Many people with chronic pain have exhausted the usual courses of treatment to remedy their symptoms. They’ve tried rest, ice, over-the-counter or prescription pain medications, corticosteroid injections, physical therapy, chiropractors, massage therapy, and acupuncture to no avail. When those common treatments failed as an option, the patients started asking doctors who specialize in regenerative medicine for help. In this post we’ll share more about what regenerative medicine is, who it helps and what to expect pre and post treatment so you can decide if it’s an option it’s time to explore.

Regenerative medicine is the practice of replacing and engineering human or animal tissues to restore, heal, and improve function of unhealthy tissues and organs. Thus encouraging the human body’s natural ability to heal itself. There are two main types of regenerative therapy: Platelet Rich Plasma (PRP) from your own blood, or Stem Cells from your own bone marrow or fat tissue or from donor amniotic fluid.

Things to consider if you are planning to explore regenerative medicine treatments:

Which type of treatment is the best option? Your physician will recommend best course of action based on the type of tissue you are trying to treat and the quality of the cells used for the treatment. Both PRP and Stem Cells can be used to facilitate growth or repair tissues. However, don’t expect either treatment to work wonders! They say you cannot just throw seeds and water down on dry barren land and expect a lush lawn to grow; but if you have an established grassy area with irrigation and a small area of dead grass you will have a better chance of improving that beautiful green lawn. So, make sure you understand why you are trying your treatment or what improvements you are hoping to get out of it.

What to do before starting treatment? During pre-treatment, you’ll need to discontinue all nonsteroidal anti-inflammatory medication (Advil, Aleve, Motrin, Mobic, etc.), blood thinners, and even some supplements (Ginseng, Ginkgo, Ginger, ect). Consult with your physician regarding any medications and supplements you may be taking so you are fully prepared and understand the process for best outcome.

What happens after treatment? Post-treatment you will need to refrain from strenuous activities for a few days. Expect some increased pain levels as your body begins to regenerate the treated tissue area. Discontinue using ice on the treatment area and instead apply heat. Plus, continue to hold off on all the above medications. The timeline to returning to pain relievers or anti-inflammatory medication can vary from 2 to 6 weeks depending on your doctor’s protocol. Your physician may also ask you to restrict or reduce weight bearing or wear an offloading orthosis on the limb being treated. Typically, your physical therapy treatments will begin with a light stretching and range of motion program 2-7 days post and a strengthening program 2-3 weeks post.

When can I return to my usual activity level? The answer to this very popular question depends on your symptoms and progress with your physical therapy program. Typically that time frame is 4 to 6 weeks following your injection. When considering your time frame you need to consider the type of tissue you are treating. Healing time for bone is about 10 weeks; for tendons, it’s about 12 weeks and cartilage could take 6-12 months.

What about the rehabilitation timeline after a regenerative medicine treatment? Once again, that timeline will vary depending on your own body’s healing ability and your Physical Therapist’s program. An effective program will likely include a custom version of the four phases described below.

• Phase 1: Symptom management, patient education, and isometric exercises. The goal of this phase is to reduce pain, swelling, and stiffness in the treated area and recover basic daily activity level. You will need to perform your physical therapy program daily with a pain level of 3/10 or less to progress to the next phase.

• Phase 2: Recovery and isotonic exercises. You will need to perform your physical therapy progressive strength program three times a week with about 48 hours of rest between sessions; along with a pain level of 3/10 or less and little to no swelling to progress to the next phase. It is important to train both sides of your body at this phase to benefit the musculoskeletal and nervous systems. 

• Phase 3: Rebuilding and energy storage. You will need to perform your physical therapy program three times a week, progressing your resistance, training intervals, and speed of movement to mimic training loads. Pain levels must be 3/10 or less with your training load to progress to the next phase.

• Phase 4: Return to sport/activity. You will need to perform sports-specific exercises and movements; be able to tolerate an overall load that meets the demand of your sport or activity, and pass all physical therapy metrics (strength testing, range of motion, quality of movement, and a psychological readiness questionnaire). The duration of this phase depends on tissue type, surgical protocols, and your overall individual wellness or fitness level.

Longer-term improvement post-procedure is why we encourage you to combine your treatment with physical therapy. Physical therapy can help you restore the function of your knee joint by further improving your range of motion, strength, and quality of movement.

Have you ever heard the quote “the grass is always greener on the other side”? Well, it’s not entirely true, “the grass isn’t always greener on the other side,” instead it’s green where you water it!  If you water it on the other side, it’ll be greener there. A Lush, thick, healthy, green lawn won’t happen if you stop watering it after seeding dry, barren, unmaintained land, and hoping the seeds take. In this case, not adding movement after treatment won’t increase the synovial fluid in the joint for it to heal and regrow. But adding movement which is the “water” needed to get new greener grass will increase the synovial fluid in the joint. So physical therapy is the water to the seeds planted during the treatment and the progressive program from your physical therapist is the thing that will improve the chances of the grass growing greener on your side!

Testimonial:

“As an active woman in my sixties, I have recently retired and enjoy spending my time dancing, hiking, biking, swimming, running, and chasing after my 3 grandchildren. However, severe knee pain disrupted my participation in many of my meaningful and daily activities, including walking and sleeping. After months of research, I decided to proceed with stem cell/PRP treatments paired with physical therapy. The Knee Joint was recommended by my Stem Cell/PRP doctor, and through detailed observation and avid listening, Danielle prescribed a home exercise routine tailed to my needs. I am ecstatic to say that within 3 months of PRP combined with religious compliance in my PT, I was pain free and my legs felt stronger. I’m on a steady road to recovery and I was able to travel throughout Europe and hike the Camino Santiago without pain! The PT exercises that Danielle designed specific to my injuries and medical procedure are a lifelong commitment with the payoff of healthy knees and keeping my quality of life.”

Rwena H.