Recently in Ireland, people are paying thousands of euro for procedures advertised as ” stem cell treatment ”, for conditions such as osteoarthritis. These treatments are not covered by health insurance companies etc. They often use the term ”stem cell treatment”, for a process that bears little if any resemblance to what stem cell therapy actually is. Below is a summary of an article written by an orthopedic surgeon outlining the limitations of stem cell therapy as it presently stands. Before you part with your money for one of these treatments, have a read of it, discuss it with your doctor and do your research.

 

Below is a summary of an article written by Mark Miller, Professor of Orthopedic Surgery, University of Virginia, ”Stem cell treatment for arthritic knees is unproven, expensive and potentially dangerous” (February 5, 2019 11.40am , http://www.theconversation.com)

Stem cells are “uncommitted” cells that are, at least theoretically, capable of becoming any type of cell – skin, heart, kidney or even knee cartilage cells. Stem cells can come from fetal tissue, including products of in-vitro fertilization as well as placenta and umbilical cord tissue. They can also come from a patient’s own “hidden” adult stem cells, which are most often harvested from bone marrow and fat. The potential for using these cells in medicine is tremendous.

The truth

Unfortunately, the excitement about stem cells has outpaced the science. In addition, due to the ethical issues associated with the use of fetal tissue, the U.S. Food and Drug Administration has severely restricted its use and obtaining an abundant source of concentrated stem cells can be difficult.

In orthopedics, researchers have proposed using stem cells for the treatment of joint/cartilage damage. This includes osteoarthritis. Osteoarthritis often results in the need for joint replacement surgery. Stem cell injections are now being  promoted as a potential way of avoiding the need joint replacement, by ”regenerating” the cartilage. Unfortunately, current technology and regulatory issues make obtaining and concentrating true stem cells a challenge, and encouraging them to become and remain cartilage cells and nothing else is even more difficult.

The problem with stem cells is that these cells can continue to evolve; they may not stop development at the cartilage cell phase. They may continue to differentiate into bone cells. This would make the joint even worse because bone creates a rough surface adjacent to the smooth articular cartilage. Bone is actually the end result of arthritis.

According to the American Association of Hip and Knee Surgeons, there are no proven medications or therapies that can delay or reverse the progressive joint destruction that occurs with osteoarthritis.

Many patients have paid out thousands of dollars for ”so-called stem cell treatment” only to later discover that they were scammed. Any positive effects of current stem cell treatment are likely not the result of the actual cells themselves but something else.

Alternatives to stem cell treatment

Depending on the cause and severity of their joint pain, patients have treatment options that range from physical therapy, to injections of various medications, to surgery. All have pros and cons; steroid injections can provide quick but short-lived pain relief, while a knee replacement can provide a permanent solution but also requires months of rehabilitation. Doctors need to help patients make the choice that best fits their particular needs.

 

Physiotherapists Tralee phone 086-7700191

 

 

Iliotibial band syndrome. The I.T. band is not the problem.

Regularly I come across  people receiving seemingly endless treatment sessions iliotibial band syndrome, with the main focus of the treatment being to try and loosen out the I.T. band. Below are a few things I believe you should consider when  treating  iliotibial band syndrome.

1. A client is told they have certain weak muscle groups which are causing the problem and are given a load of exercises to correct these weaknesses. Sometimes they are told that they need orthotics. Sometimes these treatment protocols may be necessary, but more often this is just an overuse injury that is being made way too complicated. Say you have been running for a year(or years) with no issues, why are all these ”weaknesses” just now causing you problems? Most likely they are not the cause.  Why do you suddenly need orthotics. Did you change your feet(joke)? It is more likely you are overdoing it a bit in your running.

2. All the emphasis is often placed on the I.T. band and treatment of same. The I.T. band is a long tendon and is a fairly inflexible structure, so concentrating on loosening out that is not going to give much relief in itself. Now if you shift the focus to loosening out the tightened outer quad muscles which attach to the I.T. band by fascia(connective, supportive sheet of tissue, kind of like a very strong clingfilm) and as a result pull on the I.T. band, you will generally start to recover fairly quickly. There is nearly always a section of the outer quad about a quarter of the way up from the knee which will be tight and ropy in this injury. Also don’t forget the Tensor fascia lata muscle. This is up near the hip. It is the muscle that attaches directly to the I.T. band. If this has tightened it also needs to be worked out and loosened also. The I.T band should not be totally ignored of course. Instrument assisted soft tissue release can be excellent in loosening it somewhat, as well as for loosening out tightened quad muscles and fascia.

3. Another problem with this condition is a lack of understanding as to what is causing the pain at the side of the knee. The tension and resulting friction on the I.T. band causes the bursa under it at the side of the knee to become inflamed. This is what causes the pain. Treatment options here include a combination of non steroidal anti-inflammatories, compression with ice(very effective), maybe some electro-acupuncture. You want to compress the icepack into the side of the knee to flatten the inflamed bursa and reduce inflammation. A packet of peas or one of those gel packs will not be cold enough.

4. Rest is needed. This is an overuse injury, remember, but the better and more effective the treatment, the faster the recovery.

Above is not necessarily stuff you will find in a text book but comes from knowledge of anatomy and experience in  successfully treating this condition hundreds of times over the years, often in about two treatment sessions. Injuries are often over-dramatized. Sometimes you just need a little rest, with the right physio treatment protocol to aid recovery.

Sever’s Disease – Kid’s Heel Pain

Sever’s disease (also known as calcaneal apophysitis) is a type of bone injury in kids whre the growth plate on the lower back part of the heel, where the Achilles tendon (the heel cord that attaches to the growth plate) attaches, becomes inflamed and painful. The reason for this is that the heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. Sever’s disease occurs as a result of repetitive stress on the Achilles tendon. Over time, constant pressure on the already tight achilles tendon can damage the growth plate, causing children. Symptoms of Severs disease include pain and inflammation. This is why it is more common in physically active.

Symptoms of Sever’s disease include pain, inflammation or tenderness at the back of one or both heels which sometimes also extends in to the sides and bottom of the heel ; swelling and redness in the heel ; heel pain with limping, especially after running ; difficulty walking.Although it is painful and the name sounds a little scary, severs disease is only a temporary condition with no long-term problems. It is more common in physically active kids and occurs during the growth spurt at adolescence. This can begin any time between the ages of 8 and 13 for girls and 10 and 15 for boys. To be brief Sever’s disease is not a disease, it is in fact just growing pains.

Sever’s Disease – Treatment

The primary method of treating Sever’s disease is by taking time off or at least reducing participation in sports and other physical activities. This is in order to alleviate the pressure on the growth plate referred to above. Your physical therapist may prescribe stretching exercises for the calf muscles to help reduce pressure on the achille’s tendon attachment. Icing the area by placing an ice pack in a wet towel and applying it to the area of pain for 10 to 15 minutes at a time may help to alleviate pain and swelling, as may the use of NSAIDs(non steroidal anti-inflammatories). For more information on Sever’s disease click here.

 

Physiotherapists in Tralee, Co. Kerry : Phone 086-7700191