A portable imaging system for the on-site detection of shoulder injury is necessary to identify its extent and avoid its development to severe condition. Here, firstly a microwave tomography system is introduced using state-of-the-art numerical modeling and parallel computing for imaging different tissues in the shoulder. The results show that the proposed method is capable of accurately detecting and localizing rotator cuff tears of different size. In the next step, an efficient design in terms of computing time and complexity is proposed to detect the variations in the injured model with respect to the healthy model. The method is based on finite element discretization and uses parallel preconditioners from the domain decomposition method to accelerate computations. It is implemented using the open source FreeFEM software.