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PRP Injections - My Experience (Read 630 times)

    I have been dealing with pain in upper hammy tendons since 2007 when overtraining for a half marathon. This was an acute situation back then with tendonitis, bursitis and perhaps tearing. I have done bilateral cortisone twice, rest, therapy sessions twice, biomechanical analysis, strengthening etc without success. I have persistent pain on both sides with running and sitting. Tendonapathy is tough to deal with. I thought I would share my experience just in case some of you are dealing with persistent discomfort from tendonapathy in other areas.

     

    I finally went and got bilateral PRP injections yesterday afternoon to illicit a healing response. There is some positive data but more testimonials than level one trials sayiing it works. Proven for elbow tendonosis. I had an interesting experience over 90 minutes. My sports doc first analyzed my upper hammy tendons with diagnostic/muscoskeletal ultrasound. I have an issue on both sides but worse on right. She showed me the left scanning. It did show some scar tissue and thickened tendon. She then showed me the right. It was a mess. There appeared to be some partial tears with significant irregularity of tendon, bone with scar tissue. She was surprised I could function like I could and race. She took out enough blood (60cc) to do two separate treatments on each side.

     

    They took the blood to the centrifuge machine/system provided by Harvest Technologies http://www.harvesttech.com/products/whatisprp.html. This is the company and PRP I chose based on my research. They have a higher ratio of platelets to plasma which is a key to healing. She then injected me with Lidocaine and epinephrine (which supposedly activates platelets) while the blood was spinning out the platelets and plasma.  She then performed a tenotomy on both sides which is basically poking in the tendon multiple times under the guidance of the ultrasound to irritate it and illicit a healing response. She also thinks tendon sucks up the PRP better if a tenotomy is done first.  She told me since the right side was so much worse than the left, she would use a lot or most of the PRP on that side. It was not painful during the injection on the right until the last 1-2 minutes (it is done slowly and in different places where she sees diseased tendon on ultrasound). I am not sure if the Lidocaine did not take all the way or if it was the volume of blood going in but it felt like a knife going in my tendon. She then splashed the left side with PRP – no pain at all on that side while injecting.

     

    She said I will have a lot of pain for at least 2 days because of the poking and inflammatory response caused by the PRP. She said no icing for a few days and no NSAIDS for 2 weeks. She gave me Vicodin. She said I can stretch immediately and walk. If feeling ok, I can do elliptical easy. She said I should start eccentric strengthening in 7-10 days if no pain and can even jog easy if feeling ok. My plan is to wait at least a couple weeks to jog and then keep it easy for at least a total of 8 weeks or more. She said the healing effects are active for 8 weeks. My research say it can be up to 4 months.  The delayed pain really kicked in last night and has not improved yet-difficult to sit. Hammys are extremely sore which is good and means an inflammatory response is taking place.  Neat experience.

     

    A couple articles.

    http://www.nytimes.com/2009/07/23/health/nutrition/23best.html?_r=2&sq=prp&st=cse&adxnnl=1&scp=1&adxnnlx=1277391792-iMuNvX77xiLO6M9WOrYHLw&

     

    http://www.tulsaworld.com/news/article.aspx?subjectid=17&articleid=20110131_17_A15_CUTLIN436238&archive=yes

    Those who try, fail! Those who do what it takes to succeed, succeed!!

    wrh


      Wow, thanks for this. Awesome information. I have been dealing with something similar and have been holding off on the PRP, trying to give it a little more time at my doc's and PT's suggestion. I also have some pretty severe sciatica (unrelated to the original hamstring injury) and it's hard at times to tell what is tendinopathy/hamstring injury and what is nerve pain. My hamstring is firing (it was torn in 2 places, so this is huge progress), although not strongly, so the suspicion is that a lot of it is nerve pain. Still, I might go for PRP after the first of the year if things continue the way they are. Give us regular updates!

        Good. It my goal to just inform people there may be a treatment out there for them if you have tried just about everything.

        Those who try, fail! Those who do what it takes to succeed, succeed!!

        Longboat


        Letting off steam

          Thanks.  I visited the orthopedic doc yesterday, for a recurring achilles tendon problem -- "tendonitis" keeps coming back, now at 7 months with little or no running.  After a thorough exam and scheduling an MRI, he hinted that this might be the way he'd go.  So I'm digging into the study on PRP for the achilles.  
          Your experience is helpful; please continue to update it.

          Neil

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          Nearly back to 100% 6 months after Achilles surgery. Now at 35 50 mpw.

          Base building time!

            Longboat, tendonitis means inflamed tendon. At 7 months, it may be tendonapathy without inflammation. Diagnostic ultrasound showed absolutely no inflammation in my hammy tendons. You may be a candidate. Continue to discuss with your doc.

            Those who try, fail! Those who do what it takes to succeed, succeed!!

            Longboat


            Letting off steam

              Yes, you're right, tendonitis was the early diagnosis, which was why I put it in quotes.  Then paratenonitis was mentioned, now with so long a period and frequent recurrals, tendonosis/ tendonapathy.  This was my first visit to a specialist.  Should see better after the MRI.

              Neil

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              Nearly back to 100% 6 months after Achilles surgery. Now at 35 50 mpw.

              Base building time!

              wrh


                Tchuck, how is it feeling?

                 

                I slipped on some slick pavement and reinjured my hammie at the ischial tuberosity. I think that it's just so off that I'm vulnerable to things like slipping on pavement that is painted with slick paint and then a danger zone when it gets wet. It's bad enough that I'm thinking my entire season might be kaput. I'm going to try to get into see the doc tomorrow to talk about PRP.

                  Here is a little update 4 months after the procedure.  I am not cured, but I am definitely better for first time in 6 years.  I would say I am 30-40% better and most noticeable on right side which was a mess. I know longer have that deep ache when I run which was always there. I seem to be stronger and bounce back pretty well and have minimal discomfort during my runs. I am not doing too much in the way of quality work outs other that striders and faster finish long run as I am still cautious. I am using races as speed work. Even on slower miles and low miles, I hit a 20:04  5K time which was best in 6 years. Can't quite figure that out!!!  I raced 2 weeks in a row and bounced back fine. I still have some soreness after runs but the next day is always better than previous. Also, sitting has been better with less discomfort.  I continue to ice regularly and do my strength work. The biggest improvement occurred from the 8-12 week mark after the injections.  The platelets are active for up to 4 months I have been told. I am hoping I continue to improve but I do have 3 races over 4 weeks coming in later May through earlier June. That will be the test!!!

                  Those who try, fail! Those who do what it takes to succeed, succeed!!

                  Dr_Refaat


                    spam

                      Tchuck, it's been about 8 months, could you give us an update? I've been dealing with High Hamstring Tendinopathy for about a year now and I am seriously considering a PRP injection as nothing else has helped. Have things improved at all since your 4 month update?

                      5K - 20:42 / 10K - 46:02 / 13.1 - 1:39:32 / 26.2 - 3:43:20

                       


                      I'm back!

                        I'm glad this thread was bumped -- this is me now as well. Hamstring MRI shows tendonitis / tendinopathy, with "some tearing". PRP was recommended, but back MRIs are next, as there is likely a sciatic component as well.

                        Citrine1


                          Had PRP done 3 months ago for a horrible case of plantar faciitis.  So bad I was unable to walk.  Anyway, my condition has improved tremendously.  Mine was done by an orthopedic surgeon and cost $750.00 which surprisingly my insurance reimbursed.  I am currently in PT as I really jacked up my foot, but pain has decreased significantly.  I would tell anyone to give it a try as it has worked in my case.  PRP along with aggressive and sometimes painful massage therapy to break up scar tissue has been the answer for me.

                          Longboat


                          Letting off steam

                            The Achilles "tendonitis" I mentioned above turned out to be a 60% tear of the inside of the Achilles tendon.  While stand-alone PRP was possible, it was of uncertain benefit.  I decided to go for surgical repair, which has a high success rate, but a very long recovery time. However, it was my best chance to be able to return to running at near 100%. The surgery was done in early March, and included PRP while the A.T. was open, so the plasma could be directed to the  site of the damage and repair. 

                             

                            Recovery has been remarkably quick for this injury, especially early.  I was out of the splint within a week and walking without crutches in a boot  After 3 months of primarily stretching and range-of-motion work, I started strengthening in June and was OK'd to do a little running in late June.  Since then I've built up through 35 mpw.  The biggest test so far has been 3 legs & 18 miles at Hood-to-Coast as a late sub on a non-competitive team (so I didn't have to push pace).  I notice the A.T. a little while running, but never to the point of pain.  In another month or so, I may be close to 100%.

                             

                            While it's hard to isolate PRP as a major factor, I think it jumpstarted the healing, and contributed to the quick recovery.  

                            Neil

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                            Nearly back to 100% 6 months after Achilles surgery. Now at 35 50 mpw.

                            Base building time!


                            I'm back!

                              I just got back from getting a PRP injection for my left hamstring tendons. My experience was similar to Tchuck's. The MRI (mid-August, damage mostly done in early July) showed a near-complete tear of the semimembranosus tendon, and partial tearing of the conjoined hamstring tendon, at the upper insertion. I've been doing lots of PT, and gradually adding running back; I was back to 4 miles every other day, slow, 4 min run, 1 min walk. The running was easy, but there wasn't a whole lot of improvement in the pain in the hamstring/butt now and then.

                               

                              So it was not really a big surprise for the ultrasound during PRP injection to still show a big tear, though it was a disappointment. I am really sick of this not running. Now, I can't do anything but light PT until I go back in a week and a half, and it will take 4-6 weeks until I should expect to see any effect. Aaaaaaaggghhhhh! And really, I'm skeptical this will help much. But I'm willing to try anything, and clearly, now, it wasn't healing much on its own.


                              Fat butt on couch

                                I just got back from getting a PRP injection for my left hamstring tendons. My experience was similar to Tchuck's. The MRI (mid-August, damage mostly done in early July) showed a near-complete tear of the semimembranosus tendon, and partial tearing of the conjoined hamstring tendon, at the upper insertion. I've been doing lots of PT, and gradually adding running back; I was back to 4 miles every other day, slow, 4 min run, 1 min walk. The running was easy, but there wasn't a whole lot of improvement in the pain in the hamstring/butt now and then.

                                 

                                So it was not really a big surprise for the ultrasound during PRP injection to still show a big tear, though it was a disappointment. I am really sick of this not running. Now, I can't do anything but light PT until I go back in a week and a half, and it will take 4-6 weeks until I should expect to see any effect. Aaaaaaaggghhhhh! And really, I'm skeptical this will help much. But I'm willing to try anything, and clearly, now, it wasn't healing much on its own.

                                 

                                While I'm still skeptical on the procedure, I really, REALLY hope this brings you some healing.

                                "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                                 

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