The rotator cuff is responsible for rotating and lifting the shoulder. It consists of the subscapularis, supraspinatus, infraspinatus, and teres minor. A rotator cuff tear occurs when any of these four tendons is torn by aging or trauma, causing shoulder pain and restricted range of motion. From the 30s-40s onward, degenerative changes begin in the tendons, weakening them until they tear. Once torn, tendons cannot heal on their own. If left untreated, the tear enlarges and can progress to complete tear or even arthritis, so it's best to visit a hospital promptly when pain develops.
Complete rotator cuff tears inevitably require surgical treatment, but partial tears can be sufficiently regenerated through non-surgical methods. For partial tears, treatment focuses on pain management and restoring range of motion while strengthening the surrounding shoulder muscles. Prolotherapy (ligament strengthening injections) can also promote ligament regeneration. For patients who have undergone prolonged conservative treatment or desire more aggressive treatment beyond prolotherapy, bone marrow stimulation regeneration therapy is also available.
Bone marrow stimulation involves identifying the damaged tendon under ultrasound guidance in cases of partial rotator cuff tears, then using a specialized needle to create multiple small holes in the shoulder bone to release bone marrow. Numerous bone marrow cells pour out from these holes, containing growth factor cells and regenerative cells that help heal damaged tissue. With no need for bone marrow harvesting, quick procedure time, and rapid return to daily life, many rotator cuff tear patients prefer bone marrow stimulation.
Not every rotator cuff tear requires immediate surgery. Non-surgical treatment should be attempted first. However, if the tear is larger than 3 cm (a massive tear) or if non-surgical treatment for 6-12 months hasn't relieved pain, surgical intervention may be necessary. Don't agonize over whether you need rotator cuff surgery — consider bone marrow stimulation to preserve your body's natural tissues while treating your shoulder.
