Treating osteoarthritis in the aging masters athlete
In this article Ross Hauser, MD discusses the various treatment options for the aging athlete suffering from osteoarthritis.
- If you have a question about your osteoarthritis options, get help and information from our Caring Medical staff
Aging, or commonly referred to as “Masters” athletes are able to continue participating in sports because they have good mobility and it is pain-free mobility.
Once mobility declines, once pain prevents participation, the aging athlete is faced with the reality of giving up their sport or getting medical treatment.
If you are a maturing athlete and you suffer from osteoarthritis, you may think that surgery is the answer to getting you back to your sport quickly. Research is now routinely debunking this line of thinking in favor of rejuvenation of damaged joints.
In a recent paper, doctors at Stanford warned that “The greatest threat to the health of the aging athlete is not the aging process itself but rather inactivity. Motion is critical to articular cartilage health, repair, and homeostasis (a healing joint environment).”1
What the Stanford doctors are saying is that weight-bearing stress on the joint and mobilization is a self-reparative mechanism.
Here is more from the Stanford paper: “Articular cartilage has a unique functional architecture capable of providing a lifetime of pain-free joint motion. This tissue, however, undergoes substantial age-related physiologic, mechanical, biochemical, and functional changes that reduce its ability to overcome the effects of mechanical stress and injury. . . is important to the development of new strategies to rejuvenate aging joints.”1
In other words, these researchers are calling for new strategies because you can’t repair damaged cartilage with surgery, the most common of which is arthroscopy which numerous medical studies found to be no more effective than placebo. Nor can you repair damaged cartilage with standard osteoarthritis treatments that involve symptom management such as NSAIDS, and cortisone shots.
Our strategy at Caring Medical is to treat joint instability and cartilage wear and tear with a comprehensive Prolotherapy program including Platelet Rich Plasma Therapy and Stem Cell injections. These treatments are explained below and the accompanying videos.
Treating osteoarthritis – joint stabilization through ligament repair
Osteoarthritis does not have a simple explanation although a clear path to its eventuality can be made.
- Joint instability through ligament injury comes before bone and cartilage degeneration in osteoarthritis. This is discussed in more detail in my article The progression from Joint Instability to Osteoarthritis and Degenerative joint disease.
In a landmark article published in the medical journal Gerontology researchers confirmed this observation that osteoarthritis does indeed start with ligament damage.
The researchers conclusion makes it clear:
- The reversal of the current concepts of how osteoarthritis begins needs to be shifted from cartilage and bone damage first to that of damaged ligaments and that treatment strategies could be effectively redirected (to the role of ligament laxity and injury).”2
Taking into account the progression of osteoarthritis with a ligament damage origin, it becomes clear that the ligament integrity or lack of integrity is what needs to be treated to prevent further joint destruction.
Prolotherapy, PRP, and stem cells restore joint integrity
Prolotherapy injected into the painful sites where ligaments and tendons connect to bone, as well as at trigger points and adjacent joint spaces, produces an inflammatory response involving fibroblastic and capillary proliferation, along with growth factor stimulation, that induces healing and strengthening of the damaged or diseased structure. This repairs the damaged ligaments and soft tissue, and allows the older athlete to continue with their desired activity.
The research surround Prolotherapy’s success in treating ligament damage can be found here on our introduction Prolotherapy and Prolotherapy research.
Hip and knee osteoarthritis in the older athlete repaired with stem cells
Stem cells represents a new and exciting non-surgical option for the repair of osteoarthritic cartilage changes and relieve symptoms of stiffness, pain, disability, and inability to run or even walk.
Doctors at the Steadman Philippon Research Institute in Colorado reported in their research published in the journal Sports Medicine, on the rising popularity of PRP and stem cell injections for osteoarthritis in the aging athlete.
Growth factors, platelet-rich plasma (PRP), concentrated bone marrow aspirate, and other stem cell therapies intended to treat inflammatory or degenerative conditions have spawned much interest in recent years. Previous studies have shown that the application of concentrated growth factors and autologous stem cells may stimulate healing in tissues that have a limited ability for self-regeneration. While the use of stem cell therapy to treat knee osteoarthritis is still in early development, preliminary results appear promising. Mesenchymal stem cells from bone marrow and adipose tissues are capable of differentiation into chondrocytes and can be injected into the knee joint along with platelets and growth factors after concentrating.3
“Patients treated with Bone Marrow Prolotherapy (BMP) reported significantly decreased pain and significantly increased function in all areas measured, including gains in activities of daily living, exercise ability, and range of motion, as well as losses in stiffness and crepitus. Furthermore, we propose that BMP treatment has the potential to slow and possibly reverse progression of osteoarthritis in joints by promoting the regeneration of articular cartilage.”4
Please see my article Stem Cells and Prolotherapy for Knee Osteoarthritis and Cartilage Regeneration for a more detailed discuss of stem cells.
Prolotherapy, PRP, and stem cells for back pain in master athletes
In our opinion, Prolotherapy is the treatment of choice for treating low back pain in older athletes, due to spinal instability caused by ligament weakness in the lower back and not due to degenerative disc disease. Please see our article on degenerative disc disease.
Prolotherapy. PRP, and stem cell injections are typically given into the ligaments connecting the vertebra, along with injections into the ligaments of the low back, groin, pelvic complex. This helps to tighten the connections between the pelvis and lumbar spine and assists the muscles in providing stability to the back.
Comprehensive Prolotherapy can make a significant impact in the rehabilitation of the injured older athlete.
If you have a question about your osteoarthritis options, get help and information from our Caring Medical staff
1 Luria A, Chu CR. Articular Cartilage Changes in Maturing Athletes: New Targets for Joint Rejuvenation. Sports Health. 2014;6(1):18-30. doi:10.1177/1941738113514369. [Pubmed] [Google Scholar Articular Cartilage Changes in Maturing Athletes: New Targets for Joint Rejuvenation]
2. Bailey AJ, Mansell JP. Do subchondral bone changes exacerbate or precede articular cartilage destruction in osteoarthritis of the elderly? Gerontology 1997; 43:296-304. [Pubmed] [Google Scholar Do subchondral bone changes exacerbate or precede articular cartilage destruction in osteoarthritis of the elderly?]
3. Chahla J, Dean CS, Moatshe G, Pascual-Garrido C, Serra Cruz R, LaPrade RF. Concentrated bone marrow aspirate for the treatment of chondral injuries and osteoarthritis of the knee: a systematic review of outcomes. Orthopaedic journal of sports medicine. 2016 Jan 13;4(1):2325967115625481. [Pubmed] [Google Scholar Concentrated bone marrow aspirate for the treatment of chondral injuries and osteoarthritis of the knee: a systematic review of outcomes]
4. Hauser R, Woldin B. Treating Osteoarthritic Joints Using Dextrose Prolotherapy and Direct Bone Marrow Aspirate Injection Therapy. Open Arthritis J. 2014; 7:1-9. [Pubmed] [Google Scholar Treating Osteoarthritic Joints Using Dextrose Prolotherapy and Direct Bone Marrow Aspirate Injection Therapy]