Tendon and Ligament Problems

Tendons and ligaments are made up of fibers of collagen. When these fibers are stretched or torn we may refer to the injury as a “pull”, “tear”, “sprain” (ligament) or “strain” (tendon). When they are injured they bleed, and the blood carries platelets growth factors that allow for natural healing of the tissue by creating new collagen fibers. These new collagen fibers need to be constructed in an organized fashion to heal correctly and allow the ligament or tendon to regain its proper strength and flexibility. Due to various conditions like aging and co-morbidities, there is not enough blood flow to the area to provide those platelet healing factors and hence instead of forming healthy collagen fibers there is significant scar tissue that develops in its place.

Another condition called tendinosis is a degenerative condition of tendons, marked by the chronic loss of collagen, tissue integrity, stability and strength due to overuse. Tendinopathy is very pervasive as we age, yet pain and dysfunction generally occur when sufficient stresses are applied to the degenerated tendon.

Common acute and chronic tendon injuries

  • Foot and ankle: Plantar fasciitis
    Achilles tendonitis and partial tears
  • Knee: Patellar tendonitis and tears
    Quadriceps tendonitis and tears
  • Thigh: Hamstring strains
  • Elbow: Medial epicondylitis (golfer’s elbow)
    Lateral epicondylitis (tennis elbow)
  • Shoulder: Rotator cuff tendonitis and partial tears.

Common acute and chronic ligament injuries

  • Elbow
  • Hand
  • Knee
  • Foot and Ankle

Patients try anti-inflammatory and other pain medications, topical creams and gels, braces, physical therapy, and other conventional therapy modalities but they don’t work because they don’t treat the underlying problem of scar tissue, disordered fibers and poor angiogenesis (blood flow). Clinical studies suggest improvement in pain, and healing with the use of growth factors from platelets. These studies have shown improved tenocyte proliferation, and collagen deposition. They positively affect gene expression and matrix synthesis in the tendon, meaning that the native cells called tenocytes are stimulated to produce collagen and elastin. Thus EnPLAF¬†therapies result in improved healing, reduced pain and reduced time to return to active lifestyle.

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