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Bethesda, MD(301) 530-1010
Dr. Marc GrunerSports & Regenerative Medicine
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Shoulder Specialist

Shoulder pain specialist in Bethesda, MD

The short answer

Dr. Marc Gruner is an orthopedic shoulder specialist treating shoulder arthritis, rotator cuff tears, calcific tendonitis, and frozen shoulder without surgery. Care ranges from physical therapy to ultrasound-guided injections and orthobiologics like PRP and microfragmented fat — restoring shoulder function and relieving pain.

Medically reviewed by Marc Gruner, DO, MBA, RMSK
Sports medicine physician, Mayo Clinic fellowship. Last reviewed June 2026

Shoulder pain becomes more common with age, affecting the joint between the upper arm bone (humerus) and shoulder blade (scapula), as well as the rotator cuff tendons that stabilize it. Dr. Gruner combines a careful exam with point-of-care ultrasound to pinpoint the exact source of pain.

From physical therapy and precise, image-guided injections to advanced regenerative options such as Platelet-Rich Plasma (PRP) and microfragmented fat, Dr. Gruner offers comprehensive, non-surgical solutions to relieve pain and improve function — reserving surgery for when it's truly needed.

What is shoulder pain?

The shoulder is the most mobile joint in the body, which also makes it one of the most vulnerable. Shoulder pain can come from the ball-and-socket joint itself (arthritis), the four rotator cuff tendons that stabilize and lift the arm, the bursa that cushions those tendons, or the capsule surrounding the joint. Because so many structures sit in a small space, an accurate diagnosis is essential to effective treatment.

Pain may be felt deep in the joint, over the top or front of the shoulder, or radiating down the arm. It's often worse with overhead activity, reaching behind the back, or lying on that side at night.

What causes shoulder pain?

Common causes include rotator cuff tendinopathy and tears (from overuse or a fall), shoulder arthritis (age-related cartilage loss), calcific tendonitis (calcium deposits in the cuff), and frozen shoulder (adhesive capsulitis). Impingement, bursitis, and labral injuries can also contribute.

How is shoulder pain diagnosed and treated?

Dr. Gruner uses a focused exam and diagnostic ultrasound — which shows tendons moving in real time — to identify the exact problem, often avoiding the need for MRI. Most shoulder pain improves without surgery: targeted rotator cuff physical therapy, judicious cortisone injections, and ultrasound-guided orthobiologics (PRP for select partial tears, microfragmented fat for arthritis) form the foundation, with surgical referral reserved for large full-thickness tears or advanced arthritis.

Shoulder conditions we treat

Shoulder ArthritisAge-related cartilage loss in the shoulder causing pain, stiffness, and reduced motion.Rotator Cuff TearShoulder pain and weakness from injury to the rotator cuff tendons.Calcific Tendonitis of the Rotator CuffCalcium buildup in the rotator cuff causing sharp shoulder pain with movement.Frozen Shoulder (Adhesive Capsulitis)Painful, progressive shoulder stiffness from thickening of the joint capsule.

Treatments and procedures for the shoulder

OrthobiologicsPRPConcentrated platelets from your own blood, injected under ultrasound guidance to support healing in joints and tendons.OrthobiologicsMicrofragmented AdiposeA minimally processed sample of your own fat — microfragmented adipose tissue (MFat) — injected to cushion and support arthritic or injured joints.DiagnosticsMSK UltrasoundIn-office, real-time imaging of tendons, ligaments, nerves, and joints — no radiation — to pinpoint the source of pain.Office ProceduresTenexUltrasound-guided removal of damaged tendon tissue through a tiny opening — no open surgery.

Rehabilitation protocol

What to expect week by week after your procedure. Your plan is individualized; follow these alongside your physical therapist.

Shoulder — Ultrasound-Guided Lipogems / PRP Protocol
Download full protocol (PDF)

  1. Week 1

    Protect, reduce pain and swelling

    • Sling for 7 days; begin weaning after day 3
    • No lifting > 5 lbs; avoid overhead activity 2 weeks
    • Don't sleep on the procedure side
    • Begin gentle active ROM (pendulums) 4×/day

  2. Week 2

    Begin active range of motion

    • No lifting > 10 lbs; avoid overhead activity
    • Continue AROM and PROM
    • Begin isometrics and thoracic mobility
    • Stop any exercise if pain > 4/10

  3. Weeks 3–6

    Shoulder strengthening

    • May lift 10–20 lbs; avoid eccentrics
    • Continue active ROM
    • Progressive strengthening

  4. Weeks 6–12

    Return to sport

    • Activities as tolerated
    • Begin eccentric training/loading
    • Sport-specific exercises

Do not use NSAIDs (ibuprofen, Aleve, aspirin) for 4 weeks, and avoid ice for the first week — both blunt the healing response. Acetaminophen (Tylenol) is fine for discomfort. Care is tailored to you; use these guidelines with your physical therapist.

Frequently asked questions

What kind of doctor should I see for shoulder pain?
A sports medicine physician like Dr. Gruner can diagnose most shoulder problems at the point of care with ultrasound and treat them non-surgically — often avoiding a separate referral. Surgery is reserved for the minority of cases that require it.
Is shoulder pain at night a sign of a rotator cuff problem?
Often, yes. Night pain — especially when lying on the affected side — is a classic symptom of rotator cuff tendinopathy or tears, as well as shoulder arthritis. An ultrasound exam can quickly clarify the cause.

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