- Review of radiological studies (x-rays, MRI, etc.)
- Diagnostic (anesthetic only)
- Percutaneous Needle Tenotomy (PNT)
- Regenerative Medicine
- Osteopathic Manipulative Medicine (OMM)
- Physical Therapy
- Regenerative Rehabilitation
- Home Exercise Program
- Lifestyle Modifications
- Explore the conditions that led to your symptoms
- Understand the way your symptoms have manifested an individualized change in the quality of life. (movements, activities, hobbies, or tasks that have been affected)
- Use ultrasound to isolate the exact location effected
- Formulate an evidence-based customized treatment plan based on available injection therapies with a discussion of risks, benefits, and prognosis for each.
- Perform precision ultrasound-guided injection.
- Provide a comprehensive rehabilitation program that may include physical therapy and/or home exercise program.
- Recommend lifestyle modifications and adjustments and long-term strategies to avoid reinjury and promote tendon health.
Tendons are strong bands of connective tissue composed primarily of a substance called collagen. Mechanically, tendons connect muscle to bone and transmit the force to generate movement. Muscle and tendon injuries account for a significant percentage of the over 100 million physician visits in the US per year and this number will continue to rise as our population ages and remains active.
Previously, tendon injuries and disorders were almost always considered tendinitis. Tendonitis is an inflammatory process, but recent research has shown that most of the more chronic tendon problems do not have any inflammatory cells. The primary problem in these cases appears to be a breakdown of the structural properties of the tendon collagen. Thus the correct terminology for this problem is tendinopathy, as opposed to tendinitis.
Tendinopathy results from overstressing a tendon. This can be from a singular acute bout of activity, or more often, from repetitive and sustained stresses over many months or even years. It is possible for different areas of the tendon to be in different stages of injury or disorder. Tendinopathy can ultimately lead to chronic degradation of the tendon, and rarely, to the point of tearing or rupture. There are many current treatment options for this condition including, but not limited to, rest, anti-inflammatory medications (e.g., ibuprofen, naproxen), steroid injections, physical therapy, shock wave therapy, dry needling, and surgery. Recent advancements in regenerative (restoration and growth) medicine have led to the development of platelet-rich plasma (PRP) injections as a viable treatment for various tendinopathies.