As discussed above, abnormal MRIs in healthy individuals are common. Therefore, it should be obvious that an abnormal MRI does not necessarily mean surgery is needed. To further clarify this relationship, a study was done of elite overhead athletes—those who perform repetitive “overhead” activity, such as in tennis, swimming, baseball throwing, and above-shoulder, weight-training exercises. These are athletes who are more likely to suffer injuries to their shoulders because of continual and repetitive use. At the study’s start, none of the athletes had any shoulder pain or problems, yet 40 percent showed partial or full-thickness tears of the rotator cuff on their MRIs, and an additional 20 percent showed other shoulder abnormalities. The study then followed these athletes for five years. After five years, none of the athletes interviewed had any complaints and had not needed any evaluation, treatment or surgery for shoulder-related problems during the five previous years. The study’s authors concluded, “MRIs alone should not be used as a basis for operative intervention.”