Rotator Cuff
Rotator Cuff Treatment That Finds the Root Cause
Reaching for the top shelf. Swimming laps or swinging a racquet. Sleeping on your favorite side. A sore rotator cuff turns everyday motions into negotiations, and a cortisone shot only buys a few quiet weeks. Dr. Ilana Etelzon finds what is keeping your shoulder from healing and treats that, so you can use your arm freely again without rushing into surgery.
Double Board-Certified
Regenexx-Certified Provider
Ultrasound Guided
4 Offices in NY & NJ
Why it still hurts
The tear on your MRI is only part of the picture
Your rotator cuff is a group of four muscles and their tendons that keep the ball of your upper arm centered in the shoulder socket. With age and repetitive use, those tendons can fray, thicken, and tear, and rotator cuff problems are one of the most common reasons adults over 40 seek care for shoulder pain. What surprises most people is this: a large screening study of the general population found that many rotator cuff tears cause no pain at all. A tear on your MRI tells you something happened. It does not explain why your shoulder still hurts.
Pain usually comes from the tissue around the tear: a tendon that never finished healing, an inflamed bursa above it, a shoulder blade that has stopped moving well, or a neck that is sending pain down the arm. Treatment aimed only at the tear, or only at the pain, often leaves the real driver in place.
Pain that keeps coming back has a reason. Finding it comes first.
The root causes
Six things that drive rotator cuff pain
Most painful shoulders have more than one of these at work at the same time. That is why rest and a single shot rarely settle things for long, and why your plan should match your own mix.
1
A tendon that never finished healing
Repeated strain creates small areas of breakdown, called tendinosis, that the body stops repairing on its own. The tendon stays weak and sore with use.
2
A partial or full-thickness tear
Fibers of the tendon pull apart, from a fall or slowly over years. Many partial tears respond well to regenerative care placed right at the damaged area.
3
An inflamed bursa
The bursa is a small fluid sac above the rotator cuff. When it swells, raising your arm pinches it and causes that sharp pain partway up.
4
A shoulder blade that moves poorly
When the muscles around the shoulder blade weaken, the ball rides higher in the socket and the tendons get squeezed with every reach.
5
A stiff or worn joint
Arthritis in the shoulder, or in the small joint on top of it, plus a tight joint capsule changes how the shoulder moves and loads the tendons.
6
Pain coming from the neck
A pinched nerve in the neck can send pain into the shoulder and upper arm, and it is easy to mistake for a rotator cuff problem.
Step one: Reveal
How Dr. Etelzon finds what is driving your shoulder pain
Your first visit is built around one question: what is keeping this shoulder from healing? Dr. Etelzon answers it with the same careful steps every time.
- Your storyHow it started, which motions hurt, what you have already tried, and what you want to get back to.
- A hands-on examShe tests the strength of each rotator cuff muscle, your range of motion, how your shoulder blade moves, and your neck.
- Ultrasound in the roomIn-office ultrasound shows the tendons, the bursa, and any tear in real time, while you move your arm.
- Your imaging, read closelyShe reviews your X-ray and MRI and matches what they show to what she finds on exam.
You leave knowing which drivers are at work in your shoulder and what each part of your plan is for.
Reveal
Find every driver
Diagnose all the sources of pain before treating any of them.
Repair
Treat the tissue
Image-guided regenerative care aimed at the damaged structures.
Restore
Rebuild control
Strength and movement work so the area holds up under load.
Renew
Get back to life
Return to your activities and stay there.
Step two: Repair
Treatment matched to what is actually wrong
Once the drivers are clear, Dr. Etelzon chooses treatments that aim at them directly. Every injection is placed under ultrasound guidance, so it reaches the exact tendon fibers that need it.
PRP Injections
Concentrated platelets from your own blood, placed into a frayed or partially torn tendon to restart the healing process your body stalled on.
Learn about PRP injections ›Bone Marrow Concentrate
Cells drawn from your own bone marrow, used for larger partial tears and tendons that need more support to repair.
Learn about stem cell injections ›Regenexx Protocols
Dr. Etelzon is a certified Regenexx provider, so your injections follow tested, standardized protocols used across a national network of physicians.
Learn about Regenexx ›MLS Laser Therapy
A focused laser that calms inflammation in the tendon and bursa. It is often paired with injections so the shoulder settles faster.
Learn about MLS laser therapy ›Shockwave Therapy
Acoustic waves that boost blood flow to stubborn tendon pain and calcium deposits in the rotator cuff.
Learn about shockwave therapy ›Strength and Movement Plan
Exercises that rebuild the rotator cuff and the muscles around the shoulder blade, so the tendon stays protected once it heals.
See our regenerative procedures ›Where cortisone fits
Cortisone can calm an inflamed bursa for a few weeks, and it has a place. A large review of tendon injections in The Lancet found that cortisone relief often fades and pain tends to return, so Dr. Etelzon uses it sparingly. When a tear is large and the shoulder has lost real strength, she will tell you if surgery is the better path.
Every type
What can help, from strain to tear
Rotator cuff problems range from a sore, irritated tendon to a full tear. The type guides the plan, and your drivers decide it.
Irritated tendon
Tendinitis and tendinosis
Pain with reaching and lifting, with no tear. PRP, shockwave, laser therapy, and a strength plan often calm the tendon and help it heal for good.
Partial tear
Partial-thickness tears
Some fibers are torn. This is where regenerative care shines. PRP or bone marrow concentrate placed right into the tear can help it fill in and strengthen.
Full tear
Full-thickness tears
The tendon is torn through. Some smaller full tears still respond well, especially in people who have kept their strength. When a large retracted tear needs surgery, Dr. Etelzon will tell you so.
An honest note. Regenerative care helps damaged tendon heal and get stronger. It cannot reattach a tendon that has pulled far away from the bone.
Results
Outcomes tracked across the Regenexx network
Regenexx collects patient-reported outcomes from certified clinics across the country. Explore the live results below.
Like all medical procedures, regenerative procedures have a success and failure rate. Individual results vary.
Step four: Renew
Back to the things your shoulders are for
Patients come to us wanting specific things back: swimming laps, a full golf swing, lifting a grandchild overhead, sleeping through the night on their favorite side. That is what we treat toward.
Back in the pool
A full swing again
Your first visit
What to expect, and what it costs
Your first visit is a consultation with Dr. Etelzon: your history, a hands-on exam, ultrasound, and a review of your imaging. Bring any shoulder X-rays or MRIs you have. If treatment makes sense, you leave with a written plan and a clear price before anything is scheduled.
Most regenerative procedures, including PRP and bone marrow concentrate, are not covered by insurance. Many patients use HSA or FSA funds, and monthly financing is available. See our payment and financing options.
Find us
Rotator cuff treatment across New York and New Jersey
Dr. Etelzon and her team treat shoulder pain at four offices, so care is close to where you live and work.
New York
Brooklyn
2577 East 17th Street, 1st Floor Unit 18B, Brooklyn, NY 11235Brooklyn office › New JerseyClifton
1111 Paulison Ave, Unit 2, Clifton, NJ 07011Clifton office › New JerseyNewark
73-75 Ferry St, Newark, NJ 07105Newark office › New JerseyPerth Amboy
345 State St, Unit B, Perth Amboy, NJ 08861Perth Amboy office ›Call 1 (844) 959-7246 to reach any office.
Keep reading
More on shoulder pain and regenerative care
References
- Minagawa H, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village. Journal of Orthopaedics. 2013;10(1):8-12.
- Centeno C, et al. A randomized controlled trial of the treatment of rotator cuff tears with bone marrow concentrate and platelet products compared to exercise therapy: a midterm analysis. Stem Cells International. 2020.
- Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet. 2010;376(9754):1751-1767.
Find out what is driving your shoulder pain
One visit, a clear answer, and a plan built around your shoulder and the life you want back. This is where the trying stops.