more videos breaking down the real reasons injuries do not heal the way you expect.

ABOUT DR. IVAN WONG
Dr. Ivan Wong is an orthopaedic surgeon specializing in joint preservation of the shoulder, hip, and knee. He holds an MD, FRCS(C), and a Masters of Academic Medicine, and is a Fellow of the Royal College and a Fellow of the Arthroscopic Association of North America. He is a past president of the Arthroscopy Association of Canada, has treated more than 10,000 patients over 17 years, and developed the AAGR procedure now taught to surgeons around the world. He has published over 200 articles and leads one of the largest research teams in his field, with a focus on objective outcome measurement rather than guesswork.

#ShoulderInstability #OrthopaedicSurgeon #ShoulderDislocation #JointPreservation #SportsInjury

📌 Learn more about Dr. Ivan Wong and Island Orthopaedics at https://www.drivanwong.com or https://www.islandorthopaedics.ky

The shot works. The pain drops. You sleep better and reach overhead without thinking. But feeling better does not mean the problem is solved. A torn tendon that is not fixed keeps pulling back, and waiting has a cost even when it does not hurt.

In this episode, I'm going to explain how I decide whether an injection is enough for a rotator cuff tear or whether surgery is the treatment that actually gets you back to full strength.

⏱️ TIMESTAMPS
0:00 Rotator Cuff Tear: Injection vs. Surgery? (Which Is Right for You?)
0:57 Why an MRI does not show pain
1:26 How a diagnostic injection finds the real source
2:10 What an injection can and cannot fix
3:00 Why waiting on a rotator cuff tear is not free
4:31 The real goal, a shoulder you can trust again
5:19 Why objective strength testing matters
6:30 Signs the injection did not answer the whole question
7:21 The three real questions behind treatment
8:06 What to ask before you agree to surgery

❓ QUESTIONS ANSWERED

Does a cortisone or lidocaine injection heal a torn rotator cuff?
No. An injection can reduce inflammation and calm pain enough for physiotherapy to work, but it cannot reattach a tendon that has torn away from the bone. Only surgery can physically reconnect torn tissue.

How do doctors know if an injection actually found the source of shoulder pain?
Doctors use an ultrasound guided injection with numbing medicine placed at the suspected pain site, then ask the patient to repeat the motion that normally causes pain. If the pain disappears within minutes, that confirms the pain source; if nothing changes, the real cause is somewhere else.

Is it safe to wait on rotator cuff surgery if an injection relieves the pain?
Waiting is not an emergency, but it is not risk free either. A fully torn tendon can keep retracting and the attached muscle can turn to fatty tissue over time, which makes a clean surgical repair harder the longer treatment is delayed.

📱 RESOURCES
Website: https://www.drivanwong.com
Practice: https://www.islandorthopaedics.ky
Instagram: https://www.instagram.com/drivanwongmd/
LinkedIn: https://www.linkedin.com/in/ivan-wong-415b8515

🔔 If this changed how you think about your shoulder, subscribe for more episodes breaking down the real reasons injuries do not heal the way you expect.

ABOUT DR. IVAN WONG
Dr. Ivan Wong is an orthopaedic surgeon specializing in joint preservation of the shoulder, hip, and knee. He holds an MD, FRCS(C), and a Masters of Academic Medicine, and is a Fellow of the Royal College and a Fellow of the Arthroscopic Association of North America. He is a past president of the Arthroscopy Association of Canada, has treated more than 10,000 patients over 17 years, and developed the AAGR procedure now taught to surgeons around the world. He has published over 200 articles and leads one of the largest research teams in his field, with a focus on objective outcome measurement rather than guesswork.

#ShoulderInstability #OrthopaedicSurgeon #ShoulderDislocation #JointPreservation #SportsInjury

📌 Learn more about Dr. Ivan Wong and Island Orthopaedics at https://www.drivanwong.com or https://www.islandorthopaedics.ky

Most patients judge a surgeon on the wrong things. A confident handshake, a nice office, five star reviews. None of that tells you if the surgery itself will actually work. Before Dr. Ivan Wong ever operates on anyone, he has to answer four specific questions for himself first, and if your surgeon can answer these too, you are probably in good hands. Most people never think to ask these questions until it is too late, and by then they are already committed to a plan they do not fully understand.

In this episode, I am going to walk through the four questions I ask myself before every shoulder surgery, so you know exactly what to ask your own surgeon before you agree to an operation.

⏱️ TIMESTAMPS
0:00 Choosing a Shoulder Surgeon? Forget Reviews. Ask These 4 Questions Instead
0:35 How did we land on this diagnosis
1:28 Does the image match your actual story
2:08 When would a surgeon tell you not to have surgery
2:36 Spotting patients who do not need surgery
3:31 Is there anything else this could be
4:11 How do you know surgery actually works long term
4:45 Measuring strength before and after surgery
5:15 The four questions every good surgeon should answer

❓ QUESTIONS ANSWERED

What questions should I ask before shoulder surgery?
Ask how the diagnosis was reached, when the surgeon would advise against surgery, whether anything else could explain your symptoms, and how they track long term outcomes after similar procedures. A surgeon who can answer all four clearly is one worth trusting with an operation.

How do I know if my surgeon is being thorough before recommending surgery?
A thorough surgeon can clearly explain why imaging matches your symptoms and can name a specific scenario where they would have told you not to have surgery. If they cannot give a real answer to either question, that is a red flag worth pausing on before you agree to anything.

Do surgeons always recommend the right treatment?
Not always. Some patients who are convinced they need surgery actually improve fully with physiotherapy, while others who are told it is nothing may need a much closer look before the problem gets worse.

📱 RESOURCES
Website: https://www.drivanwong.com
Practice: https://www.islandorthopaedics.ky
Instagram: https://www.instagram.com/drivanwongmd/
LinkedIn: https://www.linkedin.com/in/ivan-wong-415b8515

🔔 If this changed how you think about your shoulder, subscribe for more episodes breaking down the real reasons injuries do not heal the way you expect.

ABOUT DR. IVAN WONG
Dr. Ivan Wong is an orthopaedic surgeon specializing in joint preservation of the shoulder, hip, and knee. He holds an MD, FRCS(C), and a Masters of Academic Medicine, and is a Fellow of the Royal College and a Fellow of the Arthroscopic Association of North America. He is a past president of the Arthroscopy Association of Canada, has treated more than 10,000 patients over 17 years, and developed the AAGR procedure now taught to surgeons around the world. He has published over 200 articles and leads one of the largest research teams in his field, with a focus on objective outcome measurement rather than guesswork.

#ShoulderInstability #OrthopaedicSurgeon #ShoulderDislocation #JointPreservation #SportsInjury

📌 Learn more about Dr. Ivan Wong and Island Orthopaedics at https://www.islandorthopaedics.ky

Two patients can dislocate the exact same shoulder joint and need two completely different treatments. One needed surgery immediately. The other dislocated five times and never needed surgery at all. So what actually decides which path you take?

In this episode, I'm going to break down the real factors that determine whether a shoulder dislocation needs surgery or can heal with physiotherapy alone.


⏱️ TIMESTAMPS

0:00 Do you actually need surgery after a dislocation
0:29 Physiotherapy versus surgery explained
0:44 Jack's story, four dislocations before treatment
1:10 Why each dislocation chips away at your shoulder
1:51 Why a regular x ray misses bone loss
2:12 Why the same CT scan can mean two different treatments
3:11 How your activity level changes the decision
3:38 The Tuesday test, how your shoulder feels normally
4:26 Four questions to ask yourself tonight
5:19 Does your shoulder have what it needs to stay stable


❓ QUESTIONS ANSWERED

Does every shoulder dislocation require surgery?
No. Many patients recover full stability through physiotherapy that strengthens the muscles around the joint, but this depends on how much bone has been lost from prior dislocations and what activities the shoulder needs to handle going forward.


Why can two patients with the same CT scan get different treatment recommendations?
Because the scan only shows the bone, not what you plan to ask that shoulder to do. An active climber with the same bone loss as a gardener may need surgery while the gardener does not, since their daily demands on the joint are completely different.


Can an x ray reliably detect shoulder bone loss from dislocations?
No. A regular x ray often looks completely normal even when significant bone from the socket rim is already missing, which is why a CT scan or 3D model is needed to measure it accurately.


📱 RESOURCES
Website: https://www.drivanwong.com
Practice: https://www.islandorthopaedics.ky
Instagram: https://www.instagram.com/drivanwongmd/
LinkedIn: https://www.linkedin.com/in/ivan-wong-415b8515


🔔 If this changed how you think about your shoulder, subscribe for more videos breaking down the real reasons injuries do not heal the way you expect.


ABOUT DR. IVAN WONG

Dr. Ivan Wong is an orthopaedic surgeon specializing in joint preservation of the shoulder, hip, and knee. He holds an MD, FRCS(C), and a Masters of Academic Medicine, and is a Fellow of the Royal College and a Fellow of the Arthroscopic Association of North America. He is a past president of the Arthroscopy Association of Canada, has treated more than 10,000 patients over 17 years, and developed the AAGR procedure now taught to surgeons around the world. He has published over 200 articles and leads one of the largest research teams in his field, with a focus on objective outcome measurement rather than guesswork.


#ShoulderInstability #OrthopaedicSurgeon #ShoulderDislocation #JointPreservation #SportsInjury

📌 Learn more about Dr. Ivan Wong and Island Orthopaedics at https://www.islandorthopaedics.ky

Two football players dislocate their shoulder the exact same way. Six months later, one is fine and the other has dislocated three more times. The difference is not luck, and it is not weak muscles. It is something almost nobody checks for.

In this episode, I'm going to explain why repeated shoulder dislocations change the actual bone structure of your shoulder, why standard scans often miss it, and how to find out if it has happened to you.

⏱️ TIMESTAMPS
0:00 Why your shoulder keeps dislocating
0:39 Same injury, different outcome
1:03 How bone damage builds with each dislocation
1:21 The golf ball on a tee explained
1:52 Why bone loss makes dislocation easier
2:22 Why X-rays and MRIs miss it
3:14 What your dislocation history reveals
4:03 Why the physical exam matters more than pain
4:26 CT scans versus MRI for bone loss
5:06 Building a 3D model of your shoulder


❓ QUESTIONS ANSWERED

Why does my shoulder keep dislocating after the first time?
Every dislocation can chip away a small piece of bone from the socket rim. Once enough bone is lost, the shoulder becomes mechanically easier to dislocate, regardless of muscle strength or physiotherapy.


Can an MRI or X-ray detect shoulder bone loss?
Regular X-rays and MRIs are often not sensitive enough to detect subtle bone loss around the shoulder socket. A CT scan, especially combined with a 3D model, gives a far more accurate picture of exactly how much bone has been lost.


Why did my shoulder dislocation report come back normal?
MRI reports are based on images alone, not a physical exam of your shoulder. Bone loss does not always show clearly on a standard scan unless someone is specifically looking for it and measuring it.


📱 RESOURCES
Website: https://www.drivanwong.com
Practice: https://www.islandorthopaedics.ky
Instagram: https://www.instagram.com/drivanwongmd/
LinkedIn: https://www.linkedin.com/in/ivan-wong-415b8515


🔔 If this changed how you think about your shoulder, subscribe for more videos breaking down the real reasons injuries do not heal the way you expect.


ABOUT DR. IVAN WONG

Dr. Ivan Wong is an orthopaedic surgeon specializing in joint preservation of the shoulder, hip, and knee. He holds an MD, FRCS(C), and a Masters of Academic Medicine, and is a Fellow of the Royal College and a Fellow of the Arthroscopic Association of North America. He is a past president of the Arthroscopy Association of Canada, has treated more than 10,000 patients over 17 years, and developed the AAGR procedure now taught to surgeons around the world. He has published over 200 articles and leads one of the largest research teams in his field, with a focus on objective outcome measurement rather than guesswork.


#ShoulderInstability #OrthopaedicSurgeon #ShoulderDislocation #JointPreservation #SportsInjury