A blog detailing my recovery from Patella Tendonopathy (tendonitis/tendonosis) and my experience with PRP Injection

Tuesday, September 11, 2012

Month 4

The healing seems to have plateaued. There are definitely more good days than bad, and the pain seems to shift from one knee to the other. Still not at a level of running of where I want to be, but I seem to be making progress. According to studies the platelets are still active in both tendons, so there should still be some degree of healing still taking place, even 4 months after the initial PRP Injection. 

I have continued taking the following supplements daily:

  • MSM (I feel this is helping the most)
  • Fish Liver Oil (good at keeping the inflammation down)
  • Chondroitin
  • Glucosamine
  • Knee supplement that has all of the above including:
    • Flax seed oil
    • Boron
    • Manganese
    • Collagen Type II (2)
    • Mangosteen Extract
    • Vit C
    • Vit E
    • Vit B1
    • Vit B2
    • Vit B6
    • Vit B12
    • Pantothenic Acid
    • Zinc
    • Selenium
    • Silicon
  • Multi-vitamin

I have been doing foam rolling on my quads, calves, glutes and ITB for 10 mins every night before bed as well as stretching.

I have also been stretching these areas of my body.

Progress is slow. Whenever the knees feel good I attempt a run and seem to take a step backwards. I believe the key is patience and consistency

How have you found your PRP Injection experience? Has it helped you? What rehab protocol are you following? What has and hasn't worked for you? Do you think I should go for another shot? I am get lots of support and positive feedback and I would love to hear from you and hear about your experiences...

Thursday, September 6, 2012

Month 3

This was the month where I slowly experienced a noticeable difference. The bad days became fewer and good days became more regualr. One thing that I felt that had been different from the past 2 years of patella tendonosis, was when I sat, straightened my leg and flexed my quad muscle as hard as possible I would always get a sharp pain in the tendon, however this slowly went away and I no longer exprience this at all.

Pain going up stairs lessened each week, and I currently have no pain when going up stairs. There is however some discomfort when going down stairs. Before the PRP Injection, I could not sit at my desk with my knees bent for longer than 15 without my knee starting to burn. This uncomfortable burning sensation diminished greatly by month 3.

My knees were still not 100%, but had come quite a way in 3 months. I did, however, not go for another shot. I decided to wait and see if they would contiune to make positive progress  in time with the stretches, strenghtening and eccentric dips, until I spent more money.

By this stage I started my usual exercise routine of lifting upper body weights 3 times a week, and cycling quite rigorously (mountain biking) 2 - 3 times a week 10 - 20km. During the first few kms my knees would feel a bit niggly, but after a while they would warm up and feel fine, and then if I pushed too hard they woud start hurting again.

All about finding the balance between rest and recovery, and strenghtening!

Monday, September 3, 2012

Month 2

After 2 months my left tendon felt very similar to how it felt prior to the PRP Injection. It was still quite painful and niggly. That inital tightness and feeling of being pain free when jumping or running on th spot, had gone. It appeared as if the tendon had returned to its normal state, without being full of fluid. This was quite strange, as from what I had I read of past patients experiences, their tendon was more pianful after the first few weeks  but there was a noticeable improvement after 2 months. Surely I would be able to notice some benefit by this stage?

I had a had shot to my right knee a month earlier, based on the initial success of the PRP Injection in my left tendon. However, my right knee seemed to be in the same boat as the left knee- not much better, but not worse.

I continued to take it easy. I wore a patella tendon strap (cho-pat strap), to support the  knees while doing light exercise or walking up and down stairs. I continued with my rehab program of strenghtenin my glutes, hamstrings, calves (I will do another post on this at a lter stage, of my exact rehab protocol- primarily based on Mike Robertson's Bulletproof Knees), I also continued doing light eccentric dips, this was deterined on how my knees were feeling. If they were feeling tender or painful I would rest them and skip the eccentric dips, if they were feeling good I would do sets of 15 until they started hurting.

It was around this two week mark that I started to notice a slight change. I had periods of approx. 3 days were my knee would feel really good, and then a period where it felt really bad (worse than before). Prior to this- the injection- my knee had experience a consistent type of pain. Now this pain started fluctuating between very sore to minimallt marginal.

Thursday, June 21, 2012

Week 4

This has been an interesting week. I've had some good days and some bad. At the moment my left knee feels a bit stiff and tender in comparison to the right. It's got a kind of constant ache, perhaps this is due to the inflammation and the biological changes taking place within the tendon?

I attempted an easy 1km run today, the left tendon flared up a bit after a few 100 metres. However, the left tendon is not sore in comparison to the right when going up or down stairs and no longer seems to have the 'sharp' pain that has bothered me for the past 1.5 years.

The tendon as at it's most painful first thing in the morning and then once it warms up a bit it feels better than the right knee. I've had periods when there is absolutely no pain in the left knee and periods where it's noticeably more painful than the right knee. This could be the 'roller-coaster' effect I mentioned in Week 3.

I have continued with the Eccentric protocol on my right knee- 3 x 15 sets of one-legged squats on slant board at night. I have now reached 3kgs in the backpack. I have been doing about 10 dips on the left leg every second night, without any weights. My reasoning was that this would help direct the alignment of the collagen fibres in the tendon as it repairs.

I bought a foam roller yesterday, I have done a bit of this, but I'm now going to try and do 3 mins of rolling on each leg every second night.

I have currently been taking:

  • MSM
  • Glucosamine
  • Chondroitin
  • Fish Liver Oil
  • Vitamin C
  • Gellatine

In Week 2 I discussed the testimonial about the patient who was dissappointed and complained to his Doc that the PRP Injection did nothing after one month, and by 2 months he was completely healed and his knee felt 100%. So I'm going to give it more time and try take it easy. The Platelets are active for 6 weeks and the healing benefits of PRP continue for up to 6 - 9 months.

I'm PRP shot to my right knee on Monday.

Wednesday, June 13, 2012

Week 3

My tendon has continued its positive healing progress, and I've only had one bad day this week. Currently my knee feels better than it did before the PRP injection and there hasn't been any regression in pain. Its basically gone from the 70% it was at previously to 80%. When I straighten my leg and flex my quad muscle there is minimal pain, whereas before this would have caused a sharp pain sensation in my left tendon. The tendon itself still feels quite hard and doesn't seem to have as many bumps (I think this is the scar tissue and misaligned collagen).

I have done a few light sets of eccentric single-legged squats on a slant board and these are still quite uncomfortable on my knee. I also went for a fairly strenuous 8km mountain bike on Monday and my knee didn't feel too bad, not completely healed, but not painful. 

When I tried a light 300m jog today my left knee felt alright while my right knee had the familiar sharp pain sensation that I had before on the left knee whenever I pushed off from the ground or landed. One thing that I have noted is that my left knee feels a lot tighter and stiffer in comparison to the right, perhaps it's due to a bit of inflammation or the healing process happening in the tendon? However the chronic sharp pain I used to experience running or going upstairs seems to have subsided in the left knee.

The progress is slow and gradual as I expected, but if it continues I will be happy. I am going to go for a PRP shot in the right knee in 2 weeks. And then a follow up the PRP injection in my left knee in a month's time.

I hope that if you are considering a PRP Injection for a tendonopathy or are currently recovering from one, that you are finding this blog useful. If you have any questions, queries or comments feel free to post them below or email.

(Rafa Nadal just won Roland Garos after pulling out of the Miami Open in April due to knee pain, for which he had a PRP Injection. It seemed to sort him out again!)

Monday, June 4, 2012

Week 2

Two whole weeks have passed since my own blood was sucked out, spun around and then injected back into my left tendon. The first week my tendon felt a bit swollen, but strangely not too painful. The injection is supposed to take from 2 - 6 weeks to work, and at 2 weeks post-PRP injection my tendon feels kind of where it was before the injection. I have had some good days and some bad days, I have read that this 'roller'coaster' effect is to be expected and slowly there are gradually more 'good' days. My left tendon definitely feels alot harder and firmer than it did before and in comparison to the right tendon. This leads me to believe that some structural change is happening, that the tendon is strengthening and that the collagen is reorganizing correctly. However, after the initial pain relief and the regression back to my previous level of pain I feel slightly disappointed. Although I know I need to give it time and can't make a call on it's success just yet.

I just stumbled on this testimonial on the net, which has given me some hope and encouragement to be patient...

I saw the doctor 4 weeks post procedure and I told him I was very disappointed. I told him that I did not feel any improvement and my patella tendon still felt weak. At the 8 week appointment I told him it might be better but I wasn’t sure. He told me that sometimes it could take up to 6-9 months. He was exactly right. My knee is now 100% better than it was. About 6 months post the injection is when I really noticed the improvement in my knee. I no longer had pain upon jumping or running. I went from not being able to run without pain or discomfort to now I try to run twice a week 3-6 miles and play basketball once a week. It has been a truly amazing turnaround for me that I never thought would happen. For 2 years I dealt with this chronic injury and I never thought I would feel better. I had seen many doctors and lost hope until I found Dr. Michael Shepard.
[source: http://prptreatments.org/category/patient-experiences/]

I have been trying my best not to exercise too heavily, just some swimming and light upper body weights, along with some gentle leg rehab. I will go for a relaxed cycle tomorrow afternoon and see how it feels.