PRP for Shoulder Pain & Rotator Cuff

PRP can be effective for rotator cuff tendinopathy and partial-thickness tears in patients who haven't had surgery. The evidence is best for non-surgical rotator cuff problems — particularly chronic tendinopathy that has not responded to several months of physiotherapy. The evidence is more mixed for PRP as a surgical adjunct (combined with rotator cuff repair surgery). Your physician will review your MRI carefully and only recommend PRP when the clinical picture supports it.

PRP works best for tendinopathy and partial-thickness rotator cuff tears, where the tendon is damaged but not completely torn through. For full-thickness rotator cuff tears, particularly large or retracted tears, PRP alone is unlikely to be sufficient and surgical repair is often the better choice. We assess each patient individually based on imaging.

They work very differently. Cortisone gives quick anti-inflammatory pain relief but can weaken the tendon over time and the relief is temporary. PRP stimulates actual tendon healing — the relief takes longer to develop (2–6 weeks) but lasts much longer and addresses the underlying tissue damage rather than masking inflammation. Many patients turn to PRP after one or two cortisone injections have stopped working.

Most patients notice improvement within 4 to 8 weeks as the tendon healing progresses. Full benefit typically develops over 3 to 6 months. Tendon healing is slow — patience matters with PRP. Many patients continue to improve for up to a year after a treatment course.

The injection itself feels similar to a standard shoulder injection — most patients describe mild to moderate discomfort with local anesthetic to minimize pain. Recovery depends on the PRP concentration. Higher-concentration PRP produces a stronger healing response but more discomfort for up to 48 hours and a couple of weeks of activity restriction (no overhead lifting, sometimes a sling). Lower-concentration PRP usually means same-day return to most activities with mild soreness for 2–5 days. Your physician will recommend the right concentration at consultation.

Yes — and we encourage it. PRP works best alongside structured physiotherapy. We typically recommend a brief reduction in activity for the first 1–2 weeks after each injection to let the healing response take hold, then a return to physiotherapy. We're happy to coordinate directly with your physiotherapist.

For many patients with tendinopathy or small partial tears, yes — PRP can meaningfully delay or eliminate the need for surgery. For larger or full-thickness tears, especially in younger and more active patients, surgery may still be the better long-term option. We give every patient an honest assessment.

PRP is a private-pay procedure not covered by OHIP. Cost varies based on the concentration selected and ultrasound guidance is included on all shoulder PRP. Many extended-health benefit plans cover a portion under regenerative medicine, sports medicine or specialist injection benefits. We provide detailed receipts for insurance.