Amid the broad range of emotions and activities in which I’m engaging this week – a sad last week at Nokia before an exciting new start at MyStrands – I was able to schedule an appointment for my 6-month followup visit with Dr. Mishra regarding progress on the platelet-rich plasma (PRP) treatment for my right elbow. [I am very grateful for Kevin’s recent comment on an earlier PRP-related post, and an email from Mark, who had commented on my first elbow PRP post – and who has since also undergone the PRP treatment – which reminded me that I needed to schedule this appointment before I leave town.]
I was not looking forward to the visit, in part because I have not been diligent in my theratube exercises (probably averaging once every three days rather than three times per day since my three-month PRP checkup), and in part because I thought that if I wasn’t 100% back to normal by now, I would have to choose between surgery and living with my elbow’s current status, which is probably around 90% of pre-tendonitis strength (and absence of pain).
However, my fears, as is so often the case, were unfounded – at least with respect to the latter one (I should [still] resume more diligent theraband exercising). I found out that it can take up to 12 months for the full effects of PRP to manifest themselves, so the fact I’m not completely "cured" is not surprising, and in fact, my current status, in which I rarely feel pain greater than 3 (on a scale of 10) – even after moving a humongous solid oak entertainment center from our bonus room to the garage last weekend – is a significant improvement over the last checkup.
During this visit, I was able to exert 135 pounds of grip strength with my right hand with a subjective pain level of 1 (vs. 120 pounds of grip
strength with a pain level of 4 at the 3-month mark), and was able to resist attempts to pull down
my upturned or downturned hand with a pain level of 1 or 0. As I noted earlier, during my first visit, I was
only able to exert 65 pounds before I hit the wall (of pain) at level
9, and my resistance was lower and pain higher for the upturned hand
exercise. It is relatively rare for my elbow to be sore – except after I move heavy furniture or engage in repetitive motions for extended periods.
Among the differences I’ve noticed in the past 3 months were:
- being able to carry around and drink from my 20-oz coffee mug with no pain
- being able to carry heavy furniture with some pain (I would not have even attempted to move the entertainment center 3 months ago)
- being able to do pushups with little pain (again, I would not have attempted pushups 3 months ago)
Dr. Mishra was actually quite encouraged – and encouraging – about my prospects for eventually regaining full use of the elbow with little or no pain! And, even better (to me), he suggested that if I have not reached that status by the 12-month mark, given the progress I’ve shown thus far, he would now recommend a second PRP treatment rather than PRP + surgery (which is what I thought would be the next step).
So, once again, my optimism is restored. I just did a round of theratube exercises (that makes 3x today), and will gradually start experimenting with exercising more regularly – pushups and perhaps even full-scale elliptical training (now that I’ll be home – where we have a Precor FX – more regularly) – though ramping up on an [uncharacteristically] gradual slope. I will also restart my yoga practice.
I noted in my response to Kevin’s comment that Dr. Mishra’s PRP web page had a link to the Total Tendon Network, and that while I was excited about encountering my first Ning network "in the wild", it appeared to be a site targeting [only] tendon care providers:
This is a group of providers dedicated to improving the diagnosis, treatment and prevention of tendon related disorders.
Dr. Mishra told me that the site was, in fact, intended for both providers of treatment and patients who are receiving, or considering receiving, treatment (he said he will change the text on the login page – and said he requires login to ensure some level of quality control on this social network). I’ve signed up, but am still waiting for "approval", and so will report further on the Total Tendon Network during my next update … probably around six months from now.
Comments
11 responses to “Six month update on my elbow Platelet Rich Plasma (PRP) treatment”
I hope you are doing alright now…
Good luck with your recovery!
I don’t know how often you read these posts, but I have a few of questions regarding this treatment, and am curious if you might know the answers. Obviously we’re not physicians, but having dealt with the same issue as I am, and having been through the treatment, I value your opinion.
1. I’m a UCSF student so I can visit the UCSF orthopedic hand clinic, where at least one of the MDs does prp. My question is if there’s a significant different between different people, and if I might see varied results between him and Dr. Mishra or another provider.
2. My tennis elbow is less severe than yours, but also longer lasting (almost seven years now). Do you know if that makes for a less optimal prognosis?
3. How long were you told to avoid minor load bearing (typing, driving) and major load bearing (rock climbing, weight lifting)? How long did it take before you felt as strong as you were the day before you had the injection?
Thank you!
Hi Jesse,
Unfortunately, I don’t have any answers for your first two questions. I encourage you to either contact Dr. Mishra directly and/or join the Total Tendon Network, an online social network he has setup specifically to help past, present and future PRP patients.
As for your third question, I believe I was instructed to avoid typing for about a week, and major load bearing activities for several months. If you visit my first post on the Platelet Rich Plasma treatment for my elbow, you can see that I’ve added trackbacks below the post to all my subsequent posts on my PRP experience, to make it easier for me – and others – to follow the progress (including prescribed – and proscribed – activities) at several milestones.
Best wishes in finding a solution to your elbow problems!
Joe.
How are you at the 12 month mark?
I just started treatments for a moderate case of bicep tendinosis—I am trying avoid surgery—I found reading your blog informative.
Why did you only have one treatment? It seems the standard protocol is to have 2-4 treatments over a four or five month period.
Hi Robbie,
Thanks for the [likely inadvertent] reminder of my 1-year PRP anniversary! My elbow is not significantly better than it was at the 6-month mark, but I’ve been extremely remiss in doing the theraband exercises. I was not aware of the protocol of multiple treatments over a 4-5 month period. Given that Dr. Mishra had recommended considering a second treatment if there wasn’t noticeable improvement at the 12-month point, I will contact him and see how we should best proceed – maybe I will get another treatment (or perhaps even more than one). Unfortunately, I now work in Seattle rather than Palo Alto, so the logistics for undergoing another treatment may prove more challenging (I had to avoid flying and driving long distances for a week last time). I will post an update when a new plan is determined. Thanks for your note – and best wishes on your treatment!
Joe.
I have just had my first PRP injection,18 months after a failed surgery,for my patellar tendon which is damaged for the last 4 years.I wish the best for you and everyone suffering from this disease.You and others are very encouraging sharing their experiences with us.
Hi Joe,
Any update?
– Robbie
Dimitrios: Thanks for the kind and encouraging words. I hope your healing process goes well, and would welcome update(s) here or via email.
Robbie: thanks for the followup ping. I seem to have plateaued, and perhaps even regressed a bit: my elbow pain has increased in the past few weeks. I contacted Dr. Mishra’s office this week and scheduled an appointment for next month, when I’ll be back in the Bay area for a few days on business. His assistant, James, said he’d heard of PRP being used to treat Seattle Seahawks’ QB Matt Hasselbeck, and suggested there may be some local options in the Seattle area. Searching online, and several local phone calls have not yielded any further details. So, if you, or anyone else reading this, knows of any physicians in the Seattle area who are offering PRP treatments, please let me know. Thanks!
Thank you so much for this blog! I had a prp done for tendonitis in my right elbow about 2 months ago and your blog has helped my piece of mind considerably! My elbow still hurt more at 1 month than it did before injection and I was concerned about that. Your post helped me be more optimistic. Thanks again!
Nora Jean: thanks for the feedback. I recently saw Dr. Mishra, and plan to post an “18-month update” – which I hope will provide more cause for optimism – sometime over the holiday period. Meanwhile, I wish you all the best in your healing journey!
16 month update on my elbow Platelet Rich Plasma (PRP) treatment
In November, I visited Dr. Allan Mishra’s office for a belated followup on the platelet rich plasma (PRP) treatment for elbow tendonitis he’d administered in July 2007. As was the case before my six month followup visit, I was feeling…