Platelet Rich Plasma (PRP)
Platelet-rich plasma (PRP) containing growth factors is being used more frequently in our practice for tendon irritations, tendinitis, and bursitis around the shoulder, knee, elbow, and ankle joints.
The procedure takes a small amount of a patient's blood, isolates the platelets, and injects them directly into the injured area, where they release growth factors and promote the body's natural healing response. Combined with physical therapy focusing on soft tissue mobilization and strengthening exercises has led to rapid healing in our hands.
The PRP has the benefit of stimulating the release of stem cells from vessel walls and activating them to form self-repair cells (progenitor) further augmenting repair.
Tendinitis is an inflammation, degeneration, or injury to the tendon, the structure in your body that connects muscle to bone. Tendinitis can lead to degeneration of the collagen fibers that make up the tendon. The chronic pain that develops with tendinitis has been successfully treated with soft tissue massage, stretching, icing, and careful exercises.
In the past, when tissues and joints were injured, the common treatment in similar circumstances was a cortisone injection. Cortisone is a steroid that inhibits protein metabolism so inflamed cells that are actively turning over are shut down. This effect reduces swelling and therefore pain. Unfortunately, it also reduces activity in normal cells and tissues and leads to weakening of the tissues and occasional tendon ruptures. Joints that are repeatedly injected with cortisone show damage to the articular cartilage surfaces, which protect the ends of bones. Rather than work to actively heal the damaged tissue, a cortisone injection unfortunately only serves to mask the injury, allowing the athlete to continue to play, often causing more damage.
Current treatment of soft tissue injuries in top-level athletes and weekend warriors may combine:
- Careful diagnosis to define the specific injury. If it does not require surgical repair such as a torn meniscus or ACL or rotator cuff then:
- Ice to relieve pain.
- Soft tissue massage and mobilization to reduce swelling and stimulate healing.
- Relative rest +/- bracing with careful exercise to stimulate healing and not increase injury.
- Injections with growth and bioactive factors to promote healing.
The use of acupuncture, electrical stimulation, ultrasound, and passive treatments vary by practitioners and patients and vary widely in success rates.
Bottom line: Soft tissue injury healing can be speeded up by excellent diagnosis and care.