Complete Rotator Cuff Tear
We are often asked if Prolotherapy can be used for complete rotator cuff tears. The first question I ask is if the person can raise their arm that is held by their side and raise it over head. This movement is called abduction. Someone who can abduct their arm completely overhead does not have a complete rotator cuff tear. They may have a bad tear but there are still some fibers holding the rotator cuff tendons onto the humerus.
It is very common for someone to have a rotator cuff tear noted on MRI, even complete tears, but then when they are examined in the office they show evidence of a rotator cuff injury but by no means is it serious or a complete tear. As depicted in the book Prolo Your Sports Injuries Away! MRI's tend to over-diagnose rotator cuff tears when no tear exists, or say something is a complete rotator cuff tear when it is not. Since the traditional treatment for a complete rotator cuff tear is surgical repair we recommend that someone who has been diagnosed with a complete rotator cuff tear seek the opinion of a Prolotherapy doctor before surgery.
Surgery involves the permanent alteration of the body. If the surgeon takes tissue out such as tendon tissue, meniscal tissue, labral tissue, or bone, it is gone! A better approach is to stimulate the repair of the injured tissue with Prolotherapy. Prolotherapy proliferates fibroblasts so that the collagen tissue that makes up structures like the rotator cuff will be repaired. Most people who receive Prolotherapy are never seen again once their condition is resolved because it really is resolved.
Rotator Cuff Pain
The most common cause of chronic shoulder pain is not shoulder instability but supraspinatus tendon weakness, also known as rotator cuff tendonitis. If full range of movement in the shoulder is compromised, the supraspinatus tendon works harder to provide the motion support needed. This tendon eventually weakens and laxity develops. A supraspinatus tendon problem is manifested by pain with abduction and external rotation of the shoulder, especially when reaching for things above shoulder level, or pain in the shoulder after sleeping due to compression of the supraspinatus tendon.
The supraspinatus tendon often refers pain to the back of the shoulder. Sleeping on the shoulder causes a pinching of the rotator cuff muscles and can lead to rotator cuff weakness. There are cases where the cause of the rotator cuff tendon laxity was due to years of sleeping on the shoulder.
In most cases, traditional therapies such as exercise and physical therapy will resolve rotator cuff tendonitis. It is not uncommon, however, for rotator cuff injuries to linger because blood supply to the rotator cuff tendons is poor. Poor blood supply is a reason the rotator cuff is so commonly injured. In chronic cases of shoulder pain due to rotator cuff weakness, Prolotherapy is the treatment of choice. Prolotherapy will cause the rotator cuff to strengthen and eliminate shoulder pain. If rotator cuff weakness is not corrected, the shoulder's range of motion will deteriorate. Rapid deterioration can occur, especially in people over 60 years of age.
When shoulder muscle weakens, movement becomes painful. Those who have supraspinatus tendon laxity causing pain will stop moving their arms into the painful position. Though they may not realize it, they are slowly but surely losing shoulder movement. What begins as a simple rotator cuff muscle weakness easily treated with Prolotherapy, has the potential to become a frozen shoulder because of scar tissue formation inside the shoulder that was left untreated. The scar tissue formation causing a decrease in the ability to move the shoulder is called adhesive capsulitis.
If you have a painful shoulder due to an injured rotator cuff, call us for an appointment.