How do Tennis and Golf Elbow Injuries Occur?

These types of injuries often occur due to overuse of the forearm muscles, and the damage generally affects the tendons that connect these muscles to the bottom portion of the upper arm bone. Many of the muscles in the forearms join together into common tendons, so the tendons can receive lots of stress during certain repetitive movements.

When these tendons are used too often, they can become irritated and swollen. Inflamed tendons can then cause the elbow to be tender to the touch, movements to become painful, joint mobility to be decreased, and numbness or tingling to occur in the hands and fingers.

Golfer’s elbow occurs when the tendons that attach to the inside of the elbow, which also connect to the flexor muscles of the forearm, are irritated, and tennis elbow occurs when the tendons on the outside of the elbow, which attach to the extensor muscles of the forearm, become inflamed. These injuries are named as such because these are the two most common sports in which these injuries occur respectively. However, these tissues can become damaged by other means of chronic use as well.

 

The Downside of Surgical Procedures

Elbow injuries often have to heal on their own, and this process can last for 18 months or more due to the limited blood flow and poor regenerative ability of tendons. In some cases, patients opt to undergo surgical procedures to try to address the root of their pain directly. Surgical procedures for these injuries most often include open or arthroscopic procedures.

Surgeries generally attempt to release or lengthen the tendons or destroy the nerves causing pain signaling. While these procedures can be successful, there are a number of potential complications that can be associated with them.

If done incorrectly, surgical procedures can lead to over-lengthening of the tendons, reduced arm strength, unwanted nerve damage, and scar tissue buildup. These surgeries also have failure rates that can range from around 10 percent to as high as 80 percent, and even with a successful surgery, follow up surgeries are quite common.

 

Available Regenerative Medicine Treatment Options

There are a number of regenerative medicine therapy options that provide great alternatives to surgery. These treatments are all minimally invasive and can provide high success rates in much less time.

 

Stem Cells

Stem cell therapy utilizes mesenchyme stem cells that are isolated from a person’s bone marrow or adipose tissue. These cells are known as multipotent cells, meaning that they can differentiate into a number of other cells that can create new bone, cartilage, connective tissue, fibrous tissue, muscle tissue, and more. These cells can then be injected directly into the damaged tissue.

These injections have been shown to speed up the healing process by decreasing inflammation, promoting the creation of new blood vessels, reducing scar tissue buildup, and helping to recruit other cells to the area. The ability of these cells to create new tissue also increases the overall strength and function of repaired tissues.

 

Platelet Rich Plasma

Platelet rich plasma, or PRP, is derived from a sample of a patient’s own blood. A portion of this sample that contains a high proportion of platelets and growth factors is isolated from the sample, and it is then injected into the injury site.

Platelet rich plasma is packed with growth factors, which help to reduce swelling and create new blood vessels. Studies have shown that PRP injections can significantly improve pain levels and prevent scar tissue from forming, maintaining the strength, flexibility, and function of the original tendons.

 

Bone Marrow Concentrate

Using bone marrow concentrate, known as BMC, is very similar in practice to stem cell therapy. BMC is derived from the bone marrow in the same manner. This original product is known as bone marrow aspirate. Then, a centrifuge is used, and the red blood cells are discarded from the sample, leaving you with a sample with a higher concentration of progenitor cells.

BMC contains many stem cells, but it also contains many growth factors and platelets, though not to the degree of PRP. This therapy option provides somewhat of a hybrid between these other two treatments, providing many of the same benefits, including reduced scar tissue, decreased inflammation, lower pain levels, and increased tissue functionality.

 

AmnioFix

AmnioFix is a biologic sheet of tissue composed of amnion and chorion, which are the two layers of the amniotic sac found in the uterus during pregnancy. These membranes contain a number of growth factors, proteins, and cytokines that promote tissue healing.

This tissue matrix can be injected into the injury site, and it is able to serve as a protective layer for damaged tissues. The cells in this matrix are able to create new tissue to replace damaged tissues, recruit additional cells to the area to speed up recovery, and increase blood flow while inhibiting scar tissue buildup.

All aforementioned treatments are real options to treat tennis/golf elbow injuries without having to undergo surgery. Please contact our office at 623.535.9777 for any questions.

 

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How PRP Aids in Injury Recovery

Because of the many tissue types that PRP can help heal, it has been shown to be an effective treatment method for a number of different injuries throughout the body.

Tendon and Ligament Strains and Tears

Tendon and ligament problems are some of the most common impairments, and they are frequently repetitive injuries as well. Tendon injuries can include rotator cuff tears or strains, tennis elbow, Achilles tendonitis, patellar tendinopathy, and golfer’s elbow. Tendons are responsible for connecting muscles to bones, so they are found around nearly every joint in the body. When muscles are used repetitively, the tendons are forced to absorb a large amount of shock, and they can become irritated from rubbing against bones.

Ligaments connect bone to bone. The most common injuries are in either the knee, with the ACL, MCL, PCL, or LCL, or in the elbow, with the UCL, which is commonly injured with throwing. The knee ligaments are often injured in sports such as skiing, basketball, football, or soccer, and the UCL is most commonly injured while playing baseball or softball.

Tendons and ligaments generally heal very slowly because they have very little blood flow. However, with PRP injections, tendons and ligaments have been shown to increase their regeneration and increase the strength of the tissues after healing. This can maintain the integrity of the tendons and ligaments, allowing equal function compared to the original tissue.

 

Osteoarthritis

Osteoarthritis causes damage to and wears down the articular cartilage found on the end of the bones. This reduces joint mobility and can cause constant pain. Osteoarthritis is common in older adults, but it can occur at any age in joints that are overused. The ability of PRP to regenerate cartilage tissues can be a significant help in treating this condition, reducing symptoms and restoring joint function.

One study of 78 individuals who suffered from bilateral osteoarthritis in the knees showed that both a single injection and two injections of PRP into the knee produced positive results, lowering pain and stiffness while increasing physical joint function. They noticed these results both after two to three weeks and after six months. The control group in the study degraded in all of these categories.

 

Cartilage Tears or Spinal Disc Compression

Cartilage tears are most common in the meniscus of the knee, and the intervertebral discs between the vertebrae in the spine can become worn down, dried out, and compressed over time. Both of these injuries result from damage to fibrocartilage. These areas are composed of thick areas of cartilage, and they play critical roles in resisting compression and absorbing forces put through the body. PRP therapies have been shown to help reduce inflammation in these areas, stimulate new cartilage and blood vessel growth, and restore overall function.

One study compared the difference between PRP injections directly after a spinal disc injury, two weeks after the injury, and a control group. Both groups that received PRP injections showed improvement, but the group that received the treatment immediately showed more promising results. The benefits noted included reduced inflammation, more spinal fluid inside the discs, and increased disc height that improved function.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338460/

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Platelet rich plasma is generated from a sample of blood. The blood contains a number of different components, including red blood cells, platelets, growth factors, clotting factors, and more. Each of these serves a specific purpose, and being in the blood, they are able to be transported quickly to an injury site.

Platelet rich plasma is only a portion of the blood, but it is highly concentrated with growth factors that play a critical role in tissue healing. Growth factors are responsible for controlling inflammation levels, improving cellular communication to enhance the regeneration process, recruiting additional cells to the damaged area, creating new blood vessels to improve healing, and more.

PRP and its Ability to Heal a Patellar Tendon Tear in a High School Athlete

Patellar tendonitis is an injury that commonly affects athletes of all ages, but especially those in high school. This injury occurs when the tendon connecting the kneecap to the lower leg bone and is common with repeated jumping. A high school lacrosse athlete experienced pain in this area and was diagnosed with this injury. He underwent physical therapy, took NSAIDs, and used a brace. But, after pain lingered for more than a year, he underwent an MRI and they discovered he had a tear that nearly spanned the entire tendon.

This athlete became a candidate for PRP therapy, and at the beginning of therapy, he experienced pain with both running and jumping. However, after undergoing treatment with multiple PRP injections, he was able to return to full health quickly and continue his athletic endeavors.

PRP Treatment of an MCL Tear in a Professional Soccer Player

Another prime example of PRP’s effectiveness was seen in the rehab of a professional soccer player who experienced an injury to the medial collateral ligament (MCL), which is located on the inside of the knee. This ligament is often injured if the knee bends too far inward. This soccer player fully tore his MCL after a collision with another player.

Wanting to return to the field as quickly as possible, the athlete decided to undergo weekly PRP injections for three weeks. Just three days after the initial injection, he was able to walk pain free and resistance training exercises were started just five days afterwards. Full knee range of motion was reached 10 days after the first injection, and the brace was removed.

After only 2.5 weeks, the athlete experienced no pain, had regained 85 percent of his strength in his quadriceps and hamstrings, and was permitted to return to practice with his teammates. After one week of practicing, he was able to fully participate in a game. Previous studies have noted recovery times of between four and eight weeks, so returning to full game participation in only 3.5 weeks is quite impressive.

Stem Cells in BMC in the Treatment of Osteoarthritis for Former NFL Players

Osteoarthritis occurs when the cartilage tissue in the knees, hips, shoulders, and other joints wears down from overuse, causing pain with many movements. This is commonly seen in older individuals or in competitive athletes at younger ages.

The NFL is a grueling league, and playing football places large amounts of stress on the joints throughout the body. Fifty-one former NFL players agreed to undergo stem cell injections in order to try to address their pain. These athletes experienced arthritis in the shoulders, hips, and knees. In all three locations, the players noted a 70 percent improvement in both pain and functionality one year after injections.

This stem cell treatment prevented all but four of the 51 athletes from electing to have surgery to further reduce pain levels and increase functionality.

While all three of these examples focus on athletes, PRP and stem cell treatments provide great options for people who live an active lifestyle no matter what their skill level. In each of these stories, the athletes were able to alleviate their pain quickly and effectively and undergoing surgical procedures to address their injuries was unnecessary.  To see if either of these treatments can help you live a pain free life, please visit one of locations in Avondale or Surprise, Arizona.  You can also contact us directly at 623.535.9777 or visit us online at www.activelifepaincenter.com.

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