Does that bum knee still bother you? Has tennis elbow kept you off the courts? Is that shoulder pain not going away? Some of us struggle with pain for weeks or months, and sometimes for years—held captive by extreme discomfort that makes it impossible to freely live our lives. For some people, after physical therapy, acupuncture, meditation and medication, the pain remains—morning, night and all the hours in between.
Promising treatments for professional athletes and folks like us
“Patients come to me because they can’t do what they want to do in their lives,” says Adam Pourcho, D.O, a Mayo Clinic fellowship-trained sports medicine doctor and physiatrist at Swedish. Physiatrists concentrate on physical medicine and rehabilitation to help patients get their full level of function back. They treat musculoskeletal injuries, neurological illness and sometimes, disabling conditions. They coordinate care with primary care physicians, orthopedic surgeons and other specialists. Some physiatrists, like Dr. Pourcho, specialize in sports medicine. As the head team doctor for the Seattle Storm, Dr. Pourcho treats these amazing athletes for hand and shoulder injuries, ankle and foot sprains and strains, and knee and back injuries. At Swedish’s Regenerative Medicine Clinic he sees patients with some of those same injuries—weekend warriors, other athletes and people with chronic pain.
Regenerative Medicine
Sports medicine doctors and physiatrists often integrate “regenerative medicine” into their patient care. This is an energizing kind of treatment—it harnesses the body’s own healing powers to stimulate and enhance a natural healing process. It is non-surgical and minimally invasive. Patients come to the Regenerative Medicine department at Swedish with problems like osteoarthritis; tendinitis, such as tennis elbow, golfer’s elbow or pain in their Achilles tendon; or ongoing pain in their knees. Plantar fasciitis, damaged tissue in the heel, is also common. Some problems come from injury and some from wear and tear. Dr. Pourcho likens osteoarthritis to “the loss of tread on tires.”
Regenerative medicine has benefitted horses in the equestrian world for over three decades. In the 1990s, some dentists began using it to enhance dental implants. Today, Swedish uses three types of regenerative medicine.- Platelet-rich plasma (PRP), which has been used since the 1980s. If you sustain an injury and experience bleeding, platelets naturally go to the injured area. There, they release growth factors, basically programming signals that tell your brain the correct type of stem cells to send to the injured area. In this treatment, blood taken from a patient is put into a centrifuge, which rapidly sorts out platelets from other blood products, harvesting far more than are usually found in a person’s blood. The physician then uses ultrasound to accurately guide the injection of the PRP into the injured or damaged area to stimulate and enhance healing.
- Stem cell therapy, where a physician concentrates stem cells out of bone marrow harvested from a patient’s pelvis. After activating them with platelet-rich plasma, the physician uses ultrasound to guide the treatment to the intended target tissue.
- Ultrasonic tenotomy (“Tenex procedure”), allows the physician to percutaneously debride tendons and fascia through a tube within a tube system. Sound waves clean up and withdraw bad tendon tissue through a small incision, without damaging normal tissue. This is usually done without the use of stitches to close the incision.
Stories with positive results
A physical education teacher came to Swedish complaining of severe heel pain he’d suffered with for the past 18 months. Even standing was painful, and it was compromising how he did his job. He chose to have a Tenex procedure and a platelet-rich plasma injection. The subsequent pain progressively ebbed, and within four months he was back to his usual activities; his job, hiking 40 miles in two weeks and jogging. Dr. Pourcho’s story is a little different. “I was walking my dog and we basically went two different ways, as he went off in chase of something. The result was a 90 percent tear of the common extensor tendon in my elbow.” Several months after treatments of platelet-rich plasma and stem cells, Dr. Pourcho was pain free and back to his usual workouts.
The future of regenerative medicine
Many exciting capabilities are on the horizon for this kind of non-invasive help for extreme pain caused by injury or degeneration. The hope is that the combination of ultrasound to diagnose and guide treatment will enhance current procedures and therapies, making them less invasive and more specific. We are already able to regrow tendons, and hope to someday target regrowth of cartilage. More and more we will be able to help people heal without invasive cutting, and more insurance companies will cover these procedures, as we continue to collect good data. Gene therapy marches on, as seen in cutting edge cancer treatments. This holds promise for the use of gene therapy in regenerative medicine.
Accessing Regenerative Medicine at Swedish
Services are available at Swedish’s Cherry Hill, Issaquah and Bellevue facilities. Tenex treatments are done in the Pain Center at the Cherry Hill location. To read more or contact Regenerative Medicine, go to: www.swedish.org/restore or call 206-320-2600 or 425-498-2272.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
