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
The popular ‘high intensity interval training‘ workout boasts many benefits, but are you ready to HIIT it?
If you, like many, jumped straight into it, just consider the advice below which I offer my patients, courtesy of Joe McConkey (Boston Running Centre).
You’re ready for running HIIT workouts if you have:
- Been running 4-5 times a week for at least 4 months
- Regularly thrown in runs at paces 60 to 90 seconds per mile faster than crusing pace.
- Been completing a weekly long run of at least 50 minutes.
In terms of strength and flexibility, you should be able to:
- Hold a squat position for 90 seconds
- Grab and touch your heel to your butt whilst standing, feeling only a minor quad stretch.
Start with one HIIT session a week, and build up to no more than two in a 10-day period.
This advice is tilted towards runners so isn’t for all HIIT sessions, which can be adapted to any sport. But just think twice before you train intensively, and make sure you are FIIT enough.
Alex Horne Chiropractic, back with a vengance!
Many back pain sufferers know that catching 40 winks can be tough for your back.
“But why can rest make me sore?”
Between your vertebrae, there are discs made up of fluid and strong fibres helping to distribute pressures on the spine, for example during sitting, bending or running.
During sleep, the load on our spine is relieved, giving our discs a window in which to heal and hydrate. In the morning a typical spine is 1-2cm longer* (this can be up to 5cm in space!*) as hydration causes them to expand.
These lofty heights are lovely, however more fluid in the disc creates a pressure increase. Bending in the morning produces approximately four times more strain than during the day**, putting you at a greater risk of injury.
Discs have a poor blood supply, so rely upon rehydration and protein replenishment to stay healthy. Of all cartilage in the body, they wear down the fastest*, so ignore them at your peril!
We are largely immobile when asleep, so the facet joints, which are designed to move, can also feel stiff on waking. (Problems aren’t usually caused, but accentuated by sleep).
“So what do I do?”
Mornings are quite a delicate time. Your discs need to depressurise without being subjected to heavy strain or big stretches, but, at the same time, your facet joints like to be stretched out.
The best advice is to slowly expose your back to you body’s weight before subjecting yourself to any stressors. Continue reading Make a stand in the morning!
Until at least April, it is hard to get enough vitamin D, so here are some tips on how to supplement:
1.The most effective vitamin source is D3. D2 (often prescribed) will do, but isn’t as effective*.
2.Supplements of D3 are absorbed just as easily into the body as from dietary sources or from the sun*.
3.Cod liver oil contains lots of vitamin D, but take care not to over suplement due to high vitamin A levels*.
4.The average person can safely supplement with 5000iu´s*.
5.10,000 iU´s is the average persons maximum daily dose and shouldnt be exceeded*.
6.A study found supplementing with 4000iU´s of vitamin D was enough to bring a significant majority of adults out of vitamin D deficiency**.
7.Sun beds provide sufficient UVB radiation (required for vitamin D production in skin) even in short sessions*.
8.Not all D3 supplements are vegetarian friendly.
9.A vitamin D supplement is around 65 times cheaper than a boring 6 day budget holiday to Majorca and lasts around 2 times longer!*** That’s roughly 130 times more cost effective, and no drinking their dodgey water what don’t taste like what it oughta!
***Based on 100 doses/supplement and 6 days of casual sunlight making up for 49 days without sufficient sun exposure thanks to fat soluble vitamin D storage (study).