OK, there are different of types of prolotherapy injections. To date, I’ve have had the Dextrose (sugar water) in a couple of areas (with great success after a few injections) and am now getting PRP for a tear in my Glute Medius that never healed properly.
PRP, otherwise know as Platelet-Rich Plasma, has been written about as many famous athletes such as Tiger Woods, Rafael Nadal, Steph Curry and several others have received PRP for various problems such as sprained ankles and chronic tendon injuries. These types of conditions had previously been treated with medication, physical therapy or even surgery. Many athletes credit PRP with their being able to return to competition much sooner.
You ask why? It’s because platelet activation plays a key role in the process of wound and soft tissue healing. The use of platelet-rich plasma (PRP) is a portion of the patient’s own blood having a platelet concentration above baseline. It can be 5 to 10 times greater or even richer. Since platelets contain hundreds of proteins called “growth factors” the concept is that PRP promotes faster healing of injured tendons, ligaments, muscles, and joints as well as can be applied to various musculoskeletal problems.
PRP injections are prepared from one to a few tubes of the patient’s own blood with strict aseptic technique. After being centrifuged, the activated platelets are injected into the abnormal tissue, releasing growth factors that recruit and increase the proliferation of reparative cells. Ultrasound imaging may or may not be used to guide the injection. Dr. Fullerton used a sonogram on me for mine (which you’ll see soon).
Several clinical studies have demonstrated that PRP injections have improved function and decreased pain to various maladies, including – but not limited to – elbow, wrist, shoulder, hip, knee, and ankle tendonosis. Early work is also showing promise for osteoarthritis.
Side effects of PRP injections are very limited as the patient is utilizing their own blood, which they should have no reaction to. Some relative rest is needed immediately following the procedure, then usually followed by a progressive stretching and strengthening program.
As you witnessed in my first blog entry, I video documented my blood draw. They ended up taking 120cc’s of my blood this day to net 10cc’s of PRP for my Prolotherapy. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining plasma.
My blood was separated twice. First time is to separate the red blood cells from the plasma. Second time, the plasma is put in the centrifuge to get a higher concentration of platelets. Below is a video of my blood draw going into the Centrifuge…very cool!
Please excuse my video editing here…I’m bound to get the hang of this iMovie thing soon!
Every time I mention Prolotherapy to someone, I am amazed at how many people say that they have never heard of this. Then, I refer to athletes like Coby Bryant and Tim Duncan and explain how they have had PRP Prolotherapy and all of the sudden they say, “oh, yeah…I’ve heard of that stuff. So, do you have bad knees?” I laugh and then continue into the explanation of what and how prolotherapy works.
I’ll defer this answer now to the “expert”…and I mean one of THE EXPERTS in this field. From what I understand, there are only about 35-40 highly experienced prolotherapy doctors in the United States (yes, a ton of other doctors do these injections across the U. S.). I have never met any MD who understands the body and functional movement quite like Dr. Bradley Fullerton. He takes the time with you to figure out the root drivers to your musculoskeletal pain. A boatload of thanks goes out to Dr. George Fett (a prolo expert in Rome, Italy) for referring me to Dr. Fullerton!
So, why am I getting prolotherapy? Believe it or not, I have always been pretty active in my life. From the tender age of 6, I have participated and competed in everything from Gymnastics, Ballet, Tap, Jazz, Cheerleading, Springboard Diving, Swimming, Softball, Track & Field, Tennis and Golf. Throughout the years, I have had more than my share of sprained ankles, strained muscles and musculoskeletal pain.
A cheerleading injury I had during my sophomore year in high school is the primary reason for a majority of my aches and pains today. I fell about 5 feet and hit the ground on my left scapula and thoracic spine area in a stunt dismount mishap. As I was falling, all I could think of was “OMG, turn yourself around so that you do not land on your head and snap your neck!” I ended up landing in a twisted position that day injuring a number of areas including my Glute Medius (but didn’t know it at the time).
Years after this fall, I experienced countless muscles spasms and severe pain as my body learned to recruit other muscles for compensations. Runner’s knee swelling and pain, lumbar spine discomfort, sprained ankles… all due to my injuries and femur instability. Despite my involvement in professional sports and movement analysis, I never figured out my own root driver. That is, until I met Dr. Bradley D. Fullerton.
Initially, I went to Dr. Fullerton to get a prolotherapy shot in my elbow after my mentor and friend, James Waslaski , treated my golfers elbow at an orthopedic seminar I was attending a couple of years ago (This is where I met Dr. George Fett). As he examined my elbow, Dr. Fullerton asked me to show him the movement I did when I injured it. I showed him my down swing and explained to him how I hit something hard in the ground and how this something was obviously the cause of my golfers elbow.
Dr. Fullerton reminded me how it’s important to keep in mind the interplay between my elbow and shoulder girdle in this motion. In particular, how the upper trapezius and levator scapulae originates on the spine and the latissimus dorsi involvement. This relationship with the shoulder has implications that affect the scapula-thoracic joints. For example, poor scapular stabilization increases activity of the upper trapezius for stabilization, which in turn increases scapular elevation and stress on the cervical origin of the trapezius, lats and fascia. In short, my shoulders were putting a tremendous amount of stress on my scapula and this stress can lead to a number of other changes in the body.
Next thing I knew…Dr. Fullerton was now examining my scapula-thoracic area. When he did this and compared my right to my left side, he asked me “have you ever fallen and hurt this left part of your back before?” I first responded “No” and then said, “Oh, wait a minute, yes, back in high school!” He then proceeded to show me where my injury had never healed properly on the sonogram. PURE GENIUS!
From here, I looked at so many things differently in the body. On a recent visit with Dr. F, I asked him about Glute Medius and Minimus, hip stability in regard to my fall. I explained my “Twisted Fall Impact” theory to him and next thing I knew we were scheduling an appointment for a sonogram for my Glute Medius and Minimus and discussing his theories.
You may be wondering how two simple muscles can be such relevant players in keeping your posture erect. The simple fact is that they’re key pieces in keeping your movement stable, so that when you walk or run, your hips are able to act as a support system for your upper and lower body. Someone who is chronically weak when in motion is likely experiencing less than adequate support from these muscles, which places a lot of strain on other systems within the body and can tire you out very quickly.
This brings us to today…me getting PRP Prolotherapy for a big tear in my Glute Medius.
I bet you’ve wondered why you just can’t get out there and start jogging, lifting weights, or take a boxing fitness class without it producing some sort of discomfort in your body soon after you start. Just Do IT…isn’t that all we need to do? Just get out there and get moving?
Well, not exactly…
The reason why your knee starts to swell when you go jogging or your elbow hurts when you start playing tennis is because random exercise doesn’t correct body misalignments. AND, with continued random exercise and repetitive sports you actually risk making yourself worse. Your strong parts keep getting stronger while your weak parts get weaker, hence perpetuating any malalignment in your body. And well…you could be exercising for weeks, months and years and actually be putting yourself farther down the road to dysfunction.
It always amazes me how long someone will keep doing things and ignoring pain.
For example, if your upper back is hunched over all day working at a computer and you take a spinning class…you will tend to do this class in the same hunched over position. This reinforces the position of your muscles that keep you hunched over your desk. If your body is out of alignment, then starting that 8-week boot camp or spin class isn’t going to magically correct it.
If you ask me, I think all weight machines, free weights, stationary bikes, golf clubs , tennis racquets, and reformers (and even yoga mats need to be on this list too!) should have “Warning Labels” on them.
You ask why???
Because of things like age, previous injuries and gravity, our alignment gets off, as we move, it hurts, so we move less, as we move less and less, our range of motion becomes less and less. What used to be enjoyable to do in sport or recreation (or even turning our head to check the blind spot in our rearview mirror), has now become uncomfortable or harder to do.
Face it. The body doesn’t like pain. No exception.
In any physical activity, we naturally favor using our strong muscles. Same thing goes for that exercise class you signed up for last week. In an attempt to keep up with your instructor, you’ll end up using whatever muscles necessary to get the job done. Hence, we move within our own set Range of Motion boxes. Stiffness and inflexibility prevent us from accessing and using the very muscles we need to use.
Even if you do all your exercises with meticulous correct alignment…feet shoulder width apart, eyes looking forward, etc. Its not going to get you back into proper alignment (though it does help). Your stronger muscles will end up doing the work and the disparity between the two just keeps getting bigger.
BEFORE your weaker muscles can become stronger and alignment corrected, space must be created for this change to happen. This means stretching and opening things up in your body and taking away the restrictions. I’m not talking about a few brief attempts at touching your toes or a few cat-camel back stretches. I’m talking about REAL tissue stretching that genuinely opens up tight areas and creates space for your weaker muscles to get stronger.
Most of the time, attaining REAL space can only be accomplished through one-on-one help. I spend an enormous amount of time during therapy sessions properly stretching, creating space for alignment corrections, and then teaching my clients how to maintain this at home in between our sessions. My custom integrated therapy programs are based upon this concept. I spend time listening to my clients, assessing their movement with motion analysis, testing muscles, correcting imbalances with various techniques, doing corrective exercises, and then assessing and testing them again. I stress that getter better aligned is a process and this process takes time and effort. In other words, time isn’t spent chasing pain and rubbing on what’s hurt in my therapy sessions.
Just as we become more fixed in our ways as we grow older, so do our bodies. What was once a slightly forward head posture has become more forward. All the gyrating and twisting you do in your attempts to enlist the weaker muscles in the pilates class ends up relenting to your stronger muscles…and to another compensation in your body movements.
The way I see it…you have 3 choices:
Keep doing what you’re doing and see minimal improvement (if any at all). Keep paying for your stubbornness the next day with unnecessary soreness.
Keep on pushing your body relying on what you know and at the risk of hurting yourself or doing serious damage that will eventually require having some part of your anatomy cut on or shaved off (do you even know that part of your scapula is shaved off in most rotator cuff surgeries?).
Get HELP. Approach your training from a different perspective and truly improve your performance. With One-on One expert guidance, you will get your body back to moving the way it was designed to move.
Why One-on-One? Let’s face it, fitness classes and clubs are a business. Their goal is to make money. That’s why they have these attractive 20 somethings’ with abs and butts of steal in their ads. It’s impossible for group instructors to monitor and personally coach individuals in a class of 20 or 30 in a hour. Let’s do the math…
60 minutes divided by 20 = 3 minutes per person
60 minutes divided by 30 = 2 minutes per person
From my experience, I know how long it can take for me to get someone to perform a corrective exercise properly and to contract the right muscles while relaxing wrong ones…usually way more than 10 minutes to get this done correctly…and you think you are the exception to the rule?
Now, I’m not bashing the exercise industry. Let me interject that I have the utmost respect for those who exercise regularly without causing damage to their bodies. Anyone who does this to maintain health and sticks with it is a hero in my book. It’s just that the ones who usually succeed at these programs or sports are usually a select group. They are usually the people who already possess the attributes needed for that class…strength and flexibility.
Rather, I just want to stress by aligning yourself first you bring more efficiency, results and enjoyment to your sport or exercise program.
So, we often avoid what we really need. It’s human nature.
