Brandon, a 32-year-old factory worker presented to our office with chronic right shoulder pain.
He stated that his first injury to his shoulder occurred in high school while playing football. He has always stayed active and enjoys lifting weights. Since high school he has had several additional injuries to his shoulder.
A recent MRI showed extensive tearing in some of his rotator cuff muscles. He was told by his doctor that even thought the outcomes for these types of surgery are not great, in his case, surgery may become inevitable.
Examination revealed significant tenderness when palpating the involved tendons. It also revealed a significantly reduced range of motion of the right shoulder.
Orthopedic testing showed that the involved tendons were being impinged every time that Brandon reached out or up. Marked reduction of range of motion was also noted in the neck with associated muscle tension and imbalances. X-rays of the neck revealed a loss of the normal curve and moderated disc degeneration and the C5 disc level. His shoulder x-rays were less remarkable, but a review of the MRI confirmed extensive tendon damage.
We explained to Brandon that in order for his shoulder joint to work properly, his neck, upper back and scapular joint must also be working properly, a course of rehabilitation involving corrective spinal and joint adjustments, therapeutic exercises, and Platelet Rich Plasma (PRP) Injections were prescribed. The adjustments and the physical rehabilitation would correct the bio-mechanical function of the area to reduce stress and normalize function. The PRP Injection significantly enhance his body’s ability to heal the injured tissues.
Solution
PRP is produced from a person’s own blood. It is a concentration of one type of cell, known as platelets, which circulate through the blood and are critical for blood clotting. Platelets and the liquid plasma portion of the blood contain many factors that are essential for the cell recruitment, multiplication and specialization that are required for healing. After a blood sample is obtained from a patient, the blood is put into a centrifuge, which is a tool that separates the blood into its many components. Platelet rich plasma can then be collected and treated before it is delivered to an injured area of bone or soft tissue, such as a tendon or ligament.
PRP is given to patients through an injection, and ultrasound guidance can assist in the precise placement of PRP. After the injection, a patient must avoid exercise for a short period of time before beginning a rehabilitation exercise program.
Brandon was started on passive treatment involving joint mobilization and massage. Soon after, he began on his full rehabilitation prescription and progressed well through care. One year later, Brandon is thrilled to be lifting weights again with no restricted motion or pain.