12/01/2026
Michelle here from AcuPhysio.
Several years ago I asked Dr Leesa Galatz (leading shoulder surgeon in the US) what she thought about cortisone injections for shoulders.
Her answer was simple:
“Three maximum per joint per lifetime.”
Why?
Because while cortisone can reduce pain, it isn’t good for joint or tendon health long term.
In the shoulder, bursitis is very common on scans, often alongside rotator cuff damage.
Bursitis is usually a protective response to poor shoulder mechanics and muscle imbalance. The body inflames the bursa to protect the tendon from being overloaded or pinched.
Research shows repeated or high-dose cortisone:
• Weakens tendon structure
• Reduces collagen production
• Delays tissue healing
• Increases rotator cuff tear risk
It may provide short-term pain relief, but it can compromise long-term shoulder health.
📚 What the science shows
Corticosteroids suppress tendon cell activity and collagen production, reducing tendon strength (Khan 1999; Dean 2014).
They are linked with a higher risk of rotator cuff tears after injection (Roh 2012).
Steroids also cause deterioration in the mechanical strength of rotator cuff tendons, making them weaker and slower to heal (Dean 2014).
If you want a long-term solution for shoulder pain…. restoring movement, strength, load tolerance and tendon health is a better solution than numbing the problem.
💙If in doubt, talk to us before rushing for a cortisone injection; as we care about the future of your shoulder.
