How many of you Road Runners have ever experienced pain or soreness in the back of your thigh (hamstrings), in the back of your ankle (Achilles) or the side of your thigh (iliotibial band)? If so, there’s an excellent chance that it’s caused by a tendinopathy:
Tendon = the white stretchy tissue that attaches muscle to bone
opathy = condition or disease process.
There are three main types of tendinopathy: tendon strain (tear), tendinitis and tendinosis. Runners who run long enough will probably experience every type of tendinopathy.
Traditional treatment for tendinopathy
RICE (rest, ice, compression, elevation) and NSAIDS are the mainstay of Mom’s management for the strains and inflammation (the “itis”). However, the degeneration of the tendon, otherwise known as tendinosis, doesn’t always respond to these traditional treatments.
When tendon is not healing
Your race is in three or four weeks, the last thing you want to do is sit this one out. Platelet rich plasma (a.k.a. PrP or blood-spinning) may be an option. PrP is a procedure done in my office where I draw your blood; place that blood into a centrifuge to spin down and separate the platelets from the rest of the blood; and inject only the platelets (which house growth factors) with some plasma with a few white blood cells into an injury site to help heal tissue.
Factors that affect PrP
This procedure has helped some of the biggest professional athletes, as well as non-athletes alike. Research has shown mixed results, and most experts believe this is because not all PrP is created equal. Varying levels of platelets exist in everyone. At your next blood test, compare your platelet level to your family member’s level, or even to your own last blood test results…much different, right? Also, some PrP kits can control the amount of platelets, red blood cells, and white blood cells, which have an affect on success of treatment.
Taking Advil or Aleve could also render your platelets dysfunctional; stop all NSAIDS before and after the procedure. Not eccentrically loading tendons within the first couple weeks after the procedure has also provided suboptimal results. PrP is very promising - as evidenced by the abundance of available literature and by studies in the pipeline - and may be the right therapy to successfully treat your tendinopathy.
Fernando J. Manalac, M.D., MMM, CAQSM, CMQ, is a fellowship trained non-surgical sports medicine physician at Holy Cross Orthopedic Institute in Fort Lauderdale, FL. Board certified in Internal Medicine, Sports Medicine and Medical Quality, Dr. Manalac specializes in non-operative management of musculoskeletal issues at any age. Learn about the Sports Medicine program at Holy Cross Orthopedic Institute by visiting HolyCrossOrthopedics.com. For physician referral information, call 954-900-6653.