Quadriceps Tendon Pain

The Centeno-Schultz Clinic offers PRP, prolotherapy and bone marrow and platelet derived stem cell therapies.  An understanding to function and stability is essential and is covered in Ortho 2.0.  Direct visualization using MSK ultrasound or x-ray is our standard to ensure accurate placement and to avoid the complications associated with blind knee injections.

Muscle and tendon function is critical to the knee joint health. A brief review of the anterior compartment is helpful.

The quadriceps is a group of large muscles in the front of the thigh.  It consists of four major muscles:

Rectus femoris: A large muscle that covers most of the other, deeper quadriceps muscles.

Vastus lateralis

Vastus intermedius

Vastus medius

A tendon is a fibrous band of connective tissue that connects the muscle to the bone.  The quadriceps tendon attaches the quadriceps muscles to the patella.

Quadriceps control knee extension and stabilize the kneecap (patella).

Pain can arise from the quadriceps tendon due to inflammation, chronic degeneration or tear.  A tear can be either partial or complete and is usually the result of trauma.  Tendon weakness predisposes to tears.  Conditions that can lead to tendon weakness include  quadriceps tendonitis, chronic diseases, steroid use, immobilization and the use of a class of antibiotics called fluoroquinolones.

Orthopedic Stem Cells: How they work

At Centeno-Schultz Clinic we acknowledge the regenerative potential of stems cells in treating common orthopedic injuries.   Dr. Centeno authored a chapter on stem cell use in orthopedic injury.
Regenexx C & Regenexx SD are alternatives to knee surgeries.

How do stem cells work?

Three principal ways:  differentiation, paracrine affect and regulation of inflammation.

Mesenchymal stem cells are multipotent and can differentiate into cartilage, tendon, bone and ligament.

Paracrine means that mesenchymal stem cells release certain growth factors to assist in tissue repair.  Mesenchymal stem cells  can be viewed as construction managers as they recruit other cells to the local area and coordinate the repair of damaged tissue.  The growth factors include TGF-beta, VEGF and FGF.

Finally MSC’s have been demonstrated to regulate inflammation.  Inflammation is not all bad and is the first step in healing.

Day # 2: Centeno-Schultz Clinic participates in Children’s Hosptial Charity Event

Nowhere but Upward !

Day # 2 started early with memories of the  8.7 mile, 1831 foot elevation climb of Vail Pass yesterday.

0700 Day 2 Courage Classic 2011

Today was fantastic.  Rode from Copper Mountain around lake Dillon and climbed Swan Mountain Road to Sapphire Point which afforded  a stunning view of Lake Dillon and Gorge Range.  Total miles was 45.90. miles.

The Centeno-Schultz Clinic/Regenexx rode with the Gears of Courage Team who raised $243,000 in donations.

The keys to good articular cartilage have been discussed and include regular aerobic activity.  Today I achieved that goal after 4 strong hours of riding.

What an honor it is to ride for the children at the Children’s Hospital of Colorado.

Summit of Swan Mountain Road 2011

Centeno-Schultz Clinic/Regenexx Participates in Children’s Hospital Charity Event

The number of childhood illnesses and treatments is endless.  Unfortunately money for treatment is finite.

The Courage Classic is a three-day,157-mile bike tour through Summit County that raises money for the Children’s Fund. In 2010, the Courage Classic raised $2.3 million, making it one of the hospital’s highest grossing events.

The Centeno-Schultz Clinic and Regenexx supports it’s community and children.  Day 1 was 58 miles and involved Vail and Tennessee Pass. The latter is a steep climb that crosses the Continental Divide.

PRP Therapy: One Size Fits All

At the Centeno-Schultz Clinic we acknowledge the important of taking a history, performing a physical examination and reviewing radiographic studies.  We appreciate that MRI’s or x-rays alone rarely identify the source of pain.  Many painful conditions such as facet dysfunction are not reliably detected on conventional radiographic studies.

Some health care facilities have recently advertised PRP treatments through radiology departments without the need for an initial evaluation.  A prospective patient calls, provides a brief history and secures an appointment.  No initial examination is required nor is a complete history  taken.  The platelet rich plasma is injected via guidance and the patient is subsequently discharged with no followup.

We find this treatment lacking on many counts.  In medicine one size does not fit all.  Not all conditions require the same PRP therapy.  In contrast an automated, bedside machine which can only produce a one PRP product, a state of the art lab practice such as the Centeno-Schultz Clinic can customize platelet rich therapy.  Important factors in a patients history are taken into consideration at the Centeno-Schultz Cinic. We have blogged previously on how medications such as statins can complicate certain conditions such tendonitis.  Patients see their physician immediately after the injections to evaluate the immediate results and followup in clinic weeks thereafter to ensure clinical progress.  It is this attention to detail that differentiates the Centeno-Schultz Clinic from others.