One of the most common orthopedic injuries we see at Performance Rehabilitation & Regenerative Medicine is tennis and golfers elbow. These are separate and distinct tendon/muscle conditions that are often confused and can occasionally happen together. Tennis elbow presents with pain and/or weakness in the muscle group on the outside of the elbow (lateral side) and golfers elbow on the inside (medial side). Obviously, both of these conditions commonly arise from their respective sports for which they are named, however in clinical practice this is not always the case. Medically, both of theses conditions are known as elbow tendonitis affecting some 7 million Americans each year.
What are tendons?
Tendons are thick bands of tissue, with poor blood supply, that connect muscle to bone and are responsible for joint movement and stability. It is very common for tendons to become injured as a result of repetitive motion and /or poor biomechanics. As a result, the tendon becomes inflamed, irritated, and sometimes will tear resulting in intense pain and often weakness in the muscle. This inflammatory reaction is called a tendonitis in the acute phase (1-2 months). Since tendons have a very poor blood supply healing is often slow and incomplete which results in scar tissue in the tendon. This, significantly impairs the movement, strength, stability and function of the elbow. All of which are necessary to be fully engaged in your sport whether you are a weekend “warrior” or a professional athlete.
Treatment Options
Traditionally, the medical treatment included non-steroidal, anti-inflammatory, oral medication (NSAID’s), cortisone injections, physical therapy and home management. Physicians and therapists alike recognize that there is limited success with treatment and have welcomed the advancements in Stem Cell Therapy. Until recently, if a patient failed conservative treatment, their only option was a surgical release of the tendon and debridement, which has limited success.
Stem Cell Therapy: 21st Century solutions
Adult stem cell (ASC) therapy is an exciting new procedure within the sub-specialty of Regenerative Medicine that is offering non-surgical, orthopedic solutions to otherwise potentially surgical conditions. ASC’s are the wave of the future for treating chronic, unresponsive tendon conditions.
Stem Cell Therapy is quit simple, ASC’s are obtained directly from the patient in a simple, pain-free procedure done in the office and reintroduced back to the patient (analogous), during a same day during a one-hour procedure. ASC’s are different than the controversial embryonic stem cells. ASC’s procedures are FDA-cleared and safe for human application.
Adult Stem Cells are undifferentiated, special cells found in bone marrow (hip and lower leg) and adipose tissue (buttock and abdomen fat) which have been proven to repair and regenerate chronic tendon damage when grafted to the injured site, under the aide of ultra sound guided imaging. Since tendon tissue has poor vascularity with limited healing compounds, stem cell injections are typically followed up with one or more Platelet Rich Plasma (PRP) procedures. It is believed that PRP is the catalyst of the regenerative process by “turning on” growth factors and bio-active proteins that are essential for complete healing. A common metaphor I use with patients to help explain the process is the stem cells are the lawn seed and the PRP is the fertilizer. Both are essential for complete repair and healing of tissue.
It is essential that the patient understands that the procedures described above are to repair and regenerate injured or degenerated tissue. Results are seen in 1-3 months and patient does not typically experience immediate relief of symptoms.
We encourage our patients to undergo 4-8 weeks of physical therapy and rehabilitation after the stem cell procedure to regain full strength, function and return to an active lifestyle.
If you feel your are a candidate for a Regenerative Medicine procedure or have questions and you live in the tri-state area, we recommend you make an appointment to discuss it with one of our doctors. For more information visit us at www.deveperfrehab.wpengine.com or call us at 908-754-1960.
About the author
Joseph Mejia D.O., F.A.A.P.M.&R, Is a graduate of University of Michigan and West Virginia School of Osteopathic Medicine. He is Board Certified in Physical Medicine & Rehabilitation and Sports Medicine. Dr. Mejia received his Fellowship Training in Interventional Pain Management from University of Medicine and Dentistry. He has advanced training in regenerative Medicine and is the Medical Director and Partner of Performance Rehabilitation and Integrated Medicine.
