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Condition overview · Orthopedics

Shoulder & rotator cuff

Shoulder pain spans rotator-cuff tendinopathy and partial tears, labral injuries, frozen shoulder, and glenohumeral arthritis. The biologic strategy is tuned to which tissue is involved and how chronic the problem is.

Rotator cuff tendinopathyPartial-thickness cuff tearsLabral injuriesFrozen shoulder (adhesive capsulitis)Glenohumeral arthritis

Therapies for this condition

Four options for the shoulder.

We choose between cellular therapy (marrow or adipose), PRP, and EPAT based on what's actually injured, a partial cuff tear, an arthritic joint, or a chronic tendinopathy each have a different best-fit biologic strategy.

01 · Cellular therapy

Bone marrow aspirate concentrate (BMAC)

MSC-containing · same-day · image-guided

A small volume of marrow is drawn from your iliac crest under local anesthesia, concentrated in our on-site lab, then delivered with ultrasound or fluoroscopic guidance to the target tissue.

  • Best fit when
  • Partial-thickness rotator cuff tears
  • Glenohumeral arthritis with cuff involvement
  • Failed prior PRP for cuff or joint
Read the full Bone marrow aspirate concentrate page →

02 · Platelet-rich plasma

Platelet-rich plasma (PRP)

Blood-derived · in-office · 60–90 min

Concentrated platelets and growth factors from your own blood, prepared in our lab and delivered into the target tissue under ultrasound guidance. The most-studied autologous biologic across orthopedic indications.

  • Best fit when
  • Rotator cuff tendinopathy (no full-thickness tear)
  • Mild-to-moderate glenohumeral arthritis
  • First-line biologic step before considering BMAC
Read the full Platelet-rich plasma page →

03 · Non-invasive pulse therapy

EPAT (Pulse Activation)

No needles · series of 3–6 sessions

Extracorporeal Pulse Activation Technology, non-invasive acoustic pulses delivered to tendons and entheses to stimulate microcirculation and repair signaling. Used alone or layered with PRP.

  • Best fit when
  • Chronic calcific tendinopathy
  • Adjunct before/after PRP for stubborn cuff pain
  • Patients preferring a non-injection option to start
Read the full EPAT page →

04 · Cellular therapy · adipose

Microfragmented adipose (mFAT)

Adipose-derived · same-day · image-guided

Your own fat, microfragmented in our on-site lab the same day and delivered into the joint under ultrasound guidance. Considered for the arthritic glenohumeral joint, where a fuller biologic and a cushioning scaffold help.

  • Best fit when
  • Glenohumeral (joint) osteoarthritis
  • Wanting to delay or avoid shoulder replacement
  • Wanting an autologous cell source beyond marrow
Read the full Microfragmented adipose page →

Is this you?

Find out if biologic therapy is the right next step for you.

A clear, condition-specific candidacy brief, so you can come to consultation already knowing where you stand and what to ask. If another path will serve you better, we'll point you to it.

Likely a good fit

  • Cuff pain or partial tear that has outlasted PT
  • Glenohumeral arthritis that hasn't yet reached replacement criteria
  • You're willing to follow a structured rehab plan for 12 weeks
  • You don't have a full-thickness retracted tear needing surgery