SPORTS SHOULDER INJURY
Ross Hauser, M.D. Marion Hauser, M.S.,R.D.

Shoulder pain is a common problem amongst both serious and recreational athletes. Chronic instability, rotator cuff tendinitis, impingement syndrome, AC joint separations can each be effectively treated by Prolotherapy. 

Prolotherapy has many advantages over surgery, including less rehabilitation time, cost, and the fact that it gets at the root cause of the athlete's problem, which is tendon or ligament weakness. 

Flaws with Rotator Cuff Surgery
A study done at the Mayo Clinic in 1997 by Dr. Mansat and colleagues reported a complication rate of 38 percent in shoulders undergoing rotator cuff repair. In order of frequency, the complications of the surgery were frozen shoulder, deep infection, and dislocation. Many of these patients who developed frozen shoulder had undergone a second surgical procedure to remove the adhesions. 

Rotator Cuff Tendinitis and Impingement
Syndrome Rotator cuff tendinitis occurs when the small muscles of the rotator cuff become strained causing weakness of these structures and subsequent tendinitis. Pitchers, quarterbacks, tennis players (serving), and swimmers are prone to rotator cuff tendinitis and impingement syndrome because they perform a lot of overhead movements which is when the rotator cuff is in its most vulnerable in this position. 

Impingement syndrome occurs when the rotator cuff tendon becomes pinched between the humeral head and the overhanging acromion process when the arm is raised above the head. This happens when the space becomes narrowed, as occurs when the rotator cuff muscles weaken and the humeral head rides high in the socket or when bone spurs and calcium deposits narrow the space. Impingement also occurs when the contents of the subacromial space increase in size, most often due to a swollen rotator cuff tendon or bursa, which is painfully squeezed between the humeral head and the acromion process. 

Common treatment for rotator cuff tendinitis and impingement syndrome by traditional medical doctors includes rest, non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and cortisone injections into the subacromial space. Because a cortisone injection has very strong anti-inflammatory properties, it may reduce the swelling in the tendon and bursa, relieving the symptoms. These treatments may temporarily help, but since the underlying cause has not been addressed the problem invariably returns. Degenerative fraying and tearing of the tendon may occur if constant irritation of the tendon occurs from the impingement process over time. The best way to treat this unresolved process is with Prolotherapy injections to the ligaments and tendinous insertions of the rotator cuff and deltoid. This, combined with gradual re-strengthening of the rotator cuff muscles, give an excellent chance for a full recovery and performance.