New guy here....I am fairly certain I have a small tear in

Hi. It sounds like the tear is giving you trouble, but unfortunately, not much will be done by a surgeon until your arm cannot be "used normally", (or so I believe). I don't know where you live, but if you have access to prolotherapy, you should research that. You sound like a perfect candidate. I haven't had it, but know several people that have had a lot of success with that in their joints. I had rotator cuff surgery. It's been a year. And I'm glad it was done, but my tear was a little more involved and caused by a fall. I still have a few issues, but am doing great overall. Wishing you the best, whatever you decide. Icing, rest and ibuprofen may help.

usually surgery is indicated for full thickness tears and tears from outright trauma (falls etc) that cause full thickness tears or severly limited function. Does your job require heavy or overhead lifting?  All things to consider. I am 58 and had a MTB fall resulting in full thickness supra and infra spinatus and labrum tears and discovered shredded biceps during surgery. I am also a Physical Therapist and so my job is...well...physical.

My Dr recommemded surgery and I debated hard over it, know that it's not an easy surgery and the recovery is hard, slow and painful. I was fairly function after a cortisone shot also...my range was normal but strength not as good as normal...but I knew it was a ticking time bomb. I had the surgery and am at week 13. Still not allowed to lift more than 2# but recovering fairly well. My Mom had to come to help me for 3 weeks. My kids are already raised, thank goodness. That being said, you will certainly be no help to your wife if you have surgery. You will probably be in immobilizer 4-6 weeks and no lifting till 12 weeks (and we're talking therabands and 2# at 12 weeks). It progresses from there. You may still have pain and stiffness after surgery...even if all goes well. You might not. There will always be an opportunity to have surgery...but never an opportunity to take it back. So do everything you can do conservatively first. That includes activity modification. Maybe you don't need to throw your child in the air...I know it's fun...but not good for your shoulder. Strict awarenes of body mechanics and posture are important. Practice mindful movement. Work on strengthening your rotator cuff...which it sounds like you have already done in rehab. When you can...if you can...get another opinion. If you find that your range of motion and strength are deteriorating, maybe you will need to consider surgery. 

I used to do trail running and heavy weight lifting for competitive body building. My knee had torn meniscus and was killing me. I was scheduled for knee surgery and decided to really lay up on the heavy leg weights and running. The knee started feeling better and I cancelled the surgery. I went 11 years before the knee started really acting up again. I would not like to have the arthroscopy for the knee but the last time I went to a new Dr (insurance change) he said no, it's not definitive tear...So part of me wishes I had gone through with the surgery cause now I can't get it...the other part of me is glad I put if off because it's now been 16 years since I didn't have the surgery and have managed to stay very active in hiking, cycling, rockclimbing and even did a little trail running up till I was 50 and broke my neck in a MTB accident. 

So, you never know either way. It's a tough call. sometimes just laying off heavy weights...different mattress if  you sleep on your side...new exercises...cortisone shot. I wish you the best outcome possible whatever way you go!