T Nation

PRP vs. Cortisone for Tendonitis (Supraspinatus)


I have been skimming lots of the PRP threads but many of them are older. Have PRP cocktails been improving I would hope and does anyone have recent experience, or those who are in sports medicine have opinions?

Also I do not seem to have a tear, just tendonitis. Many threads are people with tears trying to avoid surgery which is not the case with me. Doc did not even think it was worth doing an MRI because my strength is pretty good all around the various tests they do, and my pain is not so bad (its the worst when sleeping). He said he can do an ultrasound and it will show if there perhaps are any minor tears, and the ultrasound will guide him in injecting either cortisone or PRP. Pros of cortisone he said are it will work much faster plus insurance covers it. Says since its in the tendon and not the joint it will not do anything negative so not to worry. PRP will take longer and cost $450.

A little over two months ago I started a new workout, and it included some “heel claps” that involve grabbing the chin up bar with your hands facing inwards, thumb on one hand touching pinky on other so that both your shoulders are internally rotated (not sure how to describe the grip, in the old days we called it commando grip). Then invert yourself and clap your feet together over the bar. I am assumiing that is what made my shoulder hurt the next day right in front (presumably the bicep tendon). Being 245 it probably was not a good idea to go inverted with that grip with my shoulder bearing all that weight. Next day the pain started…

I did a lot of high rep upper body stuff the next few weeks thinking that would help it chill out and all it did was irritate it. So I started getting ART, deep tissue massage, and acupuncture while backing off bench and overhead pressing. In about 3 weeks it started feeling better, so I first went back to bench only using close grip, in a few weeks kept feeling better (while keeping up with ART, massage, acupuncture), so I kept going up in weight on close grip bench and was getting pretty damn strong (repping 315 going very slow and controlled). Next I went back to overhead pressing with KBs going light weight higher rep. Felt good for a few weeks so I added in high pulls and basically right when it was about to be healed up probably jumped back in the game too soon – and then rather than the front of my shoulder hurting it started hurting/aching down the middle of the deltoid. It clicks and feels crunchy and achy, and again mainly when I am sleeping. Even hurts gripping the bar on squats now so started using the safety squat bar.

Since it has been over two months dealing with this dang thing I finally decided to see an ortho…and two different doctors in the office ran me through the ringer with tests and felt like it was safe to say nothing is torn just bad tendonitis. X-Rays surprised me in that they did not show any arthritis and all the “gaps” they said look good in my shoulder joint area. So basically said I could speed things up with cortisone or PRP along with PT or just lay off it and do PT for a while. Like many on here I am sure, just laying off and quitting upper body workouts is hard.

I am very tight upper body wise and have been told I likely get shoulder issues at times because my neck, back and hips are so tight. I am half tempted if I get PRP shot and have to lay off workouts for a while, to also try rolfing if I can swing it financially and while the shoulder is healing let someone tear up my neck, back and hips to see if it helps and I can get some flexibility and mobility going on with my tight upper body. I have massive traps and super tight shoulders, even before this pain crept up on me I was not able to do half the moves and stretches in yoga class that they do with the upper body.

Any opinions on cortisone vs PRP, and possibly doing rolfing afterwards to improve the situation I am all ears. Or lay off lifting and keep up with ART and acupuncture and see if it resolves itself before getting any injections?


More reading and speaking to friends in sports medicine, I am passing on cortisone. Not like I am a college or pro athlete and need to get back fast, and it does seem like there is potential for weakening the tendon. Also without an MRI, lots of people say tendonitis is too easily diagnosed when it could be tendonosis.

PRP I get feedback from friends go for it as it worked for them…I just do not know if its worth the money as I am not rolling in disposable income. Wondering if Rolfing would finally be worth a shot in addition to continuing acupuncture, deep tissue massage, and ART. Thankfully my insurance covers acupuncture, deep tissue, and ART so it really is not that expensive for me. The Rolfing would just be the big investment. Plus will start PT soon…

Curious if anyone with shoulder tendonitis/tendonosis tried PRP or rolfing…and the old sled dragging articles from Dave Tate says those Westside guys did lots of front and rear raises high rep on sled pulls that helped nagging shoulders…but I also read that slow, controlled eccentric lifts can help strengthen tendons. And when it comes to PT some say do the old school rotator cuff exercises, other articles say work more on mobility of the entire upper/mid back, neck, traps, and both shoulders not just the injured one…confusing!