Platelet Rich Plasma Injections May Improve Ankle and Shoulder Instability

Many of us have had the horrible feeling of the ankle "giving way" while walking or stepping off of a curb. Some people have the same feeling occur in the shoulder. When this happens time and time again, it is called ankle instability or shoulder instability.

People with chronic instability experience repeated turning of the ankle or shoulder; persistent discomfort and swelling; pain or tenderness; and/or the ankle or shoulder feeling wobbly. Ankle or shoulder instability might develop from a sprain or injury that did not heal properly or that was not rehabilitated completely. When a person sprains an ankle or injures a shoulder, the connective tissues, or ligaments, are stretched or torn. Each subsequent sprain or injury leads to further weakening or stretching of the ligaments, resulting in greater instability and the likelihood of developing additional problems in the ankle or shoulder.

Treatment usually involves physical therapy, bracing and/or medication. If the instability continues, there are minimally invasive surgery options available. However, I am most excited about the potential of Regenerative Injection Therapy using a patient's own platelet rich plasma (PRP) and growth factors from fat for healing ankle and shoulder instability. Regenerative Injection Therapy is a new, non-operative treatment that enhances surgical repair and provides and option for orthopedic conditions that have traditionally required surgery or other extensive procedures. We draw the patient's blood, similar to a lab test, and place it in a special machine that spins the blood at high speeds, which separates the platelets from the other blood components. When treating instability, the platelets are then concentrated and re-injected into the ankle or shoulder. In turn, the platelets release substances known as growth factors that lead to improved natural tissue healing.

I recently observed a colleague treat shoulder instability with PRP and have adopted the procedure in my practice as a solo treatment or to enhance surgery when necessary. The procedure is called a peppering technique, which involves multiple small injections into the loose ligament or tendon. This technique causes the stretched tissue to contract, which resolves the instability. The results are impressive, and my patients are benefiting after only one or two treatments.

I have more information about instability and Regenerative Injection Therapy on my Web site. Thanks for reading!