The shoulder is one of the largest and most mobile joints in the body. The rotator cuff is a group of muscles and tendons that surround the joint. Its function is to keep the joint in its socket, allow for a wide range of motion and provide joint stability.

The most common causes of shoulder pain are rotator cuff tears, and shoulder tendinitis. However, arthritis of the shoulder joint is also a common source of pain.

Management of shoulder pain typically involves conservative measurers like over-the-counter pain medicine, anti-inflammatory drugs, steroid injections and physical therapy. When this fails, surgery is the last option to stabilize the joint and relieve pain. But even surgery may not provide effective repair partly due to the low quality of tendon healing.

Rotator Cuff Tears

Rotator cuff tears are a common cause of shoulder pain and disability, especially in older adults and athletes. Symptoms may start as a dull ache that gets worse with repeated overhead activities. Sleeping on the damaged shoulder can interfere with your sleep. Arm weakness and difficulty performing normal daily activities are also associated with a rotator cuff tear.

Ultrasound guided platelet – rich plasma injection for a partial tear of the rotator cuff is an effective procedure to decrease pain and improve function.

PRP augmentation during surgical rotator cuff repair

While surgical rotator cuff repair provides good pain relief and decent functional recovery, the quality and speed of tendon to bone healing is unpredictable. Additionally, repaired tendons are inferior to uninjured tendons, which creates a risk of re-injury and tears. Studies report that PRP injections applied during arthroscopically repaired rotator cuffs decreased re-tear rate.

Shoulder Tendinitis

Tendinitis is inflammation of the rotator cuff tendons in the rotator cuff. It can occur acutely or become chronic. Symptoms are inflammation, significant pain, discomfort and loss of function.

There is good evidence that PRP therapy can relieve pain, promote repair, and enhance blood flow so nutrients are delivered for healing, and stem cells are recruited to regenerate tissues.

Biological enhancement of the rotator cuff with PRP may provide accelerated healing over the short-term with a rapid decrease in pain and faster return to normal daily activities.

What is Platelet – rich Plasma?

Blood is primarily plasma, the liquid that contains red blood cells, white blood cells and platelets. Platelets are best known for their blood clotting ability, but platelets are a natural reservoir of hundreds of biologically active proteins called growth factors that play a key role in wound healing and tissue repair. When there is an injury or inflammation, platelets flood the area to stop bleeding, and heal damaged tissues.

PRP is a solution made by concentrating platelets, and growth factors to increase potency. Increased concentrations of platelets and growth factors boost the body’s repair mechanisms and shorten recovery. PRP harnesses the power of your body’s natural healing abilities to promote healing, and regenerate tissues that help you recover quickly.

How is PRP made?

A small amount of your blood is collected and prepared to separate the platelets from the other blood components. The concentrated platelets and growth factors are

combined with the remaining blood and local anesthetic, for your comfort.

The PRP Procedure

The PRP solution is injected in to the injured area, often under ultrasound guidance. The activated growth factors stimulate the release of repair cells to accelerate the healing process and provide symptom relief.

Side effects are minimal and may include pain at the site of injection that can last for a few hours or days and swelling that resolves within a few days. After treatment a patient will be advised to rest and avoid exercise for a time.

Generally, it can take up to a month to experience pain relief which will improve over the course of 3-6 months after treatment. However, the recovery period is determined by the type and severity of injury.

PRP therapy offers pain relief without the risks of surgery, anesthesia, and a long recovery. In some cases, PRP therapy is an alternative to surgery; and in some cases, it is used during surgery.

PRP therapy stimulates and accelerates tissue repair and healing, without invasive procedures and the associated risks. PRP therapy may significantly improve your function and quality of life, so you can get back to the life you love.

Is PRP therapy safe?

PRP therapy is very safe. It is not a drug. Because it is made from your own blood and injected into the site of your injury or degeneration, there is no risk of adverse reaction, or disease transmission.

How does PRP work?

PRP injections soak injured cells in the concentrated plasma and the numerous growth factors to enhance one or more phases of bone and soft tissue healing. PRP also enhances proliferation of stem cells and fibroblasts to boost healing and regeneration of damaged tissues.

Studies show that the increased concentration of growth factors catalyze the body’s repair mechanisms and shorten recovery time.

Benefits of PRP Therapy

PRP therapy reduces inflammation, relieves pain, promotes repair, increases collagen production for firmer and more resilient cartilage, enhances blood flow to deliver nutrients that support healing, and recruits and supports stem cells to regenerate tissues. PRP restores normal healing mechanisms and accelerates repair of damaged tissues.

The result is improved pain relief without the risks of cortisone injections, surgery, anesthesia, and a long recovery. Most patients can resume their work and activities immediately after treatment. In some cases, PRP therapy is an alternative to surgery.

Side effects are minimal and may include pain at the site of injection that usually lasts for a few hours and swelling that resolves within a few days.

Is PRP right for me?

When conservative methods fail to relieve pain and restore function, PRP therapy can help you heal with minimal scarring and halt tissue degeneration. It is a fast, painless procedure that takes just a few hours from start to finish.

Our physicians are specially trained in the procedures and preparation of PRP. Physicians Rehabilitation has locations in Fort Myers, Lady Lake, Naples, Port Charlotte and Sun City Center Florida for convenient, high-quality specialized sports-medicine and orthopedic services. Contact us to learn about how PRP therapy can benefit you.

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References

• Sengodan VC, et al. Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma. J Clin Imaging Sci. 2017 Aug 14; 7:32.
• Vavken P, et al. Platelet -Rich Plasma Retear Rates After Arthroscopic Repair of Small- and Medium -Sized Rotator Cuff Tears but is not Cost-effective. Am J Sports Med. 2015 Dec;43(12):3071-6.
• Molly M, et al. Effects of Platelet-rich Plasma and Indomethacin on Biomechanics of Rotator Cuff Repair. Am J Orthop. 2017 November;46(6): E336-E343