Shoulder Impingement Syndrome and Shoulder Pain

Shoulder red pain

Shoulder Impingement Syndrome is a common problem.  Regenerative Medicine and Platelet Rich Plasma Injection Therapy offers a revolutionary new way to treat this problem.

Shoulder Pain is a Significant Problem.

Shoulder Pain is one of the most common musculoskeletal complaints.  About 70% of the population will experience some degree of shoulder pain in their lifetime.  Problems with the rotator cuff are the most common cause of shoulder pain.  About 2 million per year visit their doctor for rotator cuff problems.  Shoulder dysfunction costs the United States about $7 billion per year.

The shoulder contains many different structures and several joints.  These allow the shoulder to move in many different directions.  

Current traditional treatment does nothing to help the shoulder heal itself.  The traditional treatments include medications, corticosteroid injections, and surgery.  All of these options are associated with side effects that can potentially be quite severe.  

A new type of treatment option is now available.  Regenerative Medicine and the use of Platelet Rich Plasma Injection is a game-changing treatment option that is now available from the Regenerative Medicine and Joint Preservation Center of Santa Rosa.

Shoulder anatomy 2

The shoulder is a complex area which requires all components that make it up to work well in order to be pain free

shoulder impingement (1)

The most common structures involved in shoulder pain are the rotator cuff tendons

The Normal Shoulder

The Shoulder is an amazing structure.  It is made up of various joints, ligaments, muscles, and tendons that all must work together for the shoulder to work properly and be pain free.   

The main bones that make up the shoulder include the humerus (arm bone), clavicle (collar bone) and the scapula (shoulder blade).  The movement of the shoulder comes from a combination of the movement at the shoulder joint (glenohumeral) itself and from the movement between the scapula and the chest wall (scapulothoracic).  Proper shoulder function depends on the surrounding muscles, since they provide stability and strength.  One of the most important set of muscles and tendons are called the rotator cuff.  

The health of the rotator cuff is important to maintain the normal shoulder function.  It is this rotator cuff that can become injured and start causing pain and dysfunction of the shoulder.  

The Rotator Cuff is one of the most important structures of the shoulder

Shoulder Anatomy Video (Rotator Cuff Anatomy at 4:00 - 4:37 in video)

Shoulder Impingement Syndrome and

Rotator Cuff Tendinopathy

rotator-cuff-supraspinatus-tendon-tear (1)

Shoulder Impingement Syndrome involves the Rotator Cuff Tendons

Shoulder Impingment Syndrome is one of the most common problems causing pain in the shoulder.  Sometimes the problem is also called Rotator Cuff Tendonitis.  Impingement Syndrome is caused by the rotator cuff tendons becoming inflammed and over time developing weaknesses, tears, and degenerative changes.  The part of the rotator cuff tendon that gets involved has a relatively poor blood supply and is often not able to repair itself sufficiently to heal.  The damage can, unfortunately, continue and could develop into a larger complete rotator cuff tear.

partial rotator cuff tear arthro

Partial Rotator Cuff tear seen from inside the shoulder joint

Impingement Syndrome can be caused by several things including activities, trauma, or wear and tear.

These degenerative changes and tears in the Rotator Cuff Tendons can cause significant pain in the shoulder.  This pain is often worse with certain movements or activities, particularly overhead or reaching activities.  Often the shoulder starts becoming stiff as well, worsening the problem.

Once damaged, the Rotator Cuff Tendons have a very difficult time healing on their own.  The chronic inflammation, degenerative tearing, poor blood supply, and poor healing environment all contribute to the shoulder pain and dysfunction continuing and worsening.  

The Problem With Traditional Treatments for Shoulder Impingement

Traditional treatments for Shoulder Impingement Syndrome include Physical Therapy, NSAIDS, corticosteroid injection, and surgery.  


Traditional treatment for Shoulder Impingement often do not address the root cause of the problem

Physical Therapy and specific exercises do have a value to treat Shoulder Impingement Syndrome, particularly to improve range of motion and strengthening the muscles that surrount the shoulder.  Rest and icing/heat can also afford some temporary relief of symptoms.  Unfortunately, these do nothing to help speed up or stimulate the healing process.

NSAIDS (non-steroidal anti-inflammatory drugs) are taken orally and go throughout your whole body and therefore may have very limited anti-imflammatory effect on the shoulder itself.  The area of injury does not have a good supply, so these oral medications do not get to the site of injury.  Additionally NSAIDS are associated with significant side effects, including ulcers, internal bleeding, heart attack, and stroke.  Additionally, by reducing the overall inflammatory process, many components of the body’s normal healing mechanisms are also blocked by these medicines.  These medication also do nothing to stimulate the body to heal.

Corticosteroid injections are unfortunately used quite commonly for Shoulder Impingement Syndrome and Shoulder Tendinosis.  These medication reduce the inflammation where they are injected; however, they can damage the tendons and ligaments that are so critical to shoulder function.  Corticosteroids also shut down the healing processes (the anabolic or building up processes) and therefore prevent the body from continuing with the normal healing that it wants to do.  These medications can also cause softening of the joint cartilage and cause acceleration of the degenerative joint processes.  Studies have clearly shown the deleterious effect of steroid injection in tendinopathies. (Br J Sports Med 2014 48:1620)  Another study showed corticosteroids kill rotator cuff cells. (Bone Joint Res 2014;3:328-34) 

These medicine produce effects in the shoulder that are completely unnatural and opposite to what is needed for the shoulder to heal and recover.

shoulder impingment drawing

Surgery to “decompress” the rotator cuff tendons actually creates irreversible damage to critically important structures in the shoulder

Surgery for Shoulder Impingement has become quite common.  In some situations surgery might be necessary, such as in a situation where there is a complete tear and other appropriate treatment options have not been beneficial.  The most typical surgery that is performed involves removing the undersurface of one of the bones in the shoulder, thereby “decompressing” the shoulder rotator cuff tendons (acromioplasty).  It has been shown by various studies that the structures of the bones and ligaments in patients with pain are not significantly different than the structures in people that do not have pain.  Additionally, altering the bony and ligamentous structures, as is typically done in surgery,  does not lead to symptom improvement.  (JBJS Am 2011 Oct 5:1827)

It would seem reasonable to try to have another treatment option available that would allow the body to heal naturally, reduce pain, reduce inflammation, and build up the important structures of the shoulder to improve function.  There is a new option now available.

The Regenerative Medicine and Joint Preservation Center of Santa Rosa offers techniques of Regenerative Medicine and Platelet Rich Plasma to treat these conditions in a revolutionary new way.

Stem Cell and Platelet Rich Plasma (PRP) Treatment for Shoulder Impingement Syndrome

Shoulder PRP

Platelet Rich Plasma (PRP) injection offers a revolutionary way to treat Shoulder problems by stimulating the body to heal itself

Platelet Rich Plasma (PRP) is an orthobiologic regenerative injection therapy that can effectively treat Shoulder Impingment Syndrome and Shoulder Tendinopathies.  PRP can reliably alleviate pain, restore shoulder function, stimulate the healing of damaged tendons and ligaments, reduce inflammation and pain, and slow the arthritis process.

The bioactive molecules and platelets in Platelet Rich Plasma (PRP):

     - provide a natural way to “kick start” and stimulate the body’s own healing mechanism to heal damaged tissue

     - appropriately balances the anti-inflammatory and inflammatory processes to allow healing and reduce pain

     - stimulate the damaged rotator cuff tendons to heal by activating tendon cells, and increasing blood vessel growth

     - inhibits the breakdown processes (catabolism) which would otherwise cause continued weakening and deterioration

     - stimulate the anabolic process which allow the body to build up and strengthen structures in a natural accelarated fashion

The Platelet Rich Plasma is injected into the affected tendon to stimulate it to heal.  Additional PRP can also be injected into the subacromial space and shoulder joint to aid in healing and reducing inflammation and pain.  

Studies have shown that PRP is more effective than corticosteroid injection for treatment of Rotator Cuff Problems and that PRP Treatment prevents the need for surgery on those shoulder. (AAOS 2013)

Platelet Rich Plasma Treatment has distinct advantages over the other treatment options.  The treatment is safe, without any of the typical side effects and destructive nature of the other traditional treatments.   PRP Treatment for Rotator Cuff Tendinopathies gives longer lasting relief, stimulates the damaged tendons to heal, reduces pain, improves function, and reduces the need for surgery better than any of the other options.

PRP may also be used if a patient has had surgery on their shoulder and is not recovering well.  Very often the environment of the shoulder has been altered so much from the surgery, that healing can longer occur.  The Platelet Rich Plasma injection can help “kickstart” the healing process and allow the shoulder to progress with the healing process.

The Platelet Rich Plasma that is used for Shoulder Impingement Syndrome has to be specifically prepared to maximize the effectiveness for the structures being injected.  Not all PRP is the same, and PRP injections need to be customized for their specific intended use.

The Regenerative Medicine and Joint Preservation Center of Santa Rosa makes this revolutionary new technology for treating Shoulder Impingement Syndrome available.

shoulder weights workout

Regenerative Injection Therapy with PRP for your shoulder can get you back to what you love doing.

©         Regenerative Medicine and Joint Preservation Center of Santa Rosa    2017