Rotator Cuff Injuries

The rotator cuff is a group of muscles and tendons that helps lift, rotate, and stabilize the shoulder. Rotator cuff injuries can range from tendon irritation or tendinopathy to partial-thickness and full-thickness tears. Symptoms can develop gradually from overuse or degeneration, or suddenly after a fall, lifting injury, or other trauma. The severity of a tear on imaging does not always match a person’s symptoms, so a thorough evaluation is important.

Common Symptoms

Treatment depends on the type and size of the injury, symptoms, shoulder function, activity demands, and imaging findings. Many people with tendinopathy or some partial tears improve with nonsurgical care.

Standard Treatment Categories

• Physical therapy and exercise: A guided program may improve shoulder strength, movement, and function.
• Activity modification: Adjusting painful movements and allowing time for recovery can help manage symptoms.
• Medication: Anti-inflammatory medication or other pain-management options may be considered when appropriate.
• Injections: Some people may discuss corticosteroid injections or other procedures for persistent symptoms.
• Orthopedic or surgical evaluation: Surgery may be considered for certain traumatic full-thickness tears, substantial weakness, or symptoms that have not improved with appropriate nonsurgical care.

Stem cell therapy for rotator cuff injuries and platelet-rich plasma, or PRP, are being studied because injectable biologic approaches may influence inflammation and the environment around injured rotator cuff tendons. Researchers are evaluating different cell sources, preparation methods, injection techniques, injury types, and rehabilitation plans. This research is contributing to the broader study of regenerative medicine for rotator cuff injuries.

What Researchers Are Studying

• Influence inflammatory signaling around injured tendon tissue
• Support the tendon environment and surrounding shoulder structures
• Be delivered safely and feasibly to the affected area
• Improve pain, shoulder function, range of motion, or other patient-reported outcomes

PRP and cell-based products are distinct approaches, and their preparation and delivery can vary. Research also needs to distinguish between improved symptoms and structural healing of a torn tendon.

Note: Regenerative therapies for rotator cuff injuries are not FDA-approved and are investigational. Results from one product, injection protocol, surgical procedure, or type of shoulder injury should not be assumed to apply to another.

How Stem Cell Therapy for Rotator Cuff Tears Is Being Studied

Cell-based therapies and biologic allografts are being investigated for their possible effects on inflammation and the tendon environment. Early studies are generally small and use different treatment methods, which makes direct comparison difficult. PRP is prepared from a person’s own blood and contains platelets and signaling proteins. PRP for rotator cuff tears is being studied both as a nonsurgical injection and as an addition during surgical repair. These are different uses of PRP, and findings from one should not be assumed to apply to the other.

2024: PRP Reported Better One-Year Pain and Function Outcomes Than Corticosteroid

Subacromial Injection of Platelet-Rich Plasma Provides Greater Improvement in Pain and Functional Outcomes Compared to Corticosteroids at 1-Year Follow-Up — Read Study

This randomized trial compared a subacromial PRP injection with corticosteroid injection for rotator cuff tendinopathy. At one year, the PRP group reported greater improvement in pain and shoulder-function outcomes. These results add to clinical research examining PRP injection as a potential option for improving symptoms and shoulder function in people with rotator cuff tendinopathy.

2024: PRP Used During Rotator Cuff Repair Was Associated With Lower Retear Rates

Arthroscopic Rotator Cuff Repair Combined With Platelet-Rich Plasma Reduces Retear Rate: A Meta-Analysis of Randomized Controlled Trials — Read Study

This meta-analysis included 21 randomized trials and 1,359 people undergoing arthroscopic rotator cuff repair. PRP was used during surgery, not as a nonsurgical injection. Retear rates were lower in the PRP groups than in the control groups, and some measures of pain and shoulder function also favored PRP. These findings highlight PRP’s potential role as an addition to surgical rotator cuff repair.

2024: Wharton’s Jelly Allograft Reported Short-Term Improvements in an Observational Study

Safety and Efficacy of Wharton’s Jelly Connective Tissue Allograft for Rotator Cuff Tears — Read Study

This retrospective observational study evaluated 87 people who received a Wharton’s Jelly connective-tissue allograft for shoulder and tendon conditions after conservative care had not provided enough relief. Participants reported improvement in pain and function through 90 days, and no adverse reactions were reported. The findings provide early clinical information on Wharton’s Jelly allografts and support continued research into their potential role in shoulder and tendon care.

2021: PRP Reported Greater Short-Term Pain Relief and Function

Platelet-Rich Plasma in Patients With Partial-Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and Function Compared With Corticosteroid Injection — Read Study

This double-blind randomized trial followed 99 people with imaging-confirmed partial-thickness rotator cuff tears or tendinopathy. Participants received an ultrasound-guided PRP or corticosteroid injection and completed assessments at baseline, six weeks, three months, and 12 months. At three months, the PRP group showed greater improvement in pain and shoulder-function scores than the corticosteroid group. The groups did not differ significantly at six weeks or 12 months, and there was no significant difference in treatment failure or later surgery.