Chronic High Hamstring Tendinopathy - PRP Injections

dublinlush

Anyone else suffering from this? I'm pretty crushed by it. Had it for almost a year now. Tried EVERYTHING. Nothing makes it better. PT and strengthening made it worse tbh. Got lots of nerve pain as a result. I'm in my 50s so am supplementing now with collagen and vitamin c to try and help heal the tendons. I'm lined up for a new MRI and possible PRP injections. I'm desperate at this stage to just be able to walk longer distances, cycle and swim. Nothing crazy just normal exercise. Anyone had good experience from PRP? I'm seeing a guy at Stem Medica in Dublin. He's confident it will expedite healing within 2-3 months with 2 injections. It sounds long but when you've had it for a year, it's a lifeline!

banie01

I haven't had PRP nor do I know anyone who has. Your question piqued my interest so I had a trawl through published reports and articles.

Whilst their is plenty of marketing spiel for PRP, there is remarkably little quality evidence for it. Indeed the "best" study I could find was for PRP in relation to hair loss and that was an N of 30 so not exactly high quality data.

As it's not a "drug" it isn't subjected to the same standard of evidence as steroids or NSAIDs. It's "natural" and just "concentrating your own body's cells" to help speed up your healing process.

That initially sounds great, but there's lots of stuff in your body that you don't want concentrated and re-injected. It's bro science IMO, it sounds plausible and it can be upsold as "natural". But, I have looked through lots of journals and can't find any study apart from the Rogaine one, where it performs any better than a placebo.

I'd want some actual evidence of treatment efficacy before I throw money at PRP. Would steroids via a guided injection be a better option? Probably a far cheaper one too. Guided injection is about 160 versus how much for the PRP?

Edit

Just had a read of the disclaimer on the website of the clinic you are using. TBH, it's not something that would inspire any confidence for me. It is the internet classic of "not advice, just information" also no evidence, just testimonials.

Whatever benefit of the doubt I afforded them is gone after browsing their site.

Look I know how debilitating chronic pain is, I know how hard it is to treat and how hard it can be to find a Dr that will listen to you. But?

If I was in your shows, I'd seek a Dr that provides ultrasound guided injection or one that deals in sports medicine to advise you on treatment.

Even down to the clinic you're using not listing their staff or credentials on their site. It just jars me tbh. If I'm looking for medical treatment, I want to view the medical director and docs offering the treatment and taking my money.

I think stem cell treatment has transformative potential, I think these lads are peddling quackery tho.

dublinlush

Hi there, thanks very much for your detailed and considered response.

I tend to agree with you about the dubious nature of the clinic and what they are offering but I am a bit desperate these days so I'm exploring all avenues. In fairness the guy I consulted with (ortho surgeon with anesthetics degree according to the Irish Register/RCSI) wasn't pushy. He also does US guided injections but I know that steroids can damage tissue so I am reluctant to go down that route. He has ordered an MRI for me - there is a huge backlog due to the HSE hacking - and he'll analysis the images and we take if from there. He advised my to try other adjunct treatments and to keep going with physio. And also to take collagen supplements with Vit C. I eventually went to a new physio and had a dry needling session which isn't for the faint-hearted but was very helpful in releasing huge amounts of tension in my glutes and legs and has improved my range of motion. I'm hoping I will get better with time but my mental health as suffered a lot - a big surprise for me as I'm usually a very positive optimistic person.

Let's see what the MRI says and if by that time I'm a little better then I won't need any injections. I actually watched a whole conference with academics and practitioners - ortho specialists and physios - online - discussing the benefits or lack thereof of injections of all kinds. They were all super skeptical. Yet well-known athletes continue to use PRP to return to sport successfully.

Thanks again for your advice - I do appreciate it - and will heed it.

terminator74

Hi there - sorry to hear about your hamstring problem. I am no medical expert so I can only speak from personal experience as someone who suffered from high hamstring tendinopathy in 2016/2017. I also had a PRP injection in 2012 for planter fasciitis. I'll start with my experience of HHT. For context, at the time, I was 42 years of age - very good standard of fitness and did a lot of club running (road, track and XC). I could feel a progressive soreness in my hamstring towards the end of 2016. I had just recovered from some back issues in early 2016 through a lot of core and strength programme with my physio. Got to the stage in Jan 2017 when the pain post running in my hamstring was really sore. Sitting for any prolonged period and standing up was very painful. I went back to physio who set me on another course of pretty intensive s&c. It was extremely stubborn at first and despite lots of strength work on glutes, hips and lower back I didn't feel I was improving. I did persevere and started running again, albeit through some pain. Around March I started to notice a decrease in post run pain but maintained the s&c work and by May I was back in full training. I did a lot of Nordic curls and from what I can recall goblet squats. dead leg lifts and other lower limb strength work.

I got a PRP injection for plantar fasciitis in 2012 after I had exhausted all other avenues. I had the procedure done in Santry Sports Clinic. The injection into the heel of the foot was the most painful procedure I have ever experienced. The pain in the heel at the site of the injection was very sore for two weeks. I was offered a second injection as the the pf didn't improve at all. I refused and went back to other physio program options.

Not sure what you can learn from my experience but maybe not give up on the more traditional route of physio (i went to Sports Med in D2) who were excellent. I have heard varying assessments from medical and physio professionals about the efficacy of PRP injections (very common in the US i believe). However, it didn't improve my pf in anyway but, to my mind, caused trauma and pain to the area.

Best of luck

dublinlush

Thanks very much terminator74. Appreciate you taking the time to write up your experience. Interesting comments about the pain PRP caused you - sound horrendous! I hope the PF has subsided and the conservative route worked for you. You're totally right about being wary of these things and sticking to the traditional methods. My problem has been mental and as well as physical: I developed sciatica nerve issues (mainly pins and needles) from overdoing the S&C initially and that has floored me - literally. I'm finding it hard to deal with a bunch of health issues at the same time, my head is all over the place, my work is suffering and I need to get my act together rather than hope that a quick fix exists for everything. I guess it's about learning to be patient... not my forte! All the posts I read on both HHT and sciatica indicate rest, strengthening and time is what heals in the end. Let's see how we go! Thanks again for your input. ;-)

caviardreams

Hi dublinlush

Wondering if you ever got this sorted? I am in the same boat - 5 months+ now with HHT and nerve pain into the mix as a result.

Progress is very slow with resting and physio exercises etc and unable to train for months

Would love to find out if you got it sorted

Cheers

B

Dontfadeaway

https://www.boards.ie/discussion/comment/120419672#Comment_120419672

Did you get it sorted? I’m having similar symptoms, but no diagnosis yet

caviardreams

https://www.boards.ie/discussion/comment/121508655#Comment_121508655

Progress - slow progress but definitely progress. Can do a lot more now pain free but still some things I can't do.

Lots of physio and strengthening and paying attention to flareups and being realistic about what I can't do.

dublinlush

Hi, I'm very sorry I didn't see these messages until now. My Boards notifications don't always work so I miss stuff. Just in case if anyone is reading this, yes I finally got the thing sorted. I'm around 95% better, I don't think I will ever be fully recovered and I can't run, but I can swim and cycle, and most importantly I can sit down!! I didn't do the PRP in the end which was probably a good thing. I found a PT online in the UK who was able to help (others here in Ireland and another online guy called Brodie Sharpe all made it much worse), and I did 6 dry needling sessions with a brilliant lad called Dene Hickey in Dublin. The whole thing was a massive pain in the a**e, but slowing everything down with the PT rehab and altering the structure of the tissue in my glute and hip through the needling, helped loads. Time and patience was key. You will heal eventually but it is very very slow.

franglan

Have something similar. HHT and gluteal tendonopathy as well. Have physio-ed it, done dry needling and shockwave therapy for past 8 months to no really obvious benefit. Got PRP done last week in Dublin into upper hamstring, second injection in 2 weeks time into glute. Zero improvement in the 5 days since injection and I probably am expecting too much too soon. Doctor said I could go back doing leg work in gym as normal after 5 days - everything else I've read says at least a month... Anyone have any thoughts on this approach. Back to normal would mean RDL's, squats, leg press, deadlifts with tapbar etc at normal weights prior to jab....

dublinlush

5 days is probably too soon to say. I would recommend not going fully back to 'normal' just yet. Take it slower and don't do hard stuff like RDLs and deadlifts immediately. You need to give everything a chance to heal, let your body get used to the impact of the injections and then to take weight again. My biggest takeaway from my rehab was patience and time. I had to pace myself carefully but it worked eventually. Good luck!

caviardreams

https://www.boards.ie/discussion/comment/122296537#Comment_122296537

Agree - I had to drop everything except some flat walking (would have been doing squats etc) and just build on physio very slowly. After several months, add weight to squats but only 2kg per fortnight. Slow, build load and capacity and watch for flare ups. Still can't do stretches etc but can do a lot so focus on that. Cycling pain free etc which is a win. Physio told me you will always have it at you and it's about managing it and working around it

Interesting re brodie - I am on the FB group and people rave about him. Often thought of giving him a go

dublinlush

I am on the FB group too. They have been a life saver I have to say. I connected with a couple of others who had trouble with Brodie too and they gave me the contacts of a different lad in the UK who helped me a lot. He had had the same injury himself and had done a masters in how to fix it! Brodie treats runners mainly and I'm not a runner myself. It seemed to make a difference to his attitude. Also he doesn't assess you properly. You have to complete and write up a self-assessment yourself, which is clinically not really ok IMHO.