PRP injection for tennis elbow - successful or not?

Discussion in 'Health & Fitness' started by aussie, Jun 16, 2013.

  1. RogueFLIP

    RogueFLIP Semi-Pro

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    For chronic issues, again, looking elsewhere for causes and not treating symptoms.....and finding unresolved soft tissue restrictions. Thank you for helping me solidify my response #5. :)
     
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  2. aussie

    aussie Professional

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    Thanks for this information Dave. I'll certainly let the PRP injection run its course (I understand that the injection remains áctive' for 6 weeks after the injection) and reavaluate the situation after 8 weeks. If the problem still exists, I'll consult an ART practitioner and I understand that they look at whole of body causes, not just the wrist/forearm/elbow. I beginning to think that ART may be my last throw of the dice before surgery, but I need to let the PRP run its course.

    I can always have another PRP injection, but if I have experienced no benefits at all from the first, well you know the saying of throwing good money after bad! I'll also look into the Flextend glove as I've heard of some good results, but I'm not sure if they are shipped to Australia. Thanks guys for your continuing advice and support.
     
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  3. drak

    drak Professional

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    I have had both my Achilles TENDONS PRP'd, twice in the left tendon the 2nd shot about 4-5 weeks after the first shot. I had 100% results on the 2-shot left tendon, 80-90% on the right 1-shot tendon. I recently has a stem cell/PRP combo coctail in my left knee as did my wife much more recently in her right knee. For me these new treatmenst have worked extremely well for a aging 55+ 4.5 who can still get it done when the body allows.
     
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  4. aussie

    aussie Professional

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    drak did the first PRP injection have any beneficial results at all to encourage you to get a second one, or was it a leap of faith by you to try the second one when the first didn't have any noticeable benefits? Interestingly too that PRP is not regarded as that successful for Achilles tendonosis, but in your case it worked out well.
     
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  5. drak

    drak Professional

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    it's hard to tell because I wore a boot for 10 days then took it real easy until and significantly after the second shot - no tennis for over two months, I had planned on two shots for the left achilles from the beginning
     
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  6. sadowsk2

    sadowsk2 Rookie

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    Any update from the OP as to how he is progressing since the PRP?
     
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  7. aussie

    aussie Professional

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    Hi guys, have been somewhat slack in updates. I felt you guys may tire of me never having any positive news on my progress. Well in short, there has been no progress. Some days I feel a little progress but that is then followed by days when the pain around the lateral epicondyle returns. The upshot is that some 8 weeks after the PRP injection, I am no better.

    However, I am not a quitter and I will be getting a second PRP Injection on Tues 27th. I read in many accounts of PRP injections that a lot of people only respond to the second injection. I am obviously hoping that I will be in that category!

    I'll have some questions to ask of the physician when he ultrasounds the elbow to guide the injection. Such as can he notice any improvement in the tendon with better collagen alignment, less scarring, less calcification etc. I'll be interested to hear his views on the state of the tendon attachment following that first injection.

    Anyway, I'll post the results of my visit for injection number 2. I know that many of us are searching for that gold standard treatment for tennis elbow - around a half of all recreational players suffer from this debilitating problem so any information is readily devoured.
     
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  8. sadowsk2

    sadowsk2 Rookie

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    Hey Aussie,

    I have to say my tennis elbow has FINALLY shown some serious progress. You can re-read my posts earlier in this thread to better understand my timetable... Basically, over the last three weeks I have been hitting with some Junior High and High School kids in a group environment over a 2 hour period once per week. They aren't world-beaters out there, but they can hit decently, and sustaint a rally... My elbow will be sore for a few hours and then the pain goes away.

    I actually "dialed it up" this past Wednesday where I hit "all-out" so to speak with some 4.0's (which was where I ranked prior to my injury last year) for an hour hitting session. The elbow was pretty sore (but not "painful" so to speak) the next day, however my gripping strength was just fine. 48 hours after that i was pain free.

    Additionally, I have doing physical therapy 4-5 days a week now completely pain free. My PT has consisted of:

    1.) 50 total reps of the blue flex bar
    2.) 50 total reps with a 10lb barbell with my arm fully extended and UNsupported of wrist flexion and extension curls.
    3.) 50 total reps of a standard arm curl and again 50 reps inverted (wrist pronated)
    4.) I also do 50 reps with a large hammer with wrist pronation and supination exercises (again, arm fully extended and unsupported)....

    How much has the PRP had in the grand scheme of my cautious recovery? Its difficult to say. It should be noted that one of the leading experts (and biggest proponents of PRP), Dr. Pavelko Mishra (of Stanford University), has written that the fully benefits of a PRP typically aren't seen until a MINIMUM of 12 months post procedure for most people... Fo me, I'm around the 10 month mark and over the past several weeks I've noticied a dramatic improvement...

    I have a follow-up appt with my ortho doc next week Thursday and I plan to ask him if I should continue hitting despite feeling sore for the following 24-48 hours or if I should shut it down still... Hope this insight helps you in some small measure.
     
    Last edited: Aug 27, 2013
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  9. scotus

    scotus Legend

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    It's great to hear that your elbows are in good condition now.

    But I would never recommend 50 reps of BLUE flexbar for those with tennis elbow.

    That may be a good exercise for strengthening the muscles but may very well damage/tear tendons. For those with TE, it is tendons that need healing.
     
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  10. mikeler

    mikeler G.O.A.T.

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    The blue one was better for my GE while the green one is ideal for TE.
     
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  11. andreh

    andreh Professional

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    Yep, I'm using the green one at 3x10 a day. It really pulls hard on the tendon. I have seen some rather quick improvements though. I'll know more in a few weeks if it has any good lasting effect.
     
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  12. mikeler

    mikeler G.O.A.T.

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    My daily routine is 3x15 with the green flexbar and also 3x15 with a hand gripper squeezing it with my hand fully extended out to my side palm down.
     
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  13. aussie

    aussie Professional

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    Guys, had my second PRP injection yesterday. Physician said ultrasound showed calcium deposits throughout the region of pain - where the tendon attaches to the lateral epicondyle and where the degeneration in the tendon is. He was surprised that the first injection had given no pain relief as he has had good success with PRP with TE.

    Once again he passed the needle thru the tendon several times and made contact with the condyle (ouch!). I will take a more conservative approach to rehab this time with no exercises at all for 2 weeks and then some gentle range of motion and stretching for 3 weeks before gentle strengthening exercises from then.

    It's all wait and see at this stage so wish me the best.
     
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  14. sadowsk2

    sadowsk2 Rookie

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    Calcification is a common occurrence For those with chronic tendinosis... I actually now have a bone spur right on my epicondyl... I actually hit today for two hours with nothing more than minor inflammation and soreness for an hour or so.... I then proceeded to do all my physical therapy exercises later today completely pain free... The only thing I can suggest is waiting and continuing to follow the PT protocol.
     
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  15. andreh

    andreh Professional

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    I also have long standing severe tendinosis. I actually made quite quick progress as soon as I started with the flexbar. Went from not even being able to shadow swing the racket to being able to shadow swing forehands in just two weeks. Months of eccentric dumbell excersises didn't do anything. I'm very hopeful.
     
    Last edited: Aug 29, 2013
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  16. aussie

    aussie Professional

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    For the time being I'm going to keep the Flexbar and dumbells safely stored away. No exercises for 2 weeks and then gentle range of motion and stretching for another 2 before adding in some light strengthening exercises. All being well at around 6 weeks I'll add some light eccentric work with a light dumbell. If pain has gone or very low I'll add some red Flexbar work. Sounds like a plan anyway.
     
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  17. sadowsk2

    sadowsk2 Rookie

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    You won't go wrong with that approach. Keep in mind what I mentioned earlier: there is data suggesting the full benefits of a PRP aren't realized for quite some time... Obviously everyone is different and some people may respond more quickly, but I wouldn't be too upset if you don't see a rapid improvement.

    I go back to the doc Thursday and am hoping to get the green light to play... Fall/winter is fast approaching and I'd like to rejoin my winter tennis league...
     
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  18. aussie

    aussie Professional

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    I wish you all the best sadowsk2. Tennis is not life of death, it's far more important than that! I have not hit a ball since Feb 7 and my only connection with tennis since then has been to string several racquets for friends - using my left hand to do the majority of the stringing work has seen me become very inventive and quite the contortionist!

    5 days after 2nd PRP inj sees my elbow with some swelling and stiffness (as expected) and I am doing all I can to protect it from unnecessary use. I am wearing a wrist brace as often as possible during the day to keep my wrist from extending and to also remind me to use the other hand/arm as much as possible. Even pecking this out on my iPad with left index finger which I'm getting quite proficient at. Cleaning teeth left handed is quite challenging and quite comical with toothpaste smeared over half my face!

    Anyway life goes on. There are always people far worse off and it pays to keep your own problems in perspective.
     
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  19. aussie

    aussie Professional

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    Coming up to 5 weeks post 2nd PRP inj and no good news to report. While there may be some anecdotal evidence PRP may accelerate tendon healing, it has done nothing for me. In fact I have read recently that a trial was conducted using saline injections vs PRP injections and the results revealed no difference in the outcome.

    My physician has recommended that I try shockwave therapy if there is no improvement but I feel I have invested so much time and money on all manner of treatments with no success that it is time to have a consultation with an orthopedic specialist with a view to surgery.

    I have tried so many treatments, exercises, creams and medications I don't want to be one of those who suffers for many years with this debilitating condition. I will seek out a surgeon who performs arthroscopic tennis elbow surgery as this would at least be the most minimally invasive way to release the tendon.

    In the meantime I will apply some Penetrex for the next few weeks to reduce the level of pain I'm experiencing as I'm holidaying in Italy.

    Sorry I can't offer any more positive news to those of you considering PRP injections but it does seem to work for some, not just me.
     
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  20. mikeler

    mikeler G.O.A.T.

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    I have had good luck for various injuries using ultrasound. If you have not tried it yet, do so before opting for surgery.
     
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  21. vantageboy

    vantageboy Rookie

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    helped my elbow

    try prolotherapy(5 visits) and dry needling with cupping after(acupuncture)-5 visits also--then 2 weeks of a.r.t./deep tissue massge with a sports p.t.--get a elbow sleeve and wear to work. all above not 2 expensive and could get u on the court with in 2 months hopefully. good luck
     
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  22. sadowsk2

    sadowsk2 Rookie

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    I'm real sorry to hear about how you're progressing. I've been actively monitoring this thread to see how you're coming along. I would like to reiterate that proponents for PRP (Mishra most notably will tell you that you need to wait longer---> http://www.foxnews.com/health/2013/01/23/platelets-steroids-may-not-aid-tennis-elbow/).

    It was weird for me, I had the single prp done on 1 Nov 2012. I didn't notice much improvement until early August and it was a very rapid improvement. I am now playing three days a week.... My elbow will be very tender after playing and swollen but it all goes away after a nights rest. I would recommend waiting AT LEAST FIVE more months to see if you have any improvements before resorting to a surgery that doesn't promise success. I think you need to research how a tendon heals, and the time it takes the body to create collagen. 5 weeks IMO is way too soon to expect ANY positive results.

    FYI- I have been continuing my therapy 4 days a week and plan to continue doing so.
     
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  23. andreh

    andreh Professional

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    The length it takes is exactly why some surgeons in Sweden have more or less stopped doing TE surgery, motiviating it with that it would be healed in that time even without surgery. This seems to be the problem with all remedies for tendon issues.

    If it takes 12 months after treatment chances are that the healing had little or nothing to do with the treatment, alas. Time seems to be the only thing that definitivly has a chance to fix a damaged tendon.
     
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  24. sadowsk2

    sadowsk2 Rookie

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    I agree. As I posted earlier in this thread, it's difficult to say whether or not the PRP had any direct impact in me healing or was it more just good old fashioned time
     
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  25. andreh

    andreh Professional

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    Yeah. I hear you. I asked the surgeons in Sweden to cut me open, but they refused. I went to a neigbouring country and got the surgery there. Did not help, so I guess the Swedish doctors knew what they were talking about. Patience is a virtue with tendons.
     
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  26. aussie

    aussie Professional

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    The thing is, how long do you wait after PRP injections to see results? The whole point of the PRP injection is firstly to kick-start the healing process which may have stalled and secondly to accelerate the healing process by the introduction of the growth factors etc. I think most of us can feel reasonably certain that given enough time that tennis elbow will heal. This generally from all the evidence can take anywhere from a few weeks to 2 years. For me, the reason to undergo 2 PRP injections was to reduce this period. My first PRP inj was on June 27 and there has been no reduction in pain or stiffness whatsoever in the 3 months since then. So the question for me is do I want to persist with various treatments and therapies for many more months or years waiting to get better or is it time to explore the option of surgery?

    The opinion of the surgeons in Sweden is alarming if they are now turning away from tendon release surgery. All the reports I have read regarding tennis elbow surgery either open or arthroscopically have been very positive in the ultimate outcome of returning to sport.

    At this point in time I have arranged an appointment with an upper limb surgeon to at least have a discussion with him and hear his educated opinion. Believe me when I say that I do not want to rush into surgery for this problem but when do I know when enough time and treatment has elapsed for me to realize that my condition is one of those that simply is not going to heal?
     
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  27. sadowsk2

    sadowsk2 Rookie

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    Hold old are you? If you're reasonably young (ie 30s or 40s) than in my humble opinion I would NOT consider surgery as your body is still young enough to heal. Remember a PRP is murky at best in terms of its results. Mishra, like I've repeated several times before (and remember he is a HUGE proponent of PRP) seems inclined to say it takes closer to a year to see the benefit. There is no quick and easy way out here... Tendons take time to heal, they don't, get much blood, and it can be frustrating. I'm pretty confident in another three months you'll see some significant improvement (though I doubt you'll be healthy and/or ready for tennis). I would hold off on the surgery imo
     
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  28. rufus_smith

    rufus_smith Professional

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    Thanks for sharing. I read the whole thread. I've played tennis for 30 years and have had of moderate elbow tendinitis, both lateral and medial, and studied up a lot on them. Your case seems severe. I'm kind of surprised that the elbow hasn't improved much over several months. Of course, at older ages, above 50 year of age, tissue can take a longer time to heal.

    I would try to keep the pain/ inflammation down as much as possible by using frequent ice treatments, taping the area to stabilize the tendon, and using an arm bad. I sorry that's not an instant cure.

    Good Luck
     
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  29. aussie

    aussie Professional

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    Thanks guys for the continuing advice. Unfortunately time is against me as I turn 60 in a couple of weeks. Firstly because of my age the healing process is a lot slower. Secondly, my tennis years ahead of me are fewer which is why I don't want to waste too much time in healing this problem and getting back on the court.

    If I was still in my 40's taking 2-3 years to gradually recover from the tendonosis would be a more bearable option. I took nearly 5 years in my early 40's to completely rehabilitate from my second knee reconstruction in that period but at that age you know that you still have many more years ahead of you to play this game we all love.

    But now, the clock is ticking and I am running out of options. That is why a frank discussions of my options with an upper limb surgeon/specialist will be worthwhile. In the meantime, I'll keep the ice, ibuprofen and Voltaren gel going as it at least assists to keep the pain and stiffness bearable.
     
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  30. andreh

    andreh Professional

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    About the suregeons in Sweden discouraging surgery: You have to remeber that the vast majority of TE cases has nothing to do with tennis. I read at www.tendinosis.org that surgery is more successful with sports related injuries than with TE from other sources (i.e., work-related, office, typing, gardening etc.) I've done some research myself long ago and yes, it seems to agree with the statement that the surgery is a hit and miss.

    The study the Danes quoted to me was that a whopping 91% of cases were successful. Turns out success meant the patient "didn't experience any negative effect of the surgery after five years" or something like it. About 50% reported improvement and but only about 20% reported complete recovery. The point is: the do nothing approach show the same numbers in most cases. So yeah, the point the Swedish surgeons made was: surgery doesn't hurt, but it's not likely to help much either.
     
    Last edited: Oct 5, 2013
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  31. aussie

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    Also to all of you , thanks for taking the interest you have shown as I battle this condition. It is a condition that will affect approx 50% of us in varying degrees as we continue to play this wonderful game so it benefits all of us to share whatever knowledge any of can glean. I will continue to post continuing developments in my condition as time progresses and in particular the opinion of the orthopedic surgeon following my consultation. Should I undergo surgery, I will either continue this thread or commence a new one to chronicle my recovery, rehabilitation and return to the court!!

    In the meantime, I'm off to Italy with my wife tomorrow for some vacation time, but alas, the horse ride we were looking to experience in Tuscanny will not be possible for me because I can't hold the reins securely. Never mind, my left hand should be able to adequately hold a wine glass to my lips!!
     
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  32. aussie

    aussie Professional

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    Back from Italy and looking forward to discuss my treatment options with a leading upper limb specialist here in Australia. I will be guided by his recommendations whether that is to wait for some more healing time, undertake shock wave therapy (which has had some success it must be said), or undergo surgery to release the tendon etc. I'll have another ultrasound examination done to get an current image of the diseased/damaged site adjacent to the lateral epicondyle which will be interesting to compare with the US done way back on Feb 28.

    I'll keep everyone updated on how my situation develops as I know that many of you reading this have had or are currently experiencing TE and any info on treatments etc is readily devoured.
     
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  33. sadowsk2

    sadowsk2 Rookie

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    I'm not sure you're going to see any vaue from your ultrasound.... Mine looked "diseased/damaged" after my comeback. I have neovascularization, angiofibroblastic hyperplascia, and calcification... It hasn't looked any Different from when it was crippling me. The only difference now is that I am pain free, stronger, and playing three says a week including two days in a row. My orthopedic doc, who is very reputable in my area also said as much.... I would take a hard look and have a good discussion about waiting and just allowing for the body to heal (while continuing your physical therapy). I worry if you opt for the SWT, you may just be "backing up" or starting all over again.... Best of luck and keep us posted!
     
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  34. max

    max Hall of Fame

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    Aussie, sadowski: interesting stuff. I've been suffering since July with a pretty bad collected set of muscle strains and tendon strains and associated tendonitis. I've just been waiting it out. Frustrating.
     
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  35. aussie

    aussie Professional

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    Good to hear from you max, we often share views over on stringing machines and techniques. We'll, I saw an upper limb specialist a couple of days ago and we agreed on surgical intervention, an action that will probably disappoint several of you who believe I should persist with therapy before going down the surgical path.

    The surgeon is performing an open repair to the common extensor origin next Thursday 7 Nov. This will be day surgery only and I remain in a sling for two weeks.

    The surgeon believes that the 9 months I have endured this condition along with all that I have tried to rehab the condition make me a suitable candidate for the op. He says he has had great success with the repair op and believes that I will be back on the court in 3 months. When I asked if he operated arthroscopically, he said by using the open method he could more efficiently repair the damage.

    I feel that I have tried many of the standard and not so standard rehab protocols for this debilitating condition with little success. Even as I type this my elbow is in pain. I'm finding it more difficult to straighten my arm fully and I don't want to let this condition worsen to the point where there is no hope of resolution. In all honesty, my elbow is worse now than it was 8 months ago when I went for my cortisone injection.

    I'll keep updating with how the surgery goes and the subsequent rehab goes until hopefully, I get back to tennis.
     
    Last edited: Nov 1, 2013
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  36. neverstopplaying

    neverstopplaying Professional

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    I just read most of this thread now. I've need experiencing slight (level 3) tennis elbow pain. The thought of not being able to play tennis has been scary for me recently, and I sympathize with your condition. I'm playing less frequently, have isolated the specific shots that are causing me discomfort, and switched to a ultimate comfort racquet and full gut.

    Good luck with the surgery and rehabilitation.

    BTW, a switch to a Dunlop 500T is what started problems for me.
     
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  37. aussie

    aussie Professional

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    Good luck with the elbow. You seem to be doing all the right things to nurse the elbow - flexible frame, full gut etc. Remember to ice regularly, stretch both the extensor and flexor muscles in your forearm and cut back on how often you play. If the pain becomes a little worse, consider cortisone. It cops a lot of flak I know, and certainly didn't help me, but I have 2 close tennis playing buddies who both overcame minor TE with cortisone inj. Read up too on eccentric exercises for the extensors using both weights and the Theraband Flexbar and perform those daily.

    I didn't use the Aerogel 500 Tour for that long actually- didn't suit my playing style so I sold it. Once again, good luck and be prepared to back off your tennis for a while if the pain worsens. aussie
     
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  38. max

    max Hall of Fame

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    Aussie: it sounds as though you've done everything you can do, and it sounds also though surgery's the right option. I'm sure we here all hope for the very best for you.

    May God bless you---and your surgeon and his efforts---in the coming days, with the surgery and with your recovery.
     
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  39. RogueFLIP

    RogueFLIP Semi-Pro

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    Hey Aussie,

    Is this person near your location?

    http://mfrtherapists.com/listings/?state=Australia&country=AU

    I'm a bit late suggesting myofascial release to you, but perhaps if the location is feasible, she may be able to help post rehab if your current course of action doesn't give you the results you want.

    Good luck and speedy recovery.
     
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  40. aussie

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    Thanks for the suggestion RogueFLIP. Unfortunately she is in Western Australia which is the opposite side of the country. Kinda like I live in New York and she lives in Los Angeles! However if for some reason the surgery is not successful I don't intend to just give up. I haven't tried ART (Active Release Therapy) or Myofascial Release so I would certainly consider those therapies.

    Certainly right at this point I am pinning all my hopes on the surgery. There are quite a few posts on these forums of those who have persevered with tennis elbow for sometimes years and have eventually undergone surgery with excellent results. The surgeon is one of the best around and he is confident, at least pre-operatively, that I'll be playing pain free in 3 months.

    It will be interesting when I have my first post-operative consultation with him on Nov 19. Until such time as the surgeon actually opens the elbow and inspects and then repairs the damage he finds, I find it difficult to accept how a return to sport/activity prognosis and time frame can be given. I will have some interesting questions for him at that consultation you can be sure!

    Meantime, my surgery is tomorrow afternoon (it's now Wed afternoon here in Brisbane) so not much more time to go before hopefully I really am in the very early stages of my recovery from this debilitating condition.

    I will be sure to post updates on the whole procedure when I am able - I'll probably kick off a new thread because I'm sure there are many TE sufferers who sometimes consider surgery as an option when this whole recovery thing just stalls as mine has.

    Thanks for your good wishes and prayers and I'll be certain to pass them on to the surgeon tomorrow. aussie
     
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  41. sadowsk2

    sadowsk2 Rookie

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    I would be absolutely stunned if you're playing pain free in three months. From what I've been told by my docs and is supports from research I've read surgery will allow you to play (if successful) in about SIX months time... However you can expect "deep elbow pain" for up to a year.... I hope your doc is correct in his prognosis and it works out for you though
     
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  42. aussie

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    Lying on my back typing left handed with my right elbowed bandaged and resting at 90 degrees across my chest. Little pain with no movement involved, but wriggling my fingers brings a painful response in the elbow. Nearly 24 hours since open repair surgery to the tendons (ECRB specifically) and hopefully the start of my return to tennis and just as importantly, to everyday activities such as pain free shaving, brushing and flossing teeth, opening jars, shaking hands, writing, squeezing anything, picking up even light weights with the back of my hand upwards. I have not been able to do any of these things for 9 months without grimacing in pain and have not hit a tennis ball since Feb 7 so I really hope that this surgery is really the first positive step to getting this problem resolved.

    May take longer than 3 months, that's fine, as long as I see progression in the rehab, not regression as I have experienced since this first occurred.
     
    #92
  43. garywsyu

    garywsyu New User

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    Wish OP has a quick recovery after the operation.

    I have been suffering both TE & GE since May 2012 and luckily the TE is almost gone but the GE is stilling hitting me with a light sensation after play. My friend had performed a "knife/needle" operation for his TE and the result was excellent. His condition was pain free since then therefore I am considering a move as well. His act was to clean up calcification and separation of sticky tendons around the area. Seems surgery is a swift and clean suggestion for such stubborn condition. People like myself have tried ways of method and suggestions from forums but the results are contradictive.

    Can OP share a bit more what the surgeon did on his elbow and such reference would be helpful and constructive either way.
     
    #93
  44. max

    max Hall of Fame

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    aussie: thanks for the update.
     
    #94
  45. aussie

    aussie Professional

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    When I have my follow up appointment on Tues 19 Nov I'll find out from the surgeon what he found, how exactly he repaired the damage, and his prognosis moving forward. I had no opportunity to speak to him after surgery so I'm obviously keen to get as much info as possible. He is the upper limb specialist for the Brisbane Broncos, probably the premier rugby league team in Australia for the last 25 years, so I know I was in very good hands.

    Sounds like your friend had percutaneous surgical intervention for his TE which is the least invasive method and it's great the result was so positive. No one wants surgery, but when you've tried most other methods with zero results, it becomes a more palatable option. Best of luck with your GE, though it sounds like with some rest and some stretching and strengthening it may resolve. Good luck! aussie
     
    #95
  46. aussie

    aussie Professional

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    Okay, to finish this thread off and to answer the question I posed - are PRP injections for tennis elbow successful or not? For me, the answer is no. I received no benefit from the two injections I received.

    The theory behind the platelet rich saturation of the area of tendonosis seems reasonable enough, but it is just a theory. Introducing massive amounts of growth factors as well as piercing the tendon to both promote and provoke an accelerated healing cascade seems reasonable enough. But for me, it did nothing. And some of the more recent clinical trials have found that there is no difference in the healing response between PRP injections and saline injections. However, there are those who have undergone PRP injections and have experienced a satisfactory outcome - a resolution of pain and return to tennis and other activities using the extensor muscles and tendons. To those lucky enough to have experienced that response, I say good for you! I envy you and wish you a lifetime of pain free tennis without a return to this debilitating condition.

    The other thing I'll say to those who believed I didn't allow the PRP enough time to repair the tendonosis, the injecting sports physician believes that if it is going to work, a positive response is encountered within 6 weeks of the injection. In my case, I waited over 4 months and unfortunately, the positive hoped for response never eventuated.

    Where I am at now? 3 weeks following a repair to the common extensor origin, I am feeling very positive. The ortho surgeon using the open surgery method, excised the damaged and degenerated portion of the ECRB tendon (I had a partial thickness tear) and reattached the tendon to the lateral epicondyle. He tells me that the surgery went well and he expects me to make a complete recovery and to at least be hitting again at the 3 month mark. More competitive tennis will come a few months later. Interestingly, he saw no evidence of any healing response to either the PRP injections or any of the many other modalities I had used.

    I will say that the pain level for the 4 days following the op was severe - far more than I expected and I've had 2 knee reconstructions and 6 arthroscopic knee surgeries so I thought I would know what to expect pain-wise. I was wrong!

    So 3 weeks on, still elbow stiffness and not yet full range of motion, and some post operative pain. Can't quite fully extend the elbow and can't quite attain full flexion, but I improve every day. The good news - the pain I've had for 9 months where the ECRB tendon attaches to the epicondyle, it's gone! So at this early stage, even with some stiffness and post op pain present, the tennis elbow pain is not there.

    So I remain hopeful that the repair has been successful, and that as the next months roll on, the elbow pain does not return as my forearm regains strength and full function. I have no desire to rush prematurely back into tennis - having been through so much so far, I really want to rehabilitate the elbow completely before even the lightest hitting. Aussie.

    That
     
    Last edited: Nov 28, 2013
    #96
  47. mikeler

    mikeler G.O.A.T.

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    Good luck with the rehab.
     
    #97
  48. rufus_smith

    rufus_smith Professional

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    Thanks. Sounds like very good news. Cross my fingers.
     
    #98
  49. Posture Guy

    Posture Guy Professional

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    I just skimmed the thread but I'll post my general thoughts here, and I'm speaking from the perspective of someone who just had a PRP/stem cell injection in the right knee.

    I think this therapy holds a lot of promise. It's early and the data is sketchy at best. Finding a quality practitioner who will shoot straight and has a good amount of clinical experience and can speak to patient outcomes and can tailor the procedure to your situation is obviously a great idea.

    But these therapies will be of limited benefit if the underlying issue that caused the damage in the first place is not addressed. Think of PRP/stem cell therapy as replacing the worn out tires on your car. Now in my view, our joints don't necessarily break down because of the aging process, so the analogy is imperfect. If our bodies are properly aligned, motion and impact doesn't consume "tread", it strengthens it and in some cases has been shown to add it!

    But if a joint is misaligned, just like if your car is misaligned, then you'll chew up the tread, and in an uneven fashion. So back to the analogy. If you are driving your car and hit a pothole and knock the front end out of alignment and keep driving, you chew your tires up, right? Well, what happens if all you do is buy new tires? Yep, you'll chew them up, too. And that is what is happening with a lot of people and PRP. They're injecting a knee sitting below a femur that is 15 degrees externally rotated and valgus, or into an elbow where the shoulder is hinged forward and the humerus is internally rotated and the scapula has lost full mobility, and then wondering why they still have pain after the procedure. Your body may be trying to repair or lay down new tread, but the position of the joint is such that you're wiping it away as fast as you heal it up.

    Fix the alignment and the myofascial problems using the kind of stuff I recommend, and that RogueFlip recommends, get that stuff dialed in, and THEN experiment with this kind of stuff. Your odds of a great outcome are much, much higher.
     
    #99
  50. brswan@att.net

    brswan@att.net New User

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    At age 51, I had PRP for medial micro tears(the doc said Tommy-John was not available after age 45). I had been out of action for two years, but with PRP and some physical therapy, I was good to go. Still have some minor post-play pain but at least I'm banging (at 4.5 and after 24-0 season probably going to 5.0). Had the PRP done at Kerlan-Jobe in Anaheim. They're the best. Only charged $800 (not covered by insurance). If you need help, get help. PRP was the last available solution at my age, otherwise I would have been a formertennis player.
     

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