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Athletic Pubalgia & Platelet- Rich Plasma

By October 13, 2021 No Comments

Guy walks into work Monday morning with a black eye.

His friend says to him, ”What happened to you”?

Guy replies, “I pulled a groin”.

Friend says, “Pulled a groin? Why the black eye”?

Gur replies, “It wasn’t mine…It was someone elses”.

Hi,

    This is Dr. Robert McGrath of Juventix Regenerative Medical.

Groin pulls and hernias hurt and are no laughing matter. How do you tell the difference?

A standard hernia is a defect or weakness in the abdominal wall or inguinal area that allows contents to push through and sometimes get trapped. These hernias are usually noticeable and present as pain and a bulge in the groin area. They normally occur over time although they can also rip and tear when subjected to forces such as heavy lifting or straining. Repair means surgery of some type.

Sports hernias are different. They are really not hernias at all but pulls or tears in the tendons that attach to the bony pelvis.

Commonly, these injuries are seen in athletes playing sports that require a twisting motion of the pelvis such as soccer, rugby, football and hockey. The soft tissues that perform these movements are found in the pubic area and lower abdomen. In a greater majority of the cases of “sports hernias” the tendons that attach the thigh to the pelvis are the most frequently injured.

Picture a soccer player planting one leg while twisting and kicking the ball and that kicking  leg swinging across the body. The adductor muscles of the thigh pull the kicking leg from out to in towards the pelvis and the tendons which attach these muscles to bone have excessive force placed on them and can easily be “pulled or torn” close to the insertion. The condition has been renamed Athletic Pubalgia ,because it is really an injury of athletes.

The diagnosis of a sports hernia vs. other conditions is made by a physical exam and an ultrasound or MRI.

Once the diagnosis is confirmed, the primary treatment is rest. For complete tears of the tendon, surgery is the only option. For incomplete tears or strains, cortisone has been used for many years with limited results. Cortisone can actually weaken tendons and can increase the risk of rupture.

Platelet-Rich-Plasma has gained significant use within the medical community as a safe effective treatment modality for these injuries to enhance tissue healing. In one study, a retrospective case series of 408 patients treated by a single ultrasound-guided PRP injection for tendon injury demonstrated significantly improved pain scores at 6 weeks vs. other treatments. Ultrasound was also used to assess tear in tendon size at baseline and 6 weeks post injection. The average lesion size was 21.2mm pre PRP treatment and 2.6mm post injection.

In another case report, a 16 year old male presented to the clinic with left hip area pain. He was a lacrosse player and while sprinting and cutting had felt a pop in the hip area. MRI showed a ligament avulsion. The patient underwent an ultrasound-guided PRP injection and reported complete resolution of his symptoms in a week. He returned to full activity at 5 weeks post treatment.

Platelet-Rich-Plasma is a proven and cost- effective treatment option in patients with Athletic Pubalgia and other tendon injuries. However, efficacy in some cases is not 100%. The reason is not the treatment but the kit. Not all Platelet-Rich-Plasma kits are the same. PRP, by definition , may be applied to any fraction of autologous blood that contains a higher concentration of platelets than baseline. There are also variations of white blood cells (leukocytes) and differences in centrifugation methods.

Juventix Regenerative Platelet-Rich-Plasma kits have received FDA approval making it one of a few receiving this designation. The amount of platelets and leukocytes present in the final product has been tested and verified by. Independent laboratories. The gel separation method is unique and allows the results to be reproducible.

Platelet-Rich-Plasma is a proven treatment for Athletic Pubalgia.

Since not all kits are the same and the way the PRP is produced makes a clinical difference in the outcome.

“Get out of pain and back in the game”

Ask you clinician about Juventix Regenerative Products.

Regenerative Regards,

Dr. Robert McGrath

Muscles Ligaments Tendons J 2016 Jul-Sept; 6(3) 410-419  PMID 28066748

J Vasc Interv Radiol 2014;25:717-723

P M R. 2013; 5: 169-175