The shoulder has four tendons called the rotator cuff that help lift and move the arm freely forward, backward, sideways, and up and down. These four rotator cuff tendons each have specific functions, such as raising, lowering, internally rotating, or externally rotating the arm. Together, they maintain balance to keep the humerus properly positioned within the joint and prevent dislocation. When shoulder pain occurs, rotator cuff tears or damage account for approximately 80-90% of the causes. A rotator cuff tear refers to damage or tearing of one or more of the four shoulder tendons.
When the rotator cuff, which controls shoulder rotation and stability, is torn, initially mild pain gradually intensifies over time, with both the pain level and severity of the tear deepening. While rotator cuff tears are commonly associated with overuse or sudden force on the shoulder joint, aging-related degenerative changes are also a surprisingly common cause. As muscle strength weakens and blood circulation decreases, this shoulder condition is particularly problematic for middle-aged and elderly patients. The shoulder's complex structure has relatively little spare space, making it easily irritated and damaged by even minor impacts or injuries. Extra caution is especially needed for elderly patients.
Unlike other joints, the shoulder is the only body joint capable of 360-degree rotation, making it highly mobile. Once damage occurs, returning to a normal shoulder is very difficult, so treatment should begin promptly if shoulder tendon tear symptoms are present. Once a shoulder tendon tears, it's practically impossible to heal naturally. If left untreated, the torn tendon can curl inward into the joint, potentially making even surgical repair impossible in worst cases, requiring an artificial joint replacement. With neglected tears, the tendon gradually degenerates, meaning that even late surgery may not achieve 100% recovery. If shoulder pain occurs when lifting the arm, a thorough examination and treatment plan should be sought.
The hallmark symptoms of shoulder tendon tears include loss of shoulder strength and crackling or crepitus sounds. Severe shoulder pain occurs at certain angles when raising the arm to shoulder height. Night pain disturbing sleep and post-activity shoulder pain are also symptoms. Not all shoulder tendon tears require surgery, but the right treatment approach must be found for each patient. Among various treatments, 'bone marrow stimulation therapy' may be considered when conservative treatment hasn't improved symptoms or when the tear is somewhat too small for surgical repair.
Bone marrow stimulation therapy for shoulder tendon tears involves using ultrasound guidance to precisely identify the torn area, then creating multiple small holes in the shoulder bone beneath the rotator cuff using a special drill. When holes are drilled in the bone, numerous bone marrow cells emerge from within, containing autologous stem cells with various growth factors. These autologous stem cells cover and heal the damaged tendon, making this a non-surgical treatment method.
Bone marrow stimulation therapy for shoulder tendon tears doesn't require separate bone marrow harvesting and transplantation, making it convenient and less burdensome than arthroscopic surgery. Bone marrow stimulation therapy can be performed as a same-day procedure, and afterwards there are no significant activity restrictions or need for prolonged shoulder abduction brace wear, with a quick return to daily life. While surgery is necessary for large rotator cuff tears, in other cases, bone marrow stimulation therapy can treat shoulder tendon tears without surgery.
