Sunday, October 23, 2016

Platelet rich plasma injections #1

I had my first lot of PRP injections on Thursday. It's a pretty straight forward process. I donated some blood to create the PRP. The affected region was visualised using ultrasound to identify the best position to inject the PRP. Local anaethestic was injected into the skin to reduce the discomfort from the needle used to inject the PRP. Appropriate aseptic technique was used and with ultrasound guidance, the PRP was injected into the hamstring tendons (both legs). The procedure was only mildly uncomfortable and there is a bit of residual soreness in the injection sites. Slow walking at present involves some minor discomfort. The recommendations vary between doctors. At this stage it is best to limit activities for the first week following the injections. Gentle walking is okay, but no more than that. Maybe after that week it will be okay to try a short gentle bike ride. In 3 weeks time I go back for a second round of injections and repeat the process.
It is difficult to know how long the recovery will take. It is important to continue with the exercise programme, which will be with me for the remainder of my active life. The hamstrings will always need to be nursed and kept strong. Similarly core, glutes and hip muscles need to be performing at their best to take the strain off the hamstrings. No opportunity to slack off. In the meantime I'll report back again after the next round of injections.

A nice review about the role of platelets in tissue repair is found HERE.

Tuesday, October 4, 2016

Looking for alternatives #2

Strengthening exercises and appropriate rest are the hallmarks of therapy for high hamstring tendinopathy. For some rest is simply reducing what they are doing to what they can tolerate. For others it means stopping all together as there is no tolerable level. Sadly I fall into the latter category. The question remains, are rest and exercises the best option for healing a chronically degenerative tendon? Is such a tendon capable of healing to a point where it can function normally again? There are other treatment options and one includes injection of platelet rich plasma (PRP) into the damaged tendon. Platelets are full of growth factors and cytokines to promote healing of damaged blood vessels. There is some evidence those growth factors and cytokines help other tissues heal as well. As such doctors have been using PRP to treat tendinopathies. The results are mixed. For some there is an obvious benefit, for others not so obvious.

As it turns out, I have a soft spot for platelets as my PhD focused on horse platelets. Today I spoke with a sports medicine doctor about going down the PRP path to try and boost tendon healing. Despite rest and all the appropriate exercises, the hammies are still pretty niggly. The doctor thinks it is worth trying given the chronicity of my problem. The injections can leave you a bit sore for a few days, so I'm waiting a couple of weeks before starting treatment due to an upcoming work trip. In the meantime it is boxing, swimming and hamstring exercises.