PRP and Stem Cell Injections

[UberBabs]

I wonder if any of the coaches, particularly Dr. Baraki, have experience with this? I tweaked my shoulder on OHP last August and have not been as strong since. I competed in a meet last October anyway and finally went to the ortho last February. The MRI says I have a type 4 SLAP tear, partial tear in biceps tendon and bone spurs on the acromion (which is narrow to begin with). My rotator cuff is fine and robust. The surgeon wanted to pinpoint the problem so he gave me a cortisone shot in the acromion area. He thought the tears might have been old. I felt better for a few months but my shoulder is now bothering me again and I have not regained my strength. Have been unable to bench over 200 lbs since. I have a meet coming up Nov 18 and wonder if PRP or stem cell injections could be a viable alternative to surgery for the tears that I can do before the meet and still train. I don't think they will address the bone spurs, however. When I had surgery on my other shoulder in 2007 it turned out very well, but I don't want to lay off for six months again.

[Tom Campitelli]

Dear Über,

As you have experienced, corticosteroid injections are forms of temporary pain relief. Cortisone is an immune system suppressant and an anti-inflammatory compound. The shots don't heal anything, but they can make joints stop hurting, at least for a while. Alas, if you get enough of them, you can compromise the integrity of the joint.

You most likely already know what the answer is here. If you have bone spurs and various other shoulder pathologies, especially ones that hurt enough to interfere with sleep, you probably need surgery. I imagine your ortho said the same. You can try PRP or stem cells, but these treatments are unproven and the mechanisms by which they could work are not fully understood. Chances are that they will cost you more money, not heal the problem, and you will get surgery later, anyway. I don't mean to sound like a shill for surgeons here, but if this injury is hurting you and you cannot do what you want to do, then you know what needs to happen.

Alternatively, if you are not in great pain and can switch things up programmatically or with exercise selection, and you can make progress, then do that. Otherwise, the knife awaits. We'll see what others say.

[UberBabs]

Dear Über,

As you have experienced, corticosteroid injections are forms of temporary pain relief. Cortisone is an immune system suppressant and an anti-inflammatory compound. The shots don't heal anything, but they can make joints stop hurting, at least for a while. Alas, if you get enough of them, you can compromise the integrity of the joint.

You most likely already know what the answer is here. If you have bone spurs and various other shoulder pathologies, especially ones that hurt enough to interfere with sleep, you probably need surgery. I imagine your ortho said the same. You can try PRP or stem cells, but these treatments are unproven and the mechanisms by which they could work are not fully understood. Chances are that they will cost you more money, not heal the problem, and you will get surgery later, anyway. I don't mean to sound like a shill for surgeons here, but if this injury is hurting you and you cannot do what you want to do, then you know what needs to happen.

Alternatively, if you are not in great pain and can switch things up programmatically or with exercise selection, and you can make progress, then do that. Otherwise, the knife awaits. We'll see what others say.

Thanks Mr. Tom!

Yeah, I was very hesitant to get the cortisone shot, but surgeon guy assured me it was a one time diagnostic tool. My sleep is fine with respect to the shoulder (other things, like a Jack Russell terrier, interfere with sleep). It is not being able to regain my press and bench press numbers and somewhat of a tweaky feeling at times (certainly when lifting, but also when reaching out to swipe the card key in my office garage) that concern me. FYI, I am not sold on PRP/Stem Cell and how it arguably works, but even the surgeon at Kerlan Jobe told me they use it for post-surgery recovery (as opposed to an alternative to surgery). I called the famous PRP/Stem Cell guy here in L.A. today and they say it can help bone spurs. (HOW???) Can't hurt to go in for an evaluation as insurance definitely pays for that. Won't pay for the procedures, however, that are about $800 each. Should work -- IF IT WORKS -- in two or three sessions. The downside is that the sessions are two weeks apart so I will not be able to train for 4 to 8 weeks. If the PRP/Stem Cell does not work, definitely surgery. Still have to decide about the meet -- I can swallow my ego and just get a total good enough to qualify for Nationals this time and then do the treatment. If I do the treatment first I would have to skip it. And I am not getting any younger. So.

[Austin Baraki]

Platelet-Rich Plasma: Does It Work?

[Tom Campitelli]

I called the famous PRP/Stem Cell guy here in L.A. today and they say it can help bone spurs. (HOW???)

Did someone with a Doctor of Medicine (MD) degree tell you this? If so, that is badly fucked up. I hope an MD did not say this. Fingers crossed...

Here's the thing – if your shoulder is not really hurting, I would be reluctant to go in for surgery. The lack of pressing and benching performance, in the absence of pain impeding your abilities to produce force, is more likely a programming issue.

[UberBabs]

Dr. Baraki,

Thanks for the article.

Did someone with a Doctor of Medicine (MD) degree tell you this? If so, that is badly fucked up. I hope an MD did not say this. Fingers crossed...

Here's the thing – if your shoulder is not really hurting, I would be reluctant to go in for surgery. The lack of pressing and benching performance, in the absence of pain impeding your abilities to produce force, is more likely a programming issue.

The Doc did not say this. His office person did. But I have a Doc (anti-aging) who did give what I perceive is dodgy advice about bone spurs. He said to take this enzyme from the gut of the silk worm: Serrapeptase. And my yoga teacher insists that essential oils will dissolve them.

I went in for surgery on the other shoulder (left) in 2007 initially for a minor labrum tear that only hurt when I did weighted dips and then turned into frozen shoulder in the weeks leading up to the surgery. The surgeon skipped the labrum tear and just cleaned up the shoulder. That shoulder feels great. Regarding the "hurting," when I press, I feel nothing with my left shoulder but the right shoulder feels less stable and tweaky. Definitely a strength deficit from before I injured it. Maybe the tweaky feeling is holding me back on producing force?

[Tom Campitelli]

The Doc did not say this. His office person did.

It is worrying that someone in the office would make this assertion.

But I have a Doc (anti-aging) who did give what I perceive is dodgy advice about bone spurs. He said to take this enzyme from the gut of the silk worm: Serrapeptase.

This is, of course, incorrect. Is this dude an MD?

And my yoga teacher insists that essential oils will dissolve them.

Is there anything essential oils cannot do? Whole milk cures cancer. You heard it here first. I do wonder how people make claims like these with a straight face. If you ever want a laugh, look up the claims Virus makes about their bio-ceramic fabrics in their lifting singlets. Good times.

Regarding the "hurting," when I press, I feel nothing with my left shoulder but the right shoulder feels less stable and tweaky. Definitely a strength deficit from before I injured it. Maybe the tweaky feeling is holding me back on producing force?

Could be. However, what kind of time frame are we talking about here? What is the magnitude of the strength deficit you are experiencing?

[UberBabs]

Could be. However, what kind of time frame are we talking about here? What is the magnitude of the strength deficit you are experiencing?

The initial insult to my shoulder was on August 19, 2016. Before that, I was pressing 116 for triples and bench pressed 202 for a double. After that, I have been having trouble with 109 for press and can only bench 195 for a single.

[Tom Campitelli]

You are within a fairly close margin of where you were. I suspect you could reach and exceed your previous levels of strength. Have you considered paying a visit to the good peeps over at Horn Strength & Conditioning? If your shoulder is not hurting you much, I would say don't inject anything into it and don't get surgery. Instead, give it some time, keep training it and get some coaching. See what happens.

[DCP]

I have trained under "Regenerative medicine" docs (Probably one of the ones you called) and have done a few dozen PRP and bone marrow stem cell injections in the last year. I doubt they work better than placebo. The risks of injections are not trivial - infection, bleeding, worsening pain and the 2400-3200 bucks for a procedure without good evidence would not lead me to recommend it to anyone.