Orthobiologics Effectiveness for Tendinopathy Treatment

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This episode covers everything to do with Orthobiologics, PRP, stem call therapy and other injectables for the treatment of a tendinopathy.
Resources and papers covered:
Paper 1: Orthobiologics: Diagnosis and Treatment of Common Tendinopathies (2021)
Paper 2: Application of Orthobiologics in Achilles Tendinopathy: A Review (2022)
Paper 3: Effect of High-Volume Injection, Platelet-Rich Plasma, and Sham Treatment in Chronic Midportion Achilles Tendinopathy: A Randomized Double-Blinded Prospective Study.

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Proximal Hamstring Tendinopathy and OrthoBiologics: What You Need to Know


Proximal hamstring tendinopathy (PHT) can be a debilitating condition, causing pain and discomfort in the buttock area, especially when sitting. In this blog-style article, we will delve into the use of orthobiologics, such as platelet-rich plasma (PRP) and stem cell therapy, as potential treatments for PHT. We will explore the effectiveness of these therapies and whether they offer hope for those battling this condition.

Understanding Proximal Hamstring Tendinopathy

Before we dive into the world of orthobiologics, let’s briefly understand what proximal hamstring tendinopathy is. PHT is a condition characterized by pain and tenderness in the proximal or upper part of the hamstring, close to the buttocks. It often affects athletes but can also trouble individuals who are not necessarily engaged in sports. The pain can be particularly bothersome when sitting, earning it the colloquial names like “butt hurts when sitting” or “pain in the bottom when sitting.” This article aims to shed light on potential treatment options for PHT.

Meet the Host: Brody Sharp

The podcast episode we are summarizing is hosted by Brody Sharp, an online physiotherapist and a chronic PHT battler himself. He runs the “Run Smarter” series and is dedicated to helping individuals overcome proximal hamstring tendinopathy. His insights and practical takeaways make this podcast a valuable resource for anyone dealing with PHT.

Exploring OrthoBiologics for Tendinopathy

Orthobiologics, a term often associated with treatments like PRP, stem cell therapy, and other injectables, have gained attention in the field of tendinopathy treatment. In this episode, Brody discusses three key papers that explore the use of orthobiologics in treating common tendinopathies, including Achilles tendinopathy. While the primary focus is not solely on PHT, the insights are valuable for understanding these therapies’ effectiveness.

The Essence of Orthobiologics

But what exactly are orthobiologics? Orthobiologics refer to biological agents, often derived from a patient’s own body, that are injected into musculoskeletal injuries to aid in healing and reduce pain. The injection process is usually guided by ultrasound to ensure precision. Platelet-rich plasma (PRP) and stem cells are among the substances used to treat musculoskeletal issues, including tendinopathies.

Debunking Misconceptions

Before delving into the scientific evidence, it’s essential to address some misconceptions surrounding orthobiologics and PHT treatment. Brody shares his initial thoughts, influenced by reputable researchers, which suggested that injecting anything into tendons might not be necessary and could carry risks.

Examining PRP and Stem Cell Injections

As we dive deeper into the discussion, let’s explore the use of PRP and stem cell injections in treating tendinopathies. These substances aim to stimulate healing and regeneration by introducing growth factors, often obtained from the patient’s blood, into the affected area. The hope is that these growth factors will enhance the body’s natural healing processes.

What the Research Reveals

The podcast episode delves into various research papers to provide a comprehensive view of the effectiveness of orthobiologics. Here’s a breakdown of key findings:

Patellar Tendinopathy

  • PRP versus dry needling and exercise: PRP showed greater pain improvement at 12 weeks, but the pain returned at six months.
  • PRP versus shockwave therapy: PRP provided better pain relief at 2, 6, and 12 months.
  • PRP versus physical therapy (PT) alone: No significant difference in pain scores.

Achilles Tendinopathy

  • Smaller studies suggest improved functionality up to four years after PRP treatment.
  • Larger randomized control trials (RCTs) and meta-analyses provide less conclusive results.

Plantar Fasciitis

  • Limited cohort studies show promising results for PRP in treating plantar fasciitis.
  • PRP appears at least as effective as corticosteroids and more effective than saline injections in reducing pain at three months post-injection.

Critical Evaluation

While some studies indicate potential benefits of PRP and orthobiologics, it’s essential to consider the limitations and varying results across research. Many studies acknowledge biases and small sample sizes, making it challenging to draw definitive conclusions. Additionally, when comparing PRP to exercise therapy alone, the evidence remains inconclusive.

The Quest for Clarity Continues

The podcast episode concludes by asserting that PRP consistently presents itself as a safe and effective biological agent for Achilles tendon injuries, offering significant improvements in pain and function outcomes. However, as we’ve discovered, the research landscape is complex, and more extensive studies are needed to provide a clear verdict on the efficacy of orthobiologics for PHT.

In the world of proximal hamstring tendinopathy, the journey towards understanding and effective treatment options continues. While orthobiologics like PRP hold promise, it’s crucial to consult with healthcare professionals and physiotherapists who specialize in PHT to determine the most suitable approach for your specific condition.