Chronic tendon pain is one of the most common conditions seen in Sports Medicine and Orthopedic practice. Tendons are the fibrous ends of muscle that attach the muscle to bone. Every time a muscle contracts it causes stress on that tendon. Tendinitis happens when this stress occurs over and over again, leading to inflammation. If the tendinitis is not treated or doesn’t improve with conservative treatment, it can become a chronic condition called tendinosis.
Patients often experience chronic tendon pain in their elbow (sometimes called tennis or golfer’s elbow), in their Achilles tendon, rotator cuff tendons, patellar and quadriceps tendon. Although not a tendon, plantar fasciitis is also a very similar condition. The initial treatments for all of these conditions are RICE (rest, ice, compression, elevation), anti-inflammatory medication (Advil, Motrin, Aleve) and physical therapy. If there is still pain after trying these treatments, the next step was a steroid injection. If that failed, the last option used to be surgery. Now with advancements in medicine there are many new treatments to help avoid surgery. Some of these treatments are; high dose laser therapy, extracorporeal pulse activation therapy (EPAT), regenerative therapies (PRP, Stem cells) and Tenex.
High Dose Laser Therapy, or HDLT, is completely non-invasive. It uses laser energy to help promote healing. It works on four different pathways in the body. 1) It causes vasodilation, which increases blood flow to the damaged area while simultaneously reducing the inflammation. 2) Reduces pain by suppressing pain receptors. 3) Helps in formation of new capillaries which again brings more blood flow to aid in healing. 4) Penetrates into the damaged cells to activate them to aid in repair. HDLT is not painful.
EPAT, or extracorporeal pulse activation therapy is also a completely non-invasive treatment. It uses pressure waves to stimulate the metabolism, enhance blood circulation and accelerate healing. It is usually performed as series of 4-5 treatments performed once a week. There is no recovery time and patients can return to their normal routine immediately.
Regenerative medicine is using your own body to help stimulate healing in areas that otherwise would not heal themselves. The two most common regenerative therapies are platelet rich plasma (PRP) and stem cells. PRP is performed by drawing the patients blood and separating and concentrating the platelets. Those platelets are then injected using ultrasound into the site of pain. The platelets have growth and healing factors that help the area heal. Stem cells are cells that can become other cells (muscle, tendon, cartilage). The largest concentration of stem cells in our bodies are found in our bone marrow and in our fat cells. Through painless methods we can extract those cells and inject them into the site of injury. These stem cells can then repair the injured areas.
Tenex is a minimally invasive procedure for the treatment of chronic tendon pain. With advancements in ultrasound, we can see under the skin without having to make a big incision. Using the Tenex needle the bad tissue can be removed, but with an incision so small it doesn’t require a stitch, unlike traditional surgery which requires the incision to be a couple of inches long. Because the overlying tissue is not disturbed the recovery is much faster but has the same success rate as open surgery.
At Apex Sports and Regenerative Medicine we are trained in all of these non-invasive and minimally invasive procedures, which can help you recover faster and without the need for surgery. If you would like to learn more about any of these procedures you can visit our website at https://www.apexsportsnj.com/