Muscle and tendon pain can be a real drag, and often injections are recommended or considered after failed conservative treatment. Especially by that bloke in the office!
But does it work, and are they damaging?
There are lots of injection options for tendinopathy; corticosteroid, platelet-rich plasma, hyaluronic acid, prolotherapy, tenocyte implantation, stem cell… the list goes on.
There are promising studies with each of these, and there is no ‘one size fits all’ answer.
Currently, corticosteroids remain the most common ‘safe bet’ for pain relief and return to rehab. But they are short term strategies, with less effective long term results.
Although widely regarded as safe, animal trials of corticosteroids have showed that they can weaken tendons, however it is not conclusive in humans.
Platelet rich plasma (PRP), injects a concentrated mix of the bodies own cells to promote healing, and is gaining momentum. However the evidence is not yet certain as there are a wide variety of techniques and the procedure appears not to be completely perfected.
All other injections are considered more experimental when compared to corticosteroids and PRP.
So in conclusion, tell your office buddy that there is no clear winner! Having said that, expertly administered injections carry relatively few risks and do often help tendon rehabilitation. Therefore it is worth considering, especially when there is little response to therapy on its own.
Alex Horne Chiropractic… more than just a little prick.
Sources available on request
8 Vitamin D facts make Londoners want to supplement!
1. Vitamin D controls over 1000 body processes (including immune function, bone density and anti-ageing). (1,2)
2. 50% of UK adults are vitamin D deficient. (3)
3. Vitamin D production is optimal at midday, so the shorter your shadow, the more you make (relative to your height of course). (4)
4. In summer, two or three 20-30 minute exposures of mid-day sunlight/week is enough in the UK. (3)
5. You make less vitamin D from the sun the greater;
your skin is pigmented (if could take 15mins for fair skin, compared to 2 hours for dark)
your distance from the equator (3,5)
6. Clouds, sunscreen and air pollution all decrease vitamin D production from the sun. Glass completely blocks it! (4)
7. Between October and April, 90% of the UK don’t produce enough vitamin D from sun exposure, so must rely on diet. (3)
8. Few foods contain substantial vitamin D, oily fish, beef liver and egg yolks. (3,5)
Look out for the next article, how to supplement your vitamin D!
Alex Horne Chiropractic – Where the sun is always shining (from directly overhead). Don’t miss our special offer!
3) Pearce SH, Cheetham TD; Diagnosis and management of vitamin D deficiency. BMJ. 2010 Jan 11;340:b5664. doi: 10.1136/bmj.b5664
5) Vitamin D clinical guideline, NHS North of Tyne (2011)
Getting that familiar ache late into your run? After sitting for an hour? Or is it the final ascent of the Saint-Pourçain-sur-Sioule/Lyon Tour de France stage that gets you?
You might be structurally stumped, biomechanically bewildered or functionally f***ed!
Let’s assume that our technique is as fantastic as Bradley Wiggin’s sideburns were, and that in every activity we use the ‘correct’ muscles, whether you’re desk jobbing or holding the gymnastic iron cross.
At a given point from seconds to hours, those muscles will begin to fatigue, it’s inevitable.
But don’t worry; other ‘cheating, compensatory’ muscles will come to your rescue.
These will get the job done, finishing the race or getting you through to lunch, without collapsing in a heap.
Gee whizz the body is just super eh!
Not quite. These adaptations will work, but by compromising function; letting that knee grind inwards, straining your shoulders forward or de-activating your glutes.
It’s likely that most of us aren’t technically ‘perfect’ as we’d assumed, so niggles could be due to originally poor form weakening further. Regardless, if it is happening consistently, then it’s time to start finding that weak link!
By pushing yourself to a limit (whether recreational or professional) you can find this weakness, and work on it no matter if it’s big and general or small and technical.
Find your functional flummox with Alex Horne Chiropractic.