For a severe traumatic rotator cuff tear in a 60-65 year old, surgical repair is not mandatory, but not repairing it will lead to muscle atrophy and continued functional diminution.

“uh would I tell them you absolutely have to have it repaired no but I would also tell them look if you don't repair this those muscles have lost their muscle tendon connection so they're going to atrophy and later if you I know you're not painful now but if you want to still do the things you're doing and the way you do them before this accident they need to have them repaired”