Full thickness rotator cuff tears

There are two types of full thickness rotator tears: those from acute trauma and those from chronic trauma. A full thickness rotator cuff tear basically means the tear is close to being complete, but is not complete. You know this because the person can raise his/her arm over his/her head, though it will be very painful. The person who cannot raise the arm from their side to overhead may have a complete tear and thus need surgery. If you can raise your arm over your head, you know the rotator cuff tear is not complete. There are still some fibers connected, so Prolotherapy may be your non-surgical way to repair it.

Trauma: In an acute trauma, the shoulder joint is basically normal when the trauma occurs, which could be a trauma during a sporting activity or an accident. In these instances, Prolotherapy is a great alternative to Arthroscopic (surgical) repair. Arthroscopic repair is the “standard” treatment, though some folks do not like undergoing anesthesia. Believe it or not, some people just don’t like surgeries. For those folks, Prolotherapy is the best alternative I know of to stimulate the repair of the full thickness or partial thickness rotator cuff tear. Prolotherapy treatments are given every two to six weeks, depending on the amount of disability, pain and urgency of getting it repaired. If you are hoping to hurry things along, come in every two weeks. Typically three to six visits and the person can throw footballs again or do whatever sport they are into. Athletes can train while undergoing Prolotherapy, but the specific exercises given will depend on the athlete. Remember, no anti-inflammatory medications should be taken because these can block the healing effects of Prolotherapy.

Arthritis: For those with “bad arthritis” in the shoulder joint, who develop a full-thickness tear on account of the arthritis, Prolotherapy can help with the repair, but arthritis could cause the tear to occur again. What I look for is this - can the person with his upper arm/elbow at shoulder height (and forearm at 90 degrees to the upper arm) internally rotate the shoulder without pain? If the answer is yes, again, the person is a Prolotherapy candidate. If the person has severe pain with this maneuver (positive impingement sign) and they have a big bone spur at the acromioclavicular joint, then it may be that the person needs surgery, both for the repair of the tear and to have the bone spur shaved.

Bone spurs: Speaking of bone spurs – remember that they occur because the body is trying to stabilize an unstable joint. So in this case, the bone spur occurred at the acromioclavicular joint because of injury to the ligament over this joint. If the person would have received Prolotherapy at the time of the ligament injury, most likely the bad arthritis and this tear would not have occurred. You know you have an acromioclavicular problem when you have a crunching sound at the top of your shoulder when you rotate your shoulder, like when you make big circles with your arms. If this is your case, you should consider getting Prolotherapy to stabilize the acromioclavicular joint. This is my case, because of all the swimming I do. So every once in awhile I get Prolotherapy on my shoulder.

What is the gist of all this?
If your shoulder is crunching, get a Prolotherapy evaluation.

If your MRI showed a partial or complete tear of your rotator cuff and you don’t want to undergo anesthesia or surgery, then get a Prolotherapy evaluation.

I have treated many folks with partial and full thickness tears of the rotator cuff who are back to all their activities. I hope this will include you some day!