Musculoskeletal Procedures Joint, Tissue Injections & PRP

Cortisone Injections

Cortisone is a corticosteroid released by the adrenal gland in response to stress and is a potent anti-inflammatory agent. Artificial preparations containing cortisone are injected directly into the affected joint to relieve pain and reduce inflammation. The effects may last for several weeks and cortisone injections are recommended in injuries that cause pain & inflammation and those don't require surgical treatment. One such condition frozen shoulder and cortisone injection into shoulder joint relieves pain & inflammation.

Cortisone injections offer significant relief in pain & inflammation however is associated with certain adverse effects. The most common side effect is a "cortisone flare", a condition where cortisone crystallizes and cause severe painfor a brief period that lasts for a day or two. Cortisone flare can be minimized by applying ice to the injected area. Other adverse effects include whitening of the skin andinfectionat the injection site, a transient elevation in blood sugar in patients with diabetes.

Intra-articular Injection

Intra-articular injections are recommended in treating various orthopaedic conditions including sports injuries and degenerative disease, arthritis. Steroid preparations are often used for intra-articular injections and they possess anti-inflammatory activity. Corticosteroid intra-articular injections are useful in treating knee arthritis associated with synovitis and effusion.

In intra-articular therapy the steroid is given directly into the affected joint. Thus it gives an opportunity to physicians give higher doses as required, localize the effect and also minimize the adverse effects on other organs. Sometimes infection at the injected site may occur. Thus extreme precautions are taken to maintain sterile procedures while giving the injection. Repeated intra-articular injection in a joint leads to cartilage damage. So injection in a particular joint are repeated only after few months of gap. Sometimes local anesthetics are also given with corticosteroids to improve pain management with a low dose of corticosteroid.

Image guidance tools such as ultrasound, fluoroscopy and radiopaque tracer are now being increasingly used to facilitate intra-articular injection in difficult to reach joints such as hip and shoulder joints. After intra-articular injection you should give rest to the joint for few days as reduced activity delays the absorption of the steroid from the joint and prevents its systemic effect.

PRP Treatment for Tennis Elbow

Platelet rich plasma (PRP) is concentrated portion of blood plasma containing more amounts of platelets. The platelets contain growth factors that help in healing of chronic injuries. The PRP treatment involves injection of high concentration of patients' own platelets into the injured tendon in order to stimulate the body's healing capacity. The ligaments and tendons have a poor blood supply due to which healing is delayed. Injecting platelets rich in growth factors into these areas hastens the healing process because the growth factors also stimulate the defense cells, (neutrophils, monocytes and fibroblasts) which have a prominent role in repair process, resulting in quicker pain relief and faster recovery.

In this procedure, the blood is withdrawn from your body and centrifuged for about 15 minutes to separate blood plasma (liquid separated on top) and blood products (settled at the bottom). The plasma is taken and kept aside in a sterile injection. This is later injected into the site of injury under sterile conditions and ultrasound guidance. The PRP treatment is accomplished in several treatment sessions and each session may take less than an hour. You may have to wear a splint after the procedure and you may be advised to practice certain physical therapy exercises. The procedure is considered safe, risk of infection is minimal, offers minimal discomfort and the recovery is quick. However, patients may experience certain complications including pain, bruising, damages neighboring structures such as nerves, blood vessels, and infections.

Sports Concussion

Coming soon

Sports Specific Training

Sports specific training is an essential element for every sports person. Sports specific training is a process of learning more advanced skills specific to your sport. Sport specific training uses exercise program to help athletes improve skill level or the movement patterns of each exercise for injury prevention. These training programs should be tailored for individual athletes to achieve goals.

A qualified personal trainer must obtain a bachelor's degree in exercise science, physical education, and sports medicine or a related field. They should have CPR certification and first aid from reputed organizations. They also require very good communication and listening skills and assessment when working with athletes.

The athletes are screened for their movement patterns before the training. Movement screening can help determine if you have any weaknesses or faulty movement patterns or your risk of injury. These faulty movement patterns or weakness will increase the risk of sports injury and limit the athlete's ability to perform. If faulty movement patterns are detected during assessment you need to improve those patterns before training.

At the beginning of the training dynamic warm-ups are performed. The purpose of dynamic warm-ups is to strengthen proper movement patterns, stimulate your nervous system, and to move your joints and muscles. At the end of the session a combination of dynamic stretches, static stretches and self-massage techniques are performed to help loosen up the tight and fatigued muscles.

Every athlete could benefit from sport specific training. You may receive feedback for your progress from your personal trainer. Personal trainer also takes out the guesswork from your workouts. They act as an athlete's coach and provide motivation and accountability in order to avoid withdrawal from training program. They also provide you information about exercise strategies and equipments.

Musculoskeletal Ultrasound

Musculoskeletal Ultrasound (MSK) can now be used to visualize: Bone, Muscle, Tendon, and Ligament anatomy. This technology is at the cutting edge of sports- orthopedic diagnosis.

There are two main uses of ultrasound in orthopedic- sports medicine:

• Diagnosis
• Image guidance in procedures