What is a Physiatrist?
A Physical Medicine and Rehabilitation physician, or a physiatrist (fizz-EYE-a-trist), is a medical doctor that specializes in restoring optimal function for people with injuries or pain. They treat problems as common as sciatica or as complex as a spinal cord injury.
Why Choose a Physiatrist?
Like any medical doctor, physiatrists perform a careful history and physical examination. They may also use sophisticated diagnostic tests of the neuromusculskeletal system to find the source of your pain, injury or disability. A Physical Medicine and Rehabilitation physician then designs a non-surgical treatment program tailored for you. The physiatrist directs and supervises the entire treatment team of health professionals, including physical therapists or athletic trainers. The goal is to reduce or eliminate the problem and restore the area to its best condition.
To decrease the possibility of recurrence, your physiatrist can help you become an active participant in your own health and fitness. Because they offer an aggressive, non-surgical approach to pain and injury, physiatrist are the ideal choice for the treatment of orthopedic injuries.
What is Platelet Rich Plasma (PRP)?
Platelet Rich Plasma, or PRP is blood plasma with concentrated platelets. The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins, including growth factors that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate connective tissue healing: bone, tendon and ligament regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process.
How does PRP work?
To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and automatically produces the PRP. The entire process takes less than 15 minutes and increases the concentration of platelets and growth factors up to 500%.
When PRP is injected into the damaged area it stimulates the tendon or ligament, causing mild inflammation that triggers the healing cascade. As a result new collagen begins to develop. As this collagen matures it begins to shrink causing tightening and strengthening of the tendons or ligaments of the damaged area.
What are the potential benefits?
Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long term medication or surgery as well as a remarkable return of function.
What if I am seeing more than one health care professional for my condition?Comprehensive care requires a team approach and effective communication among the team. Dr. Zaharoff works with all of the individuals who may be involved in your care including physical therapists, chiropractors, podiatrists, and other health professionals. She will also make appropriate recommendations and referrals for any other medical services necessary for your care. Other options, including surgery, may be reviewed if indicated.
What if surgery is needed?
Pre- and post-operative rehabilitation programs may also be developed as needed. These programs help teach patients what to expect from surgery, how to prepare themselves for surgery and what options are available post-operatively to assist in their recovery from surgery.
Dr. Zaharoff’s individualized post-operative rehabilitation programs may include specific therapies to enhance strength, flexibility, balance, coordination, and independence. All programs are individualized to meet the needs of each patient.
What are tendon & ligaments?
Tendons, composed of collagen fibers, connect muscle to bone making it possible for you to perform everyday physical activities. Overuse or damage to tendons over a long period of time causes the collagen fibers in tendons to form small tears, a condition known as tendinosis. Damage most often occurs in the knee, ankle, shoulder, elbow wrist, biceps, calf, hamstrings and Achilles tendon.
Ligaments are also composed of collagen fibers, connecting bone to bone i.e. joints: ankles, knees, shoulders, spine, etc., stabilizing the joint and controlling the range of motion. A damaged ligament is no longer able to provide support, weakening the joints and shifting the burden of support to the muscles (and then to the tendons) which should primarily act as movement engines. Tendons and Ligaments have poor blood supply particularly where they connect to the bone . Once injured (sprains or strains) they do not heal easily and the damage progresses with the stress of day-to-day activities. As a result the tendons and ligaments become inefficient, the muscles are over taxed causing chronic pain and weakness and further damage. Medical intervention may be necessary.
Is this the same as Cortisone shots?
Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but they do not provide long term healing. PRP therapy heals and strengthens these tendons and ligaments, strengthening and thickening the tissue up to 40% in some cases.
What can be treated?
PRP Injections can be performed in tendons and ligaments all over the body. Some examples are:
· Sports injuries
· Arthritic joints
· Lower back, degenerative disc disease
· Tennis elbow
· Carpal tunnel syndrome
· ACL tears
· Shin splints
· Rotator cuff tears
· Plantar fasciitis
· Iliotibal band syndrome
How many treatments are necessary and how often is this therapy administrated?
While responses to treatment vary, most people will require 1-3, some as many as 6 sets of injections. Each set of treatments is spaced approximately 4 to 6 weeks apart. There is no limit to the number of treatments you can have, the risks and side effects do not change with the number of injections.
Is PRP right for me?
If you have a tendon or ligament injury and traditional methods have not provided relief, then PRP therapy may be the solution. The procedure is less aggressive and less expensive than surgery. It will heal tissue with minimal or no scarring and alleviates further degeneration of the tissues. An initial evaluation with Dr. Zaharoff will be preformed to see if PRP therapy is right for you.
There has been much talk about “rooster comb” or viscosupplementation injections for knee arthritis, but are they effective?
Learn more about this procedure and current recommendations about the treatment here.