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Sports and Musculoskeletal Injuries

by May 8, 2019Regenerative Medicine/Stem Cells0 comments

Injuries are part of life.

Aches, pains, breaks and sprains, injuries are a part of life for nearly everyone. Whether you’re an elite level career athlete, a casual exercise enthusiast or a relatively inactive individual, time takes a toll on our bodies. Physical activity, with all of it’s benefits for health and wellness, always carries the risk of hurting yourself, either through overuse, acute trauma or poor mechanics. An inactive lifestyle, where you may not be exposed to many external risk factors for injury, often leads to a breakdown of tissue through atrophy and degeneration, poor posture and reduced mobility. So it’s fair to say that most people will experience some form of injury or musculoskeletal pain at some point.

These injuries can manifest themselves in a variety of different ways – broken bones, torn tendons, sprained ligaments, inflamed bursae, crushed neural tissue, calcific deposits, disc herniation, myofascial adhesions. The common theme linking many of these conditions and injuries is a change in the structural integrity of the tissue, usually a degeneration or compromise of the cellular organisation of the specific areas affected by the injury.

 

Soccer Injury

If you play a sport, the chances are you have or will experience an injury at some point in your playing life.

Let’s look at an example of an injury

Take a simple tennis elbow, or lateral epicondylitis, as an example. Here we have an overuse injury of the elbow, resulting in inflammation, chronic pain, and loss of function. On a deeper level, we can see that we have repeated micro-trauma to the tendons of the wrist extensor muscles at the elbow – that is we have tiny tears and damage to the area, resulting in an inflammatory response which increases over time as the area is not afforded enough time to rest and recover, and is subjected to more continuous trauma. This becomes a chronic condition over time, as the normal healing process is interrupted by overuse, and the tissue begins to degenerate and atrophy (shrink and weaken) in the area as pain inhibits the normal use and function of the elbow and wrist.

So, how do we manage a condition like this? Well, there are several options, and each has its place in an effective treatment plan, depending on the specific details of the individual, the severity of the injury etc. Firstly, a conservative approach would involve the use of rest, adjunctive therapies like dry needling, heat therapy etc, and a comprehensive rehabilitation exercise program to restore normal function. If this approach doesn’t work, most healthcare professionals would then look to something like a corticosteroid injection into the area. This mainly works as an anti-inflammatory and pain reduction modality, with the goal of reducing inflammation and pain and allowing the person to try to restore normal function.

While both of these approaches can provide good results for many people, there are still a huge number of individuals who do not respond effectively, and are left with chronic pain which, in some cases, never resolves.

 

Chronic Injury

When pain becomes chronic it can be difficult to break the pattern and illicit healing.

This is where we consider a regenerative approach.

Let’s assess the situation. We have a level of cellular damage, tissue degeneration and inflammation, and a loss of normal function. When we consider regenerative treatments, our goal is to stimulate growth, repair and regeneration of tissue at a cellular level. It is likely that this client is not responding to the previous two approaches mentioned above because the level of degeneration has exceeded what can be managed with simple rest, rehab or pain management. So what treatments do we have in our regenerative arsenal that may help?

In order to stimulate growth and repair of a tissue, the body uses growth factors. With a condition that has developed to the point of this chronic tennis elbow, the body is struggling to elicit a healing response and a level of growth factor and stem cell activation that can overcome the chronic inflammatory nature of the injury. If we consider a treatment like PRP, or Platelet Rich Plasma, where high concentrations of these growth factors and cells are extracted from your own blood and injected directly into the target area, this is often a significant enough healing response to begin to create a change in the area, and cause an acute inflammatory process, which signals the start of tissue healing.

In a way, this can ‘reset’ the signalling in the area, and the cells in the tendon enter the ‘healing cascade’ response. These signals, highly dependent on the growth factor and stem cell activation just described, instruct for the breakdown and removal of damaged cells, and the development of new tissue, in this case, extensor tendon tissue at the elbow.

 

PRP Injection
Nano Fat Stem Cell Injection
Steroid Injection

There are a number of different treatments that can be considered for these types of injuries.

How does this compare to a steroid injection?

Where this differs from a steroid injection, is that instead of suppressing the inflammatory and pain pathways, the PRP treatment overrides the chronic response, and begins an actual healing and growth process, and not simply a symptommanagement process. This is one of the reasons why it is so important to include an active movement and rehabilitation program much earlier in the recovery process when compared to a steroid injection, to gently challenge the new growing tissue to ensure it develops in a functional and robust manner. Also on this note, this is why it is not unusual to experience an almost immediate relief in symptoms after corticosteroid injection, which wears off over time, while relief may take slightly longer to develop after PRP, but tends to be permanent as the injury is in fact healing.

A combination approach is always best.

There are a number of other regenerative treatments that are effective for managing musculoskeletal issues, such as PRF, Fat-derived cells, Marrow-derived cells and so forth, and all act in a similar fashion to heal and regenerate tissue, with slightly different pathways and indications for each. It is also important to recognize that regenerative treatments and medicine are not intended to replace more conservative or traditional treatment modalities, but rather to compliment them, and provide another option for doctors to consider when assessing an injury. As you can see above, combining PRP with an exercise protocol can lead to a far more effective outcome for the patient.

There are a huge range of injuries and issues where regenerative medicine can be extremely useful in growth, healing and repair, and the most important part of this process is to have a detailed consultation with your healthcare team to develop an effective management plan that is most suited for you.


If you’d like to learn more about regenerative treatments for sports and musculoskeletal issues, or find out if these treatments might be beneficial for you, please feel free to contact the NuaCell team on 01 806 1881 or send us an email at [email protected].

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