Marc Darrow MD,JD

If you are like many golfers, sometimes you will continue to play golf with shoulder pain and finally seek medical attention when a) they can no longer play without pain, or b) when they can no longer drive through the ball at a velocity that they are accustomed to and the frustration of added strokes has made the game miserable for them.

Now how did that shoulder get painful? For most golfers it is a matter of overuse or poor technique, such as killing the ball. Sometimes a golfer will hit the ground too hard and cause an acute impact injury. Golfers are prone to the same shoulder injuries as other sports. The list includes:

  • Rotator cuff tears,
  • Shoulder impingement or Subacromial impingement, degenerative joint disease and shoulder joint instability.
  • SLAP tear
  • Shoulder subluxation or chronic dislocation
  • AC joint pain

A painful shoulder decreases club head velocity

A German study (1) suggested what you already knew, a painful shoulder decreases club head velocity. Of course they came to this conclusion after examining many golfers using various testing methods. Here is what the study said: “Joint structure damages due to overstrain often occur even in commonly not injury-prone golfing. Triggered by the golf swing’s repetitive movement pattern and technique deficits of the player these structural damages are most likely to affect the lumbar spine as well as shoulder and elbow joint. As a synonym for shoulder impingement symptoms in golfers the term golf shoulder has been established in medical terminology.”

The authors of this study suggest wear and tear strain and poor technique can impact not only the low back and elbow but cause shoulder impingement syndrome, further they state: “a persisting shoulder impingement syndrome can have a negative effect on club head velocity.” Reduced club head velocity adds strokes.

Although “impingement” refers specifically to pressure on the tendons and bursa in the shoulder, it is a generalized term often used to refer to shoulder pain of unknown origin. Other terms used to describe pain that cannot be pinpointed are tendinitis, tendinosis, and bursitis.

Shoulder Impingement Treatment

I see many people who play golf with shoulder pain, sometimes a severe shoulder pain. They complain about pain at the top of their shoulder, the side of their shoulder and when they extended their hands over their head during the swing. After playing a few rounds, they have a problem sleeping at night because of their shoulder pain.

If you have chronic shoulder pain affecting your game you have probably tried remedies and exercises including RICE (rest, ice, compression, and elevation) and self-medicating with anti-inflammatory medications that may have helped short-term, but did not help you play long-term.

When you got to the point where you may have to stop playing, this is when you decided to get medical care. Medical care may not have been to your likening. You may have not liked the suggest your doctor gave you to stop playing for a while to see if your shoulder heals on its own. You may have liked it worse when after a long bout of rest, you picked up a club, went through a swing and the same pain remained.

When you returned to your doctor after the rest period and want to try something else to help accelerate your healing you may have been told to go to physical therapy to see if that works. You can also try a cortisone injection.

Stem Cell Therapy for shoulder pain

As I mentioned above, once the pain is determined to come from the subacromial space of the shoulder, that is the area of the rotator cuff tendons and the subacromial bursa, then rotator cuff tendinopathy, (shoulder impingement) is often diagnosed. The impingement occurs when the Acromion’s underside, presses against the rotator cuff tendons, wear and tearing at them. When a patient comes into our office we will perform a detailed physical examination of the shoulder looking for pain generators. Spots on the shoulder that elicit a pain response when pressed. Typically these are the spots of damage.

In our practice, Stem Cell Therapy is a treatment for musculoskeletal disorders. We treat degenerative joint disease, degenerative disc disease of the spine, and tendon and ligament injury. We offer stem cells drawn from patient’s own bone marrow. Stem cells are “de-differentiated pluripotent” cells, which means that they continue to divide to create more stem cells; these eventually “morph” into the tissue needing repair — for our purposes, collagen, bone, and cartilage.

By isolating the areas that are damaged and injecting these spots with stem cells we can be confident that healing can occur. The connection between Subacromial impingement of the rotator cuff and the development of rotator cuff tendinopathy is clear. In many patients we see the impingement and the tendinopathy are only parts and contributing factors to shoulder pain.

Bone Marrow aspirated stem cells injected into the shoulder

This is pointed out in our research which appears in the peer-reviewed journal Cogent Medicine. The study can be found here in its entirety: Treatment of shoulder osteoarthritis and rotator cuff tears with bone marrow concentrate and whole bone marrow injections with a June 20, 2019 publication date.

Here we were able to demonstrate that:

  • Patients with rotator cuff tendinopathy and degenerative shoulder disease would benefit from either one and two stem cell treatments. Patients reported significant improvements in resting pain, active pain, and functionality score when compared to baseline.
  • These groups also experienced a 42.25% and 50.17% overall improvement respectively.
  • The group that received two treatments experienced statistically significant improvements in active pain when compared to the group that received one injection.
  • There were no significant outcome differences between rotator cuff tear and osteoarthritis patients.

Conclusions: Our study demonstrated that patients diagnosed with shoulder osteoarthritis or rotator cuff tears experienced symptomatic improvements in pain and functionality when injected with bone marrow concentrate (BMC) or whole bone marrow (WBM). Further randomized control studies are needed to validate these findings.

Do you have questions about your shoulder pain? Ask Dr. Darrow

Marc Darrow, MD., JD. is the medical director and founder of the Darrow Stem Cell Institute in Los Angeles, California. With over 23 years experience in regenerative medicine techniques and the treatment of thousands of patients, Dr. Darrow is considered a leading pioneer in the non-surgical treatment of degenerative Musculoskeletal Disorders and sports related injuries.

A leading provider of stem cell therapy, platelet rich plasma and prolotherapy
11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025

PHONE: (800) 300-9300 or 310-231-7000

Stem cell and PRP injections for musculoskeletal conditions are not FDA approved. We do not treat disease. We do not offer IV treatments. There are no guarantees that this treatment will help you. Prior to our treatment, seek advice from your medical physician. Neither Dr. Darrow, nor any associate, offer medical advice from this transmission. This information is offered for educational purposes only. The transmission of this information does not create a physician-patient relationship between you and Dr. Darrow or any associate. We do not guarantee the accuracy, completeness, usefulness or adequacy of any resource, information, product, or process available from this transmission. We cannot be responsible for the receipt of your email since spam filters and servers often block their receipt. If you have a medical issue, please call our office. If you have a medical emergency, please call 911.

References

1 Ostreicher M, Schwarz M. Relation between shoulder impingement syndrome and club head velocity in high-performance amateur golfers. Sportverletzung Sportschaden: Organ der Gesellschaft fur Orthopadisch-traumatologische Sportmedizin. 2013 May 27;27(2):108-11. — 1243

 

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