PRP/ Prolotherapy/ Stem Cell Experiences

boosted180

New User
After a lot of frustration over an old ankle injury that doesn't seem to heal completely, I decided to do PRP (platelet rich plasma) therapy, and wanted to see what everyone else's experiences have been - whether good or bad or neutral. So if you've done PRP, Stem cell, or Prolotherapy, please report on what it was for and what your experiences were.

I was very skeptical, but was desperate and after a lot of research and consultations at 2 different clinics, I decided to give it a try. I thought, even if it doesn't work, it doesn't seem like there's any bad side-effects with these therapies (except wasting a lot of money for nothing if it doesn't work).

It's been 36 hours since I got my injection and the pain was a lot more than I expected the first 24 hours. I could hardly even walk on it. Now it's about 50% better. I was told that this was normal for the first few days. I will report again in about a week.

What's everyone else's experiences been?
 

drak

Hall of Fame
After a lot of frustration over an old ankle injury that doesn't seem to heal completely, I decided to do PRP (platelet rich plasma) therapy, and wanted to see what everyone else's experiences have been - whether good or bad or neutral. So if you've done PRP, Stem cell, or Prolotherapy, please report on what it was for and what your experiences were.

I was very skeptical, but was desperate and after a lot of research and consultations at 2 different clinics, I decided to give it a try. I thought, even if it doesn't work, it doesn't seem like there's any bad side-effects with these therapies (except wasting a lot of money for nothing if it doesn't work).

It's been 36 hours since I got my injection and the pain was a lot more than I expected the first 24 hours. I could hardly even walk on it. Now it's about 50% better. I was told that this was normal for the first few days. I will report again in about a week.

What's everyone else's experiences been?

there are some threads here with some info, just use the search function with my name "Drak" and you can find my experiences.
I don't know if your doc's suggested it but I would suggest a second PRP shot in another 3-5 weeks. I had both Achilles done and the one I had two shots on has done way better than the one with one.

Drak
 

boosted180

New User
Yes, I did read some of your posts in other threads. Seems like the most common threads for PRP are about tennis elbow.

I just thought it might be useful to have a "survey" type of thread where people can see other's results with PRP for different conditions.

PRP certainly is not a cure-all for every type of pain/ injury, so I thought it would be helpful for those who are thinking about it to see what others with their conditions have experienced with it.

For me, it was one bad sprain 6 months ago that never quite healed completely. My ankle since then just felt very vulnerable and even with physical therapy, never felt 100% and I've re-sprained a couple of times. This last time felt really bad and even after 4 weeks off of it, it didn't feel like it was getting better.

Waking up today, my pain is 95% gone! I'm so glad b/c for the past 2 days, I almost couldn't even walk. This of course doesn't mean that PRP has "worked". I still need to wait and have it strong enough to play without pain - which is the goal of me doing this in the first place.
 

Posture Guy

Professional
I had PRP with stem cells injected into my right knee about 5 weeks ago. Took it VERY easy for a week, nothing but normal activity and some gentle time on a recumbent stationery bike.

After a week, started doing some light strength work, like some kettlebell swings, leg presses, etc..., not pushing too hard. During that time started back on the tennis court just hitting with my ball machine, no running around, just very light hitting to keep my strokes grooved.

After 3 weeks I started playing again (which was fine with my doc). The knee feels pretty good, and supposedly I'm on the front end of the healing progression, that it's only now that the stem cells are really starting to do their thing. We're looking at getting another injection done sometime in the next month, not sure if it would include stem cells also or just be PRP.

Good luck, hope you find it of help!

One suggestion: get the book Pain Free by Pete Egoscue and do the exercises for foot and ankle pain. One of the biggest things we see limit the results people get with these kinds of procedures is the injected body part is fundamentally out of position and is getting beat up under load. Kind of like your car is out of alignment and you chew up the tires, so you buy new tires without fixing the alignment.

In fact, a company called Regenexx has found that their patient outcomes are SO markedly improved if they do Egoscue along with their injections that they've just named us an officially recommended provider for their patients and strongly recommend to each of them to start Egoscue prior to their first injection.

If I were someone looking at this kind of therapy to regenerate a damaged joint, before plunking down the money for the injection I would ensure the joint was in a reasonably sound position and functioning properly. You don't want compromised position and function to immediately work against the expensive stuff you just put into the joint.
 

Raul_SJ

G.O.A.T.
It's been 36 hours since I got my injection and the pain was a lot more than I expected the first 24 hours. I could hardly even walk on it. Now it's about 50% better. I was told that this was normal for the first few days. I will report again in about a week.

Why is there so much initial pain after these PRP injections?

Are the PRP injections needles much larger than normal? Or is it some bodily reaction to what's being injected? But since it's your own blood I would think that might not be an issue...
 

Posture Guy

Professional
Yeah, my knee hurt REALLY badly for about 18 hours after the injection. Had trouble sleeping that night, and I have a pretty high pain tolerance. Then it cooled off pretty quickly.

I think there are a few things going on. First, a lot of fluid is being put into the joint space, which probably impinges on nerve fibers. Ever tweaked a joint and had it swell up with fluid? How did that feel? Probably not great. And then I think what is injected likely causes an inflammatory response as well to spur the healing process.

Just my guess. I'm going to be asking my doc about it the next time I see him, will share what he says.
 

Talker

Hall of Fame
The inflammatory process is increased by the prp treatment.

Things like curcumin, fish oil, NSAIDS and many other drugs/supplements have the opposite effect in that they reduce inflammation.


I would think that anything like the above that works against inflammation should be avoided for maybe a week or so before treatment.

Anyone have information on this?
Maybe a link or some information given before treatment?
 

Greg G

Professional
I didn't feel any of this initial pain in the first few days after PRP. Probably because mine was at the elbow, and there's more space for the fluid to dissipate, compared to the intraarticular space of a joint. I did avoid any antiinflammatory medications for a few days before the PRP, and have not taken any at all after, to allow the process to work fully.
 

RobFL

Rookie
Had a PRP for GE about 3 years ago and it worked after all other therapies did not. 95% of the time i can get rid of TE or GE with traditional therapies, but that one did not respond for several months, PRP worked. I've done a lot of reading on it, i believe in the science, it seems best for micro-tear injuries where blood flow is not ideal. Also if you're getting past 40, micro-tear injuries don't seem to heal as fast.

I have an appointment Monday at Andrews Institute for a torn plantar fascia, going to consider PRP for that. I read PRP was part of Pau Gasol's therapy for his torn PF, he got back on the court in 6 weeks. I'll settle for 12 weeks. Tiger had one on his knee a few years back. They are very prevalent with pro athletes because the non-insurance coverage/out of pocket cost is no factor to them.
 

boosted180

New User
The level of pain I had initially after the injection was "not usual, but not a problem. In fact it's good b/c it means that your body has a very good inflammatory response and it should heal very quickly.", according to the doctor.

It's now been a little over a week since the injection and I could walk normally, zero pain unless the foot is in certain positions which aggravate the tendon on the medial side of the foot, which is what was injured originally.

So what do I think about PRP for my situation? Still not sure yet... I'm going to give it about another week or two and see how I feel. But after reading some of the actual published papers on PRP, I'm not as "optimistic" as I once was just hearing it from the doctors. All the places that do PRP make it sound like a miracle for every kind of pain in any kind of joint, without regard to it's cause, duration, specific reason for the pain.

The guy I went to didn't seem to care that much about figuring out exactly what was causing the pain or suggest imaging or do a more careful evaluation first before just recommending an injection into the parts of the ankle that caused pain. So I was a bit unsatisfied in that regard. But ultimately, in a week or two if I'm completely back to normal (pre-injury), it means that the PRP was beneficial and I'll be happy with that.

BTW, in a news story just a few days ago, Nadal announced that he just started a "new type of treatment" for his knee. I'm pretty sure that it's PRP and/ or stem-cell therapy.
 

Posture Guy

Professional
Nadal actually had a session with one of our therapists a few years back. I checked out his posture photos and talked to the therapist who did the assessment. By all accounts, just a great guy, super nice, no diva in him, but a postural wreck. Sad, because those issues are fixable and they are both limiting his performance and causing joint degeneration.

He can get PRP and stem cell therapy, but the position his knees are in are going to significantly reduce the benefit of any such therapy he undergoes.
 

Posture Guy

Professional
I should add, in the last week I had a couple of incidents on the court that freaked me out a bit with respect to my knee. A week ago, I was playing on a worn hardcourt and I slipped awkwardly and tumbled down, wrenching my knee in the process. Not badly, but I'm thinking "great, I just blew away all the benefits of a $1200 injection." But the knee was fine afterwards, no swelling or pain.

Then yesterday, I was running to my right for a shot and stepped on a leaf that had blown onto the court. My foot slide on it, then when it 'caught' traction on the court again, I rolled the ankle pretty badly under full weight, and the knee twisted again. Kind of a freak thing. I could keep playing, ankle was a little sore but ok. Knee got a bit sore, but not badly, no swelling.

I don't think it would've held up this well prior to the injection. I think it has had a positive effect.
 

Overdrive

Legend
Wow, that must have hurt.

I suggest getting some decent ankle braces.. Oh wait, it's ironic for me suggesting remedies for a user who knows his stuff on health/fitness.. :lol:

Anyways, get well soon!
 

Posture Guy

Professional
lol. Ankle brace wouldn't have helped in the first incident, just a smooth patch of court and the foot just slid. Ankle didn't roll, I just did a version of the splits and down I went.

With the second incident, fortunately the ankle was fine. It could've been pretty bad. My ankles are pretty robust, have never had issues with them, thank goodness.
 

Raul_SJ

G.O.A.T.
After a lot of frustration over an old ankle injury that doesn't seem to heal completely, I decided to do PRP (platelet rich plasma) therapy, and wanted to see what everyone else's experiences have been - whether good or bad or neutral. So if you've done PRP, Stem cell, or Prolotherapy, please report on what it was for and what your experiences were.

Did you consider PRP with Stem Cells instead of PRP alone?
 

rk_sports

Hall of Fame
Nadal actually had a session with one of our therapists a few years back. I checked out his posture photos and talked to the therapist who did the assessment. By all accounts, just a great guy, super nice, no diva in him, but a postural wreck. Sad, because those issues are fixable and they are both limiting his performance and causing joint degeneration.

He can get PRP and stem cell therapy, but the position his knees are in are going to significantly reduce the benefit of any such therapy he undergoes.

On a related note, just read this interesting news (maybe old news for some of you)...that among those who tried PRP are Tiger Woods and James Blake
http://gototennis.com/2010/09/25/rafael-nadal-knee-update-his-doctors-spin-on-prp-therapy/
 

Raul_SJ

G.O.A.T.
I am considering PRP with Stem Cell for Stage 1 Knee Osteoarthritis.

Consulted with a Doctor who advised against Stem Cell.

Doctor's email:
"
PRP has been effectively used to treat early arthritis of knees. Benefit of addition of stem cells, however have not been clearly documented in arthritis. Stem cells work wonderfully well for limited cartilage injury in the knee, fractures and spine fusions, but their efficacy in treating generalized arthritis has not been well documented.

PRP will be a day care procedure, where as adding stem cells would involve anesthesia and would also increase the cost significantly.

So , with current available evidence and after reading the reports of MRI and X-rays, I would recommend that you could go ahead with PRP alone, although adding stem cells might be of some additional benefit , but it is not proven yet.
"
 

Posture Guy

Professional
Raul, I agree with some of what he wrote. If the problem is "just" bony in nature, then I think stem cells are overkill.

But saying it involves "anesthesia"? Wtf? I don't know anyone who had PRP with stem cells that had anesthesia. Doing stem cells added maybe 15 minutes to my procedure time. They numbed up the area, drilled into my pelvis, withdrew bone marrow, then withdrew blood for the platelets, processed it all while I kicked back in a recliner and watched ESPN on a big screen TV, then brought me back into the room after about 45 minutes and injected it all into the knee. Was there for less than 2 hours in total.
 

Overdrive

Legend
Posture, what do you think of the moral implications on stem cells? It hasn't been discussed in the media or anyone that I know recently..
 

drak

Hall of Fame
Posture, what do you think of the moral implications on stem cells? It hasn't been discussed in the media or anyone that I know recently..

what moral issue? this is stem cells drawn from YOUR OWN blood or bone marrow, not the olden days issue of fetus stuff.
 

drak

Hall of Fame
I am considering PRP with Stem Cell for Stage 1 Knee Osteoarthritis.

Consulted with a Doctor who advised against Stem Cell.

Doctor's email:
"
PRP has been effectively used to treat early arthritis of knees. Benefit of addition of stem cells, however have not been clearly documented in arthritis. Stem cells work wonderfully well for limited cartilage injury in the knee, fractures and spine fusions, but their efficacy in treating generalized arthritis has not been well documented.

PRP will be a day care procedure, where as adding stem cells would involve anesthesia and would also increase the cost significantly.

So , with current available evidence and after reading the reports of MRI and X-rays, I would recommend that you could go ahead with PRP alone, although adding stem cells might be of some additional benefit , but it is not proven yet.
"

since stem cell treatments in some cases/studies have been purported to show some cartilage regeneration/regrowth potential I would think it would be a good choice for knee osteo as that involves the "articular" cartilage - my wife's treatment has been a solid positive so far.
 

boosted180

New User
Did you consider PRP with Stem Cells instead of PRP alone?

I asked the doc about that but he said that it's not necessary in my case. According to him, what I have is pretty minor and should heal well with just PRP.

It's now been 3 weeks since the treatment and I cant really say that I feel like it helped, or if it did, it was very minimal. I'm still not good enough to play. :(

I'm planning on taking another full 6 weeks off anyway and see if it will get better. This is definitely one of the most frustrating things I've been through. I've seen so many different people to get different opinions and try different treatments, but nothing's really worked so far- rest, physical therapy, PRP...

Part of the problem, I think is that I just didn't stay off of it when it was first injured. And so it never had a chance to heal - and by re-injuring it again and again, I probably developed arthritis in that joint and so now even a little bit of activity will aggravate it. I was trying to do some very mild physical therapy type exercises to strengthen it and it hurted for about a week.

And the same situation in my shoulder, which I hurt 2 years ago and never fully healed. And now even with mild rotator cuff exercises, it would get aggravated and hurt for one week. If I played, it would even be worse.

I feel like I cant do anything now - no tennis, no weight training, not even physical therapy! I made an appointment with one more guy who specializes in sports injuries for next week, but I afraid taht it's going to be the same ol' thing again and I wont find a real solution. I hope I'm wrong....
 

Posture Guy

Professional
Overdrive...what Drak said. No moral issues. They extracted the stem cells from my pelvis.

Boosted....can't remember if I wrote it on this thread or not. But if someone gets regenerative treatment on a joint that is either fundamentally mispositioned or is not articulating functionally, I don't care what they put in there. The outcome will not be good, or at the least will be sub-optimized versus what it could be. I'd STRONGLY recommend you get a copy of Pete Egoscue's book "Pain Free" and start doing the exercises for ankle pain. Hopefully the combo of that with the PRP will provide benefit.

I had my PRP/stem cell injections, oh, probably 6-7 weeks ago? Something like that. Knee is pretty good. Not 100% but definitely better. Just played a very tough 2 hour singles match, no issues with the knee. Having the second injection in about a month, and then that should be it. At this point I'm very pleased.
 

boosted180

New User
Boosted....can't remember if I wrote it on this thread or not. But if someone gets regenerative treatment on a joint that is either fundamentally mispositioned or is not articulating functionally, I don't care what they put in there. The outcome will not be good, or at the least will be sub-optimized versus what it could be. I'd STRONGLY recommend you get a copy of Pete Egoscue's book "Pain Free" and start doing the exercises for ankle pain. Hopefully the combo of that with the PRP will provide benefit.

Thanks. I'll order the book today. I see that he has a clinic in Beverly Hills. Would you recommend that I try to get an appointment and see him in person? You've personally had good experiences with him?

Don't mean to sound too skeptical, but I've been to so many people who sound so confident that they can fix my problem and I've been disappointed too many times. I had an appointment this Wed. for a Orthopedist who specializes in sports medicine and PRP but I'm almost thinking of cancelling b/c I'm afraid it'll be another $275 and my time down the drain for nothing. $275 is consultation only - imaging/ tx will be more obviously. I don't have insurance.

If you are that confident about Pete, I'll give him a try instead...
 

Posture Guy

Professional
hey boosted, there is NOTHING wrong with being skeptical as long as that skepticism saves some room for something positive to happen. I've had clients who were so married to their skepticism that even when good things happened, they couldn't acknowledge or even allow it. And it kept them stuck.

The owner and clinic director of the Beverly Hills clinic is Paul Schell. He's a friend of mine and one of our most experienced and successful therapists. Let's put it this way, he was the head of Egoscue University when I started as a student back in 2002. He is VERY good.

But to further set your mind at ease, all of our clinics have a couple of policies that will help here. First, if at the end of your first visit you think "ok, you're nice people but this was a complete waste of time", you don't have to pay anything. Leave with our compliments. Then if you decide "ok, I think this can help and I want to proceed", you have 1 year from the date of starting to ask for a full refund. And we put that in writing. No one else that I'm aware of in the rehab world does anything close to that.

I think you would benefit GREATLY by having Paul take a look at you. Tell him Rick Mathes from the Austin clinic referred you. I promise he'll take superb care of you.
 

boosted180

New User
Thanks, Posture Guy. I called but they don't have anything available until the end of the week so I'll need to check my schedule and get back with them. I'll ask for Paul when I call again - they originally said they'll schedule me with some lady (cant remember the name).

I'm skeptical just b/c I've done so many other things that didn't work - not that they're bad treatments, but just not the right treatments for my condition.

The frustrating thing is that it seems like everyone is so "into" their own modality that they think it's great for everyone and every condition. They don't even put an emphasis on finding out what the true diagnosis is first and what's actually causing the problem, b/c different problems will require different treatments.

My experience is that the acupuncture guy will think acupuncture cures everything and the physical therapy guy will try to sell you physical therapy and the PRP guy will convince you that PRP will do miracles for your pain, and so on....

No one has told me yet why I'm having pain all this time and why my seemingly mild injuries and sprains wont heal.

Anyway, I'll see them and let you know how it goes. Thanks.
 

Posture Guy

Professional
boosted, I LOVE your last post.

That was my experience, too. My goal with every new client is that they walk out of their visit understanding precisely why I think they have their pain and what needs to change for them to get better. If my explanation makes sense to them, awesome. If not, then I tell them they should go do something else that DOES make sense to them.

At the end of your first visit, if you don't feel Paul has explained to you why you hurt to your satisfaction, then ask him to do so.

Re those other modalities, I refer to all of them, have used all of them and I think they all have benefit. But to me, when we're talking about joint pain, joint POSITION is paramount. It's simple mechanics. A joint cannot articulate either properly or within normal friction parameters if it is fundamentally out of position. That's not opinion, it's fact. My advice in most cases is let's get the joint back into a sound position, let the body then heal what it will heal, and then use other modalities to go after whatever's left. That’s' the approach I took, for example, with my knee with PRP and stem cell therapy.

Above all else, trust your instincts. They'll never fail you.
 

Raul_SJ

G.O.A.T.
They extracted the stem cells from my pelvis.

.

Posture Guy,

In your case, did the same Doctor perform the stem cell extraction as well as the PRP injection?

What is the typical scenario for knee PRP? An orthopedist would administer the PRP injection and another specialist would extract the stem cells?
 

Posture Guy

Professional
same doc did both. Went like this:

1. Lie face down on table in procedure room. Outside of my hip gets numbed and the take a surgical drill and drill into the ilium (a part of the pelvis). Then a syringe is attached to the surgical drill bit and extracts the bone marrow used to derive the stem cells.

2. Then they shift the position of the syringe and extract the blood for the platelets.

3. I go kick back in a comfy recliner, sip some water and watch ESPN for half an hour while they process the materials from step 1.

4. I go back into the procedure room, lie on my back, and they inject all the stuff into my knee, which included the PRP, stem cells, some other materials, and ozone.

5. I limp out to the car wondering why the hell I thought I could still see some clients after this.

6. Hours later I try to go to sleep wishing I had just one pain pill. The knee really hurts and I'm wondering what tomorrow brings.

7. I wake up feeling way better than when I went to sleep and life goes on.
 

boosted180

New User
Ok, I got an appointment with Emily (Paul is unavailable until the middle of next week), but the receptionist said she's great. It wont matter for the evaluation, right? Or should I wait for Paul?

I'm looking forward to what they have to say. Thanks for the referral.
 

Posture Guy

Professional
you'll love Emily, she's great. And Paul will be there and like all of our clinics they work in a team environment so you'll meet him, he'll see you and if he needs to have input into your assessment and routine, he'll do that.

You're in very good hands. Theirs is one of the top performing clinics in the entire Egoscue system, and for very good reason.
 

RogueFLIP

Professional
I'm planning on taking another full 6 weeks off anyway and see if it will get better. This is definitely one of the most frustrating things I've been through. I've seen so many different people to get different opinions and try different treatments, but nothing's really worked so far- rest, physical therapy, PRP...

Part of the problem, I think is that I just didn't stay off of it when it was first injured. And so it never had a chance to heal - and by re-injuring it again and again, I probably developed arthritis in that joint and so now even a little bit of activity will aggravate it. I was trying to do some very mild physical therapy type exercises to strengthen it and it hurted for about a week.

And the same situation in my shoulder, which I hurt 2 years ago and never fully healed. And now even with mild rotator cuff exercises, it would get aggravated and hurt for one week. If I played, it would even be worse.

I feel like I cant do anything now - no tennis, no weight training, not even physical therapy! I made an appointment with one more guy who specializes in sports injuries for next week, but I afraid taht it's going to be the same ol' thing again and I wont find a real solution. I hope I'm wrong....

Always sad to hear a fellow player that can't play due to multiple issues. It def sounds like you've got multiple sites of unresolved soft tissue restrictions which can not only contribute to your pain, but can prevent you from healing to satisfaction by keeping you out of balance. And I've nothing against strengthening exercises, but that's really not going to address the restrictions in your soft tissue that is binding you down.

I'm skeptical just b/c I've done so many other things that didn't work - not that they're bad treatments, but just not the right treatments for my condition.

The frustrating thing is that it seems like everyone is so "into" their own modality that they think it's great for everyone and every condition. They don't even put an emphasis on finding out what the true diagnosis is first and what's actually causing the problem, b/c different problems will require different treatments.

My experience is that the acupuncture guy will think acupuncture cures everything and the physical therapy guy will try to sell you physical therapy and the PRP guy will convince you that PRP will do miracles for your pain, and so on....

No one has told me yet why I'm having pain all this time and why my seemingly mild injuries and sprains wont heal.

To further what Posture said, being a skeptic is fine, as long as you're an "open-minded" skeptic. Also realize that most Western trained medical personnel prescribe to the "separatist" model....everything is your body is separate from each other....bones are separate from muscles which are separated from nerves....ankle is separated from knees and hips, hips are separate from shoulders, mind is separate from the body, etc...which is so far from the truth.

PostureGuy and I share similar beliefs on chronic pain issues....our approach to treating differ but I pretty much agree with a lot of his advice.

Thanks for sharing your story; wish you the best with your journey and keep us updated on how things are going.
 

Posture Guy

Professional
good post as usual from RogueFlip.

Restore postural integrity. Systematically work on soft tissue restrictions and imbalances. Use things like PRP and stem cells to regenerate damaged structures. That's a strong 3-pronged approach to optimize your body's ability to perform.
 

boosted180

New User
Thanks guys. I've been doing a little bit of research (Google, Youtube... LOL) about Egoscue and it sounds fascinating and really makes sense. I'm really looking forward to my evaluation on Monday. If the *only* good thing that comes out of joining this forum is to hear this advice and getting my ankle and shoulder problems finally solved, it will have been worth it! I'll keep you guys posted on how things go. I've always been pretty open-minded (even when skeptical due to bad results in the past) - otherwise, I would have stopped looking for a solution already. =)
 

Posture Guy

Professional
Good luck, friend. I hope you have a great experience on Monday and that your problem is one Egoscue can benefit. Let us know how it goes.
 
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