Your shoulder is a complex joint that is constantly at risk of an injury like a rotator cuff tear, which can be painful and debilitating. At New England Stem Cell Institute, Dr. Paul Tortland and Dr. Jeffrey LaVallee specialize in the diagnosis and management of rotator cuff tears and offer innovative treatments to speed up your body’s natural healing powers. Rotator cuff problems are frequent and concerning injuries in orthopedic, sports medicine, and musculoskeletal medicine practices. Patients often express apprehension about possibly having a rotator cuff problem, such as, “I hope my shoulder pain isn’t due to a rotator cuff problem.”
The Rotator Cuff is a group of 4 muscles and their tendons that help support and stabilize the shoulder joint socket. Each of the muscles attaches to the scapula (the shoulder blade), and the tendons reach around and grab the ball of the shoulder to help hold it in the socket during movement. Sometimes these are referred to as the “SITS” muscles, referring to their names: Supraspinatus, Infraspinatus, Teres minor, Subscapularis.
The main purpose of the Rotator Cuff is NOT to rotate the shoulder. Rather, it’s to stabilize the shoulder joint.
The tendons and muscles of the Rotator Cuff can succumb to the same types of injuries as any other muscle or tendon, including sprains, strains, tendinitis, and tears.
As the name implies, a Rotator Cuff tear is a tear in one or more of the tendons of the cuff. These can be very small tears within the body of the tendon (known as an “interstitial” tear), massive complete tears, and everything in between. Rotator cuff tears are very common, affecting as many as 2 million people in the United States every year.
The Rotator Cuff can be injured by repetitive overuse, progressive stress over time (such as improper weight training), an acute sudden injury such as falling on the shoulder, trying to lift something too heavy, pulling too hard to start a lawnmower, and so on. The Rotator cuff is also vulnerable to degenerative changes that come with aging.
Shoulder pain while at rest is one of the most common symptoms of a rotator cuff injury. You may also experience:
During an acute (sudden) injury, you could experience a snapping sensation as the rotator cuff tears followed by severe pain and/or sudden weakness. Rotator cuff tears that develop slowly due to degeneration usually cause a dull ache and muscle weakness.
When you come to our office with concerns about shoulder pain, the team at the New England Stem Cell Institute does a thorough exam to identify the underlying cause of your discomfort. This can include a review of your symptoms, taking a medical history, and a physical exam.
To help confirm whether your shoulder symptoms are due to a Rotator Cuff injury, a diagnostic ultrasound will also be performed. Ultrasound is an excellent way to visualize the muscles and tendons of the Cuff. If there is still any doubt about whether a tear is present, an MRI may be ordered.
Treatment of your Rotator Cuff injury will depend on the nature and severity of the injury, your symptoms, and the cause of your injury. For tendinitis and mild tears, your treatment may include:
If conservative methods fail to improve your tendinitis or mild Rotator Cuff tear, then the team at the New England Stem Cell Institute may recommend regenerative medicine treatments such as platelet-rich plasma (PRP), which when injected into your damaged Cuff, can help accelerate the natural healing process.
For larger Cuff tears, fat-derived stem cell treatment is often recommended for those persons wishing to avoid surgery. Fat can be an excellent source of stem cells from your own body. Unlike PRP and bone marrow-derived stem cells, fat has the advantage of being almost like putty or filler that can fill in larger Cuff tears. This keeps the healing cells in place, so they augment tissue repair. Using a gentle, minimally invasive liposuction technique, we take a small amount of fat from the “love handles” and process it to release the stem cells and other regenerative healing cells. The processed fat is then injected into the tear using ultrasound guidance. For a massive or complete tear, surgery may be required.