Partial Tear in Subscapuleris Tendon (Rotator Cuff) - PRP Injection

Hey all!

Thought I'd share my injury saga in case any one is debating on surgery vs PT vs other options for a Subscapuleris Tendon tear in the Rotator Cuff. I have had a partial tear in mine for the better part of 2+ years, and have done LOTS of PT. I've seen some improvement, and was actually able to have the best season of my life this year, but a recent MRI showed no real healing in the tear itself. I think I just strengthed everything else around it so much that I was able to climb through it without noticing it. 

That being said, it's still torn, it still hurts and limits my climbing, and so my options from here are surgery or a PRP injection. I went with the PRP, and now I'm monitoring it to see what happens. Has anyone tried PRP for Rotator Cuff, climber's elbow or other tendon issues? I'm on day 5 and it hurts more than ever, but apparently that's a good thing. They say 3 months is the timeframe for getting the full benefit. 

Michael L wrote:

I've seen some improvement, and was actually able to have the best season of my life this year, but a recent MRI showed no real healing in the tear itself. I think I just strengthed everything else around it so much that I was able to climb through it without noticing it. 

This sounds like a great outcome. I'm puzzled as to why you're thinking of doing anything different. I'd carry on with what you are currently doing. I'd certainly avoid surgery and only try PRP if someone else is paying for it. 

If reading mountain project is anything to go by, US medicine appears to be obsessed with treating the scan result and not the person. This is unfortunate. Pain and disability are only very loosely related to the degree of tear: many people have tears that are completely asymptomatic.  If you're climbing the best you ever have and seem to not be too troubled by pain (life is not supposed to be completely pain-free) what do you expect to achieve with more invasive procedures?

Hey Michael, thanks for this thread. I know it been a bit but I'm curious to hear how about your experience. I got a PRP shot for a partial tear of my supraspinatus about a week ago and it has been way more debilitating than expected and one of the most painful experiences I've had. I couldn't move my elbow from my side for two days and it was another two or three before I could raise my hand above my head. Now, a few day after that, I have quite a bit more mobility but still lots of pain.

I have a followup scheduled another week from now but I'm curious how you fared ultimately. How soon after the shot were you able to get back to climbing?

Thanks much and I hope you're well.

Hey Shelton

If I remember correctly I took two months off. Probably more like one and a half, but yeah I rested for quite a bit. I started back with very limited and easy climbing, as well as pt. 

These days my shoulder feels ok, still definitely my weakest link, and without getting another MRI I am certain it's still torn. I pretty much have to climb around my injury and avoid specific moves that aggravate it, but overall I'm climbing very well relatively to my own personal history. Sometimes it flares up and bothers me, but sometimes I don't notice it at all!

Best of luck!

Shelton Hatfield wrote:

Hey Michael, thanks for this thread. I know it been a bit but I'm curious to hear how about your experience. I got a PRP shot for a partial tear of my supraspinatus about a week ago and it has been way more debilitating than expected and one of the most painful experiences I've had. I couldn't move my elbow from my side for two days and it was another two or three before I could raise my hand above my head. Now, a few day after that, I have quite a bit more mobility but still lots of pain.

I have a followup scheduled another week from now but I'm curious how you fared ultimately. How soon after the shot were you able to get back to climbing?

Thanks much and I hope you're well.

I have been getting PRP injections into shoulders, elbows, fingers, knee and ankle for several years now. Upto 10 injections at a time annually. I have tears and tendenosis in many tendons including both supra and infra. Just had a shot into the longus tendon in my foot.

The level of pain after the injection depends on the concentration- I was getting 16 x into tendons but that was just too sore and has been dialled back to 12 x. It is important to give it at least 1 month  before full loading . Even longer is better. Because my tears and tendonopathies are so advanced a true cure is not feasible. However my elbows don’t hurt anymore and my shoulders have intermittent pain but do not prevent me sleeping on my side. So I say it is a win. I get to continue climbing on weekends and holidays. Just had 3 weeks daily climbing and I am still ok.

The pain for the first few days po injection can be immense. I could barely move - on day 3 I usually get on an indoor bike and ride for 2 hours to flush the toxins from the system and this helps a lot.

while I get PRP annually I do also get proletherapy injections into shoulders particularly the torn supraspinatus.(it is torn internally about 1/3 wide and 50% thick on both sides) . If I gave up climbing I would be healed but of course I can’t. I get MRIs regularly and can tell that it has not healed but it has not gotten worse and I can continue to climb at my max level for years now 

good luck 

Michael L wrote:

Hey all!

 Has anyone tried PRP for Rotator Cuff, climber's elbow or other tendon issues?  

I tried PRP as a last-ditch treatment before elbow surgery. It did nothing.

Surgical repair was effective.

I just had surgery 12/4 for a full supraspinatus tear (MRI said partial but doc saw differently). I went to see Dr Hackett at the Steadman Clinic in Vail, CO at the recommendation of a well-respected, long time climber. Hackett is a climber himself and THE GUY to see for shoulder and elbow issues if you’re a climber. He just gets it. I’d pulled the research on PRP and stem cells, hoping for an alternative to surgery. Hackett shot that plan down immediately. There’s no evidence at all that PRP or stem cells would heal a tendon tear so don’t waste your money. I had a pinch in my shoulder and not really pain, but that side was noticeable weaker despite months of intense PT so I went through with surgery. Hackett did say there’s evidence that stem cells can help in conjunction with surgery but not as a stand alone option. I’d absolutely trust him since he and his team have seven NIH grants studying stem cells.

Elbow issues are a different story since medial and lateral epicondylitis, from what I understand, are just angry tendons and not torn tendons like in the rotator cuff

3 weeks ago I partially tore my subscapularis falling on ice and the MRI indicated no need for surgery according to the ortho who saw me. My PT cleared me for climbing as long as I was careful to avoid painful or weak movements. Given the long downtime involved in surgery and rehab, I'd as soon avoid that but time will tell obviously. I have fairly decent shoulder ROM and strength through most of that ROM so I am hoping a non-surgical rehab will be feasible. But still, a lot of unknowns there.

I have an old supraspinatus tear (old weight lifting tear from 20 years ago).  It has just started bothering me while climbing and my ortho PT recommended PRP as a cortisone injection did not do much.  I'm a borderline surgery candidate so not interested in any invasive surgery.  I have not been able to find any compelling data on PRP so decided to manage mine with exercise and Celebrex when it flares up.  The older I get (now 51) I realize that pain comes with the territory and I need to manage it as conservatively as possible.