Regenerative medicine and sports-related injuries
Injuries will always be a part of sports, exercise, and strength and performance training. The forces that elite athletes subject their bodies to while training and competing are almost unbelievable. Yet even light-exercise activities such as walking and cycling spawn thousands of injuries of all severity levels each year. Regenerative medicine helps you get back to top shape after injuries.
It’s also a fact that kids and sports injuries have always gone hand in hand. If anything, student athlete injuries are more prevalent (and certainly more severe) thanks to hyper-competitive high school level sports.
Right now lifestyle-level fitness programs such as Cross Fit are HIIT are also an interesting phenomenon. They’re frankly too much for most people, especially newer participants, and have become a seemingly endless source of injuries. Many (or even most) of these are due to avoidable training errors not encouraged by other, more effective approaches. HIIT is a great training system for college-level football players in peak condition who have trained intensively for years. It may be much less suitable for other athletes.
Regenerative medicine is particularly useful because it bridges 2 specific gaps. Injuries which aren’t “bad enough” for surgery often respond well to these treatments. Situations where the injury may be causing significant problem but it isn’t worth the considerable risks of surgery. It can also be effective in cases where the particularly injury isn’t likely to respond to surgery. Chronic, repeated sprained ankles are a fantastic example.
Chronic Ankle Pain
Ultimately, it’s expected that many chronic conditions of the foot, ankle, and leg will be successfully managed without orthopedic surgery. This includes some of the most frustrating, treatment-resistant, and common conditions such as knee osteoarthritis and plantar fasciitis.
When discussing regenerative treatments such as stem cell and PRP injections the following comments are illuminating. Note that these statements were not made specifically in the context of regenerative medicine. They do reflect the sentiments of the vast majority of ethical orthopedic surgeons practicing today, however.
“Remember,” says NYC orthopedic surgeon Dr. Michael M, “there is no problem that surgery cannot make worse.” An accomplished clinician and professor at the New York University Hospital for Joint Diseases, Dr. M freely acknowledges the limitations of surgery. “It’s not perfect, and I make sure that all of my students and patients know this. Especially the students. What you really want is a great surgeon who will only operate when it’s one-hundred-percent necessary.”
Ankle Sprains Regenerative Medicine
Ankle sprains are, by number, probably the most common sports-related injury that podiatrists encounter on a daily basis. During an average “textbook” sprain a person steps off of a curb or stumbles while running. The tops of the toes, or even the top of the forefoot, contact the ground first. In a fraction of a second the foot is violently forced into an unnaturally extended position. If the ankle joint is wrenched beyond its normal, healthy range of motion then significant ligament damage can occur. This is known as an inversion (rolling-inward) sprain.
Most of us know exactly what an ankle sprain feels like because it’s happened to us, once or twice. In a relatively large number of patients however, especially younger athletes, repeated sprains occur. Unfortunately, the ankle will frequently become more easily injured with each incidence. This has left many talented student athletes with “problem ankles” that persist into adulthood.
During repeated inversion sprains, the ligaments on the front and outside (anterolateral) part of the joint become increasingly damaged. This trauma is cumulative, and the physical structure of these ligaments changes. Internally, many of the collagen fibers which give the ligament strength and flexibility are broken. The ligaments become simultaneously stretched and stiffened, and they can’t perform their main function of providing stability properly.
PRP in Regenerative Medicine
What are platelets? What is plasma?
What most of us identify as “blood” is known by healthcare workers as “whole blood.” This incredibly complex fluid is like a living tissue in many ways. It’s a mixture of water, red and white blood cells, cell-like particles, proteins, and a plethora of naturally-occurring chemicals. Both platelets and plasma are components of whole blood.
Platelets aren’t cells, and indeed are smaller than even the smallest white blood cells. These particles perform a key role in clotting and healing. A scab which forms over a healing cut is composed mainly of platelets, cemented together by coagulated proteins.
Note that the surface of each platelet is also coated in various “chemical messengers” involved with the healing process. These healing and growth factors, mostly proteins, are thought to activate and sustain the healing response.
Plasma is the liquid portion of a person’s blood, and contains about 95% water. The remaining 5% consists of dissolved proteins (mainly albumin), fatty compounds like lipids, and salts (electrolytes). Trace amounts of clotting factors, hormones, and dissolved gasses can also be found. The unique composition of plasma allows it to support blood cells, platelets, and ultimately the entire body.