Category Archives: Injuries

How PRP Affects Soft-Tissue Injuries

intra-articular injectionThe discussion about platelet-rich plasma, or PRP, treatment is becoming a more popular topic by the minute. PRP treatment is being proposed as an alternative to normal orthopedic treatments that tend to be costly for the wallet and for your time. In a previous blog we looked at PRP treatments’ ability to handle orthopedic difficulties like ACL reconstruction, fractures, and osteoarthritis. This time, let’s shift our focus to: how PRP affects soft-tissue injuries.

For the purpose of this analysis we will look at how PRP affects meniscal repair, rotator cuff repair, and tendon healing.

Meniscal Repair

The evidence for how PRP affects meniscal repair is short, concise, and inconclusive. There is only one good study, which we can reference, that gives us any conclusive data about how PRP affects meniscus repair. This particular study examined animal models in which scaffolds were used for PRP injection. After 12 weeks it was concluded that PRP augmentation showed no significant difference from the control group in meniscal regeneration/repair. Thus, more studies are needed, perhaps in human subjects, to determine if PRP can aid meniscal repair.

Rotator Cuff Repair

Rotator cuff tears are one of the most common injuries that orthopedic surgeons face. For this reason there has been much research focused on the biologics of these types of injuries. These studies are most concerned with the tear location, time to fixation, need for surgery, optimal surgery technique, etc. To see if PRP treatments can aid in the healing process of rotator cuff repair 5 randomized controlled trials (RCT) and 3 nonrandomized trials were completed.

In one of the tests, it was found that patients who received PRP augmentation saw higher retear rates of the rotator cuff. Furthermore, those same patients saw no significant difference in the healing process. Thus, according to this study it seems that PRP augmentation may have detrimental effects to the rotator cuff repair process.

In other similar studies it was also found that PRP use had no significant advantages after rotator cuff repair in relation to pain, motion, strength, or retear rate. However, there was a study in Italy that showed that PRP injections used in conjunction with a thrombin component did have some positive results.

Overall though it has been concluded that there is no clear benefit of PRP use in arthroscopic rotator cuff repair, if it is used alone. In fact, in two cases it proved to be detrimental to the effectiveness of the surgery. More studies are needed to determine the usefulness of PRP injections in rotator cuff repair.

Tendon Healing

Although there has been little positive evidence suggesting use of PRP found in meniscal or rotator cuff repair, there have positive outcomes in relation to tennis elbow and Achilles tendinopathy.

Normal treatment of tennis elbow is a combination of bracing, physical therapy, and steroid injections. In three different studies the steroid injections were substituted for PRP injections. In all three studies the group that received the PRP injection noticed significantly less pain and faster healing time. Thus, it can be concluded that PRP injections can help the healing of tennis elbow.

Achilles tendinosis is another soft-tissue injury that has been treated using PRP injections. Normally this condition is treated nonsurgically with rest, pain medications, physical therapy, bracing, orthotics, and ultrasound. PRP use here aims to improve and speed the healing process. In two studies no significant healing improvement was found when PRPs were used compared to saline injections. One study did show that the use of PRP did slightly improve functional outcomes of Achilles tendinosis, there is not enough statistical evidence to suggest that PRPs are effective in aiding the healing of Achilles tendoinosis. Thus, more research is needed.

Conclusions of PRP use for soft-tissue injuries

Even though PRP treatment is still a new and up-and-coming treatment in the orthopedic world, and it may hold much promise. In relation to meniscal and rotator cuff repair it is extremely evident that much more research is needed. Different combinations of PRP need to be tested for efficacy if there is any hope of this treatment becoming successful for soft-tissue injuries. On the other hand there has been some success in treating tennis elbow and Achilles tendinosis.

Although the measure of success has been small in these areas, it leaves hope that PRP treatment for orthopedic injuries could one day be the norm. Thus, doctors and scientists must push on in their research for the best PRP treatment, backed with proven evidence of success.

7 Signs You Should Stop Exercising Immediately

Ashley Langford​ is in tune with his body. The 40-year-old Web developer and ​photographer near Dallas, Texas, traded his party-hard lifestyle for intense exercise such as P90X and CrossFit in 2010. So when his heart rate “took off” from 140 to 180 beats per minute while on the rowing machine last year, he knew something was seriously wrong. But would you know the signs it’s time to ​stop exercising immediately and head straight to the hospital? 

Treatments that reduce knee buckling may help prevent falls in older adults

Symptoms of knee instability in older adults may indicate an increased risk of falling and of experiencing the various physical and psychological effects that can result from falling, according to a study published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR). The findings indicate that determining effective treatments for knee instability should be an important priority as clinicians care for aging patients.

Knee buckling, often described as a knee “giving way,” is a symptom of knee instability that frequently affects older individuals, in particular those with knee pain and knee osteoarthritis (OA), and may be caused by muscle weakness and balance difficulties. If knee instability leads to frequent falls and fall-related injuries, exercises and other interventions that stabilize the knee may help maintain older individuals’ health and quality of life.

3 Secrets to Improving your Orthopedic Health

Walkers_350x233Thousands of people every day are starting out on a path towards a healthier lifestyle. This means that people are now more conscious about what they eat, and many people are trying out new types of exercise they would never have dreamed of before. While the goal here is to stay healthy and active, many people often forget that adding daily exercise to their lifestyle can take a toll on their body and orthopedic health.

As people become more active, the number of bone and joint injuries and chronic conditions continues to increase. This increase calls for a need to take care of our orthopedic health. Read about these few secrets that will help you improve your orthopedic health and ultimately avoid injury.

Nutrition

For proper bone health your body requires lots of calcium and vitamin D. The vitamin D allows your body to efficiently absorb the calcium, which in turn builds your bones. Because your body cannot create calcium on its own, it is important to eat foods that contain this important nutrient.

So, what kinds of foods should you eat? Dark leafy greens like spinach, turnip greens, broccoli, and kale are all extremely high in calcium. There are also many cereals that are packed full of the vital nutrient. Yogurt and other dairy products are also a great source of calcium for your body.

It is a good idea to add at least one high calcium food to your meal plan everyday. Although we usually don’t think about it, our bone health is extremely important as we get older. These foods can help your bones stay healthy so that you avoid injury further down the line.

Exercise

Leading an active lifestyle is an extremely important component to maintaining your orthopedic healthy. However, avoiding high-impact types of exercise is crucial. High-impact activities create extreme wear and tear on your bones that is counteractive to orthopedic health. Activities like fast paced walking, using hand-held weights, and stretching bands are great alternatives.

It is also important to remember to stretch before and after a workout. Increasing your flexibility will help you maintain a wide range of mobility, which will in turn help you avoid injury.

Good Posture

Most people would not expect that posture has an effect on bone health. However, having good posture can greatly reduce unnecessary pressure on your joints, alleviate ligament stress, and prevent back pain. Correct posture also keeps bones and joints in the proper alignment so that your muscles can function properly.

Sleeping posture is also incredibly important. Make sure that you sleep lying on your back or on your side with your knees slightly bent. These positions will keep the natural curvature of your spine in the correct position, and thus alleviate joint stress.

These three 3 secrets are only the first stepping-stones on your journey towards total and complete orthopedic health. Always make sure to eat smart, live healthy, and stay active. Following these simple rules will start you out on the track to success.

The Risks Of CrossFit Injury

As CrossFit becomes more and more popular among exercise enthusiasts, many people are beginning to question the safety of the activity. Whether it is a CrossFit newbie or a seasoned veteran, everybody is beginning to wonder what their risk for injury could be.

As CrossFit becomes more and more popular among exercise enthusiasts, many people are beginning to question the safety of the activity. Whether it is a CrossFit newbie or a seasoned veteran, everybody is beginning to wonder what their risk for injury could be.

The Orthopaedic Journal of Sports Medicine recently published an article that speaks directly about CrossFit injuries. The study was conducted based on surveys taken by CrossFit participants in Rochester, New York City, and Philadelphia. The survey asked a number of questions about CrossFit related injuries the participants had suffered over a 6-month period.

The Statistics

  • Only 19.4% of the survey participants suffered an injury in the 6-month period
  • Female participants had a significantly lower rate of injury than males
  • Injury locations included: shoulder, lower back, and knees
  • Many different age groups experienced injuries, so this factor had no significant impact
  • No difference was found based on length of the training sessions
  • There was no difference in injuries based on the amount of time a participant had been doing CrossFit
  • The level of coach supervision had a LARGE impact on injury rates.

CrossFit injury conclusions

Based on the statistics above, it seems that the number of CrossFit injuries is fairly low. It is important to note that these statistics are based on significant injuries only, so things like small aches and pains are not counted.

So, we can conclude that CrossFit is no more dangerous than other activities. Although there are many different types of exercises that a participant does during a CrossFit workout, it seems that this variation does not cause more injuries than other types of exercise. In fact, some may argue that the strength training of many different muscles in the body is actually highly beneficial for muscle strength and health.

However, more comparative research must be done before any solid conclusions can be made about how CrossFit injuries compare to injuries from other forms of exercise.

Ways to decrease your risk of CrossFit injury

Based on the statistics above, there is one obvious parameter that kept people from getting injured while doing CrossFit: having a coach present. It is clear that having a coach attentively watching, as you complete CrossFit workouts, will greatly reduce your risk of injury.

Coaches are knowledgeable about how to complete each workout they direct participants to do, and thus they can adjust your form, reps, or the amount of weight you are using if they feel it is too dangerous. Coaches can also modify workouts based on a participants’ injury history or current areas of pain. Because a coaches’ involvement is crucial in avoiding injury, you should consider the involvement of the resident coaches when choosing a CrossFit gym.

Also, never be afraid to ask for help when you are unsure about a CrossFit activity. The coaches are there to help you get the most out of your workout, and also to make sure you stay safe and injury free!

So if you are interested in the world of CrossFit, get out there and try it! Go slow at first and make sure to ask for the coaches’ help. Who knows, CrossFit may become your new favorite activity.

 

References: Weisenthal BM, Beck CA, Maloney MD, DeHaven KE, Giordano BD. Injury rate and patterns among CrossFit athletes. Orthopaedic Journal of Sports Medicine. 2014;2(4).

Safe Exercise

When people begin a new exercise program, they often push their bodies too far and put themselves at risk for injury. The common notion that exercise must be really hard or painful to be beneficial is simply wrong. Moderation is the key to safe exercise. Safe exercise programs start slowly and gradually build up in intensity, frequency, and duration.

In addition, if you have an existing health problem, such as high blood pressure, diabetes, a history of heart disease, or are a smoker, you should contact your doctor before beginning any vigorous physical activity.