Prolotherapy and PRP for Rotator Cuff Injury

Question: Dr. Dan, what natural treatment do you recommend for a rotator cuff injury? Is surgery the best option for rotator cuff tears?

Whenever you’re considering surgery for a rotator cuff injury, consider its fairly high failure rate. According to the American Academy of Orthopedic Surgeons, anywhere from 19 to 57 percent of rotator cuff tears repaired with surgery re-tear within six months. So I encourage you to consider alternative treatments before surgery for a rotator cuff injury. Today, I believe prolotherapy and platelet rich plasma treatments, or PRP, are the best natural treatments for your rotator cuff injury.

What causes a rotator cuff injury?

Realize that you use your shoulders all the time. Because of that, it’s very easy and common to injure the shoulder and rotator cuff. A rotator cuff injury can happen when you fall and catch yourself, when you sleep on your side, when you workout without properly warming up, when you carry the groceries, or even lift your kids. There are many seemingly innocuous activities that over time damage and weaken your rotator cuff.

But even if you don’t strain or injure the rotator cuff directly, you can injure the ligaments in and around your shoulder. Think of your ligaments as the rubber bands that hold your bones together. When you injure the ligaments, you create a little bit of joint play, or loosen those rubber bands. This results in your shoulder joint being a little looser and floppier than it should be, causing your muscles and tendons to work harder to keep your shoulder joint in place. As your muscles and tendons put more tension on themselves, they become very tight, and you set up yourself up for a shoulder or rotator cuff injury.

What makes a shoulder or rotator cuff injury difficult to heal is the fairly poor blood supply to the area, which only gets worse as you age. This slowed blood flow to the shoulder gives any injuries you have minimal chance of healing on their own. To naturally heal your rotator cuff injury, help your body help itself by increasing blood flow to the area, maintain joint mobility during the healing process, and stimulating your body to lay down new, healthy tissue.

Prolotherapy & PRP for rotator cuff injury

Prolotherapy and PRP treatments are part of the increasingly promising field of regenerative medicine. Prolotherapy and platelet-rich plasma injections, or PRP, are one of the most effective treatments for a rotator cuff injury or shoulder injury. These injections naturally stimulate your body’s inflammatory response by creating minor tissue damage. In the case of your rotator cuff injury, prolotherapy kick starts your body to remove the damaged tissue inside the rotator cuff, and lay down new, healthy soft tissue.

Depending on the degree of injury, you may need to repeat prolotherapy and PRP treatments 2, 3, or 4 times, but we continue to see outstanding results with rotator cuff tears, labral tears, and other types of damage and injury to the shoulder, often mitigating the need for surgery.

Holistic approach to healing your shoulder

To properly heal your shoulder injury, I encourage you to realize it does require a holistic approach that extends beyond treatments in the doctor’s office. Be mindful of your diet, your sleep and activity levels, and your stress levels.

When undergoing prolotherapy and PRP injections, also consider osteopathic manipulation, functional medicine, acupuncture, and nutritional medicine. Good nutrition will give your body the resources it requires to come in for the repair process; acupuncture will help with trigger points and pain, and osteopathic manipulation will maintain joint mobility as your body is laying down new, healthy tissue. Only when you are sure this approach will not be effective for your rotator cuff injury should you consider surgery. Good luck!


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Dr. Dan Williams is an internationally trained doctor of osteopathic medicine (DO) and a certified acupuncture practitioner. Dr. Dan is based out of Indianapolis. You can find more information by visiting

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