PRP has become a mainstay in treatment of high profile NFL athletes for abdominal strains, shoulder tendonitis in Major League Baseball players, and knee pain in professional soccer players. Sometimes combined with MLS Laser treatment, PRP can be a very helpful treatment modality allowing avoidance of more invasive surgery.
There are times when traditional conservative treatments such as ice, rest, padding, taping, anti-inflammatory medications, steroid injections, physical therapy, shoe inserts, night splints, immobilization, and shoe and/or activity modifications simply don’t work. When the pain is either on the bottom or back of the heel, this can be the result of a chronic inflammatory condition developing in an area that naturally, anatomically does not possess much blood flow. Both the plantar fascia attachment to the heel bone, and the achilles insertion in the back of the heel both possess little circulation.
With either chronic inflammation unresponsive to conservative treatments of the achilles tendon (called achilles tendonosis) or the plantar fascia (plantar fasciosis) the tissue in this area is very dense, hard, and fibrous.
For the past 40-50 years, the phenomenon has been known, and the philosophy of treating this has not changed in that time. The WAY this is accomplished has changed and evolved. The GOAL of treatment is to create a controlled acute inflammation in the tissue to allow the body to HEAL ITSELF. Years ago, the heel was anesthetized with an anesthetic, and a large bore needle was used to penetrate the bottom of the heel several dozen times to create this inflammatory response.
More recently, this can be accomplished with either Extracorporeal Shockwave Therapy (ESWT) which involves directing sound waves at the tissue to create the acute inflammation, as well as with Platelet Rich Plasma (PRP) injection. PRP involves drawing 20cc of blood from the arm, spinning the blood down in a centrifuge, and isolating the platelets. The platelets contain the growth factors within blood. The area to receive the PRP injection is initially anesthetized, then using an ultrasound machine for visualization, the tissue is injected several dozen times and finally the platelet mixture injected in to the tissue.
All anti-inflammatory medications are discontinued, as an acute inflammation is purposely created to allow the body to heal itself. Anti-inflammatory medications will only suppress this response. There is typically not much more pain than before this procedure, yet a short leg walking cast must be worn for 4 weeks to immobilize the area and allow this to heal. My experience with PRP is very good at alleviating resistant, chornic plantar fasciitis and/or achilles tendonitis, with a success rate of 80-85%. Call us if you would like to discuss Platelet Rich Plasma injection therapy.
IT IS IMPORTANT TO NOTE, the BRAND of commercially available PRP processing kits used makes an enormous difference! We do not fudge, nor buy cheap products, when it comes to patient treatment. Since we started performing PRP in 2008, we have ONLY used the Harvest Smart Prep system, with one of the highest yields of platelets on the market. Yes, buying the equipment was expensive, but it is the BEST way to deliver the most concentrated amount of platelets and growth factors to the affected area. For more information click here.
If you are suffering with pain and are interested in alternative therapies to promote faster healing, please schedule a consultation today.
If you are suffering with pain and are interested in alternative therapies to promote faster healing, please schedule a consultation today.