I asked before I left if anyone had exp with the issue instead everyone told me a bunch of heresy and personal opinions none of which appear to be based on actual exp that I asked about. I then reported what the DR said once I got there. I was hoping someone might say they tried PRP or Stem Cells or possibly they were doing cortisone with good results or had bad results from it no one replied with any of that information from personal exp
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No you specifically asked if anyone had experience with shots, surgery, or PRP. What was said was not 'heresy' [sic]. I have quite a bit of experience in the treatment of it.
1) PRP is shoddy at best. If it is an acute case (which yours isn't) it would be more indicated and beneficial
2) Stem Cell might be an option but you typically are not allowed to do anything training with a joint that had stem cell for 6 weeks or so. Then, you have to resume loading on a limited basis.
3) You wanted more info on cortisone injections. You have never once mentioned you tried rehab. You have complained about it in the past and only have taken off for a few days. This will NOT heal it. it will less painful but the tendon is far from healed.
Most tendonitis is misdiagnosed and you actually have tendonosis. By not allowing your tissue (tendon) to fully heal you are causing a change over from healthy collagen type I into immature type II and III. You also will have a loss of collagen continuity (i.e. collagen fibers no longer aligning with one another). This in and of itself results in loss of linkage between the fibers and the load bearing that you do will further cause damage to the tendon. If they looked at your tendons they would not appear white but instead more brown. They also wouldn't be firm but rather soft and dull.
The overall result of this will be a loss of tendon strength and increase in the bulk of the tendon. Both of which contribute highly to the cycle of injury (look up cumulative injury cycle for a better understanding). What's more interesting is in a recent seminar there was connections to tennis elbow and the development of carpal tunnel syndrome.
Laying off the dominating movements (in your case gripping exercises) are needed. It can take 6 - 8 weeks to see complete resolution of things. Dry needling, IASTM, the RIGHT rehab movements and increasing vitamin C actually are some of the best things I have seen for people with these kind of problems. Kinesiotape is hit or miss. I have had people with rotator issues come to me after being at PT for 4 weeks with little relief and in a week they are 50% better.
Is that enough for you? Being that you said you have read every scientific study in the last 25 years....this should not come as a surprise
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083985/"Current research provides initial support for the efficacy of dry needling for tendinopathy treatment. It seems that tendon needling is minimally invasive, safe, and inexpensive, carries a low risk, and represents a promising area of future research. "
