Stemcelldoc's Weblog

March 2, 2009

Biceps Tendon Repair

The biceps muscle is what gave Popeye his notoriety.

Flexing His Biceps

Flexing His Biceps

The biceps muscle consists of two separate heads:  the short head which originates from the coracoid process and the long head which originates  the cartilaginous socket referred to as the labrum.

Attachment of short head of the biceps muscle

Attachment of long head of the biceps muscle

The muscle inserts onto the radius, one of the bones in the forearm.  Tendons attach muscle to bone.

Two Heads of Bicep Muscle

Two Heads of Bicep Muscle

The biceps functions to stabilize the shoulder,  flex the elbow and rotate the forearm.  The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its attachment point at the labrum.  Tears of biceps tendon can be either partial or complete.

Symptoms commonly associated with a torn biceps tendon include sudden sharp pain, an audible snap, weakness and tenderness along anterior shoulder.

Treatment options often include surgery where the biceps tendon is reinforced with sutures and anchored to the bone.

At the Centeno-Schultz Clinc we have successfully injected the biceps tendon where it is attached into the shoulder joint.  A novel alternative to biceps tendon surgery is the injection of stem cells into the area of damage.   The stem cells have the potential or repairing and regenerating the torn tendon.   Regenexx is a simple needle-in, needle-out procedure which allows the patient to avoid the risks of surgery, anesthesia and the extensive time and expense associated with post surgery physical therapy.


February 24, 2009

Platelet Rich Plasma

Filed under: Stem Cell Basics — Tags: , , — stemcelldoc @ 4:57 pm

What do Pittsburgh Steelers’ Hines Ward and Troy Polamalu have in common?  They have both used their own blood to treat ligament and tendon injuries.  The therapy is called platelet-rich plasma (PRP) and involves the injection of concentrated platelets and plasma to the area of damage.  Instead of injecting steroids, which can lead to tissue damage and tendon rupture, physicians are now injecting a patient’s own blood products to stimulate healing.

What is PRP?  It is a concentrate of a patient’s own platelets.  In our bodies, normal platelet counts range between 150,000/μl and 350,000/μl with an average of  200,000/μl.  Animal and human studies have demonstrated that soft tissue healing enhancement only occurs when the concentration of platelets (PRP) is greater than 1,000,000/μl.  This is a concentrate of 5x the amount normally present in our bodies.

How is it made?  A small amount of a patient’s own blood is placed in a centrifuge which separates the red blood cells from the platelets.  A teaspoon of the remaining substance is injected into the damaged tissue.

How does it work?   Platelets contain several significant growth factors, which enhance tissue repair.  The most important growth factors in PRP are platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-b), vascular endothelial growth factor (VEGF) and epithelial growth factor (EGF).

What are the advantages?  It is a non-surgical therapy utilizing a patient’s own cells, and therefore is not associated with allergic reaction or transmission of disease.  At the Centeno-Schultz Clinic we use PRP for repair of ligament, tendon and muscular injury.

February 14, 2009

Adult Stem Cells

What are adult stem cells? They are cells within our body that can renew themselves and turn into other cells (differentiate).   Conceptually they can be thought of as the repairmen of the body. They live inside us in various tissues, poised to leap into action to repair damage as it occurs.  The problem is that as we age or get larger injuries,  our bodies are unable to recruit sufficient number of stem cells to fully  repair the area of damage.

There are many different types of adult stem cells but the most common are called hematopoetic stem cells.  What does this mean.  These are adult stem cells that will change (differentiate) into blood (hematopoetic)  products such as red blood cells or platelet.  Hematopoetic stem cells are easy to obtain from a peripheral blood or from bone marrow.  They are very plentiful in both blood and bone marrow. Unfortunately many ” stem cell therapies” are employing these hematopoetic stem cells due to the abundance and ease to access.  Such is the case with bone marrow aspirate concentrates which are bedside units that concentrate cells obtained from one’s bone marrow. 

Bone Marrow Aspirate Concentrate Unit

Bone Marrow Aspirate Concentrate Unit

 Unfortunately for patients, despite the advertised claims, these cells can only differentiate into blood products.

Stem cells associated with regeneration of damaged tendon, ligament, bone or disc are termed mesenchymal stem cell (MSC). 

Mesenchymal Stem Cell

Mesenchymal Stem Cell

 MSC’s can not be harvested from blood nor can they be obtained in clinically significant numbers from bedside bone marrow aspirate concentrates.  Herein lies the critical difference between current therapy and RegenexxRegenexx isolates MSC’s and then expands them so that you as a patient have the critical number of MSC’s to repair damaged tissue.  Regnexx uses your own stem cells and expands them for a variety of orthopedic aplications.

January 20, 2009

Tendon Tears and Treatment Options

Tendons are fibrous tissue that attaches muscles to bone.  A strain is an injury of a muscle and or tendon.  In severe strains, the muscle and or tendon are partially or completely ruptured .  A common example is a tear in the rotator cuff.  The rotator cuff is comprised of four principal muscles which stabilize the shoulder joint:   supraspinatus, infraspinatus, teres minor and subscapularis.


What causes strains?   Strains can result from overuse of muscles and tendons, excessive muscle contraction or trauma.  Medications can also cause tendon damage.  Cholesterol lowering medications  called statins have been linked with tendinitis.  Common statins include Lipitor, Lovastatin and Simvastatin(Zocor).

Antibiotics are also been associated with tendon injury. The FDA has issued an warning for those using Fluoroquinolones which include Cipro, Factive, Floxina and Levaquin which have been associated with tendonitis and tendon tears.

If you have sustained tendon tears as a result of medication or trauma,  surgery is not the only alternative.   Regenexx is a novel therapy that utilizes a patients own stem cells to repair damaged tendons.  It is a simple needle-in, needle-out procedure that allows the patients to avoid the risks of surgery and anesthesia.

Please review the testimonial of a patient who had rotator cuff tears in both of her shoulders, who underwent surgery on one side and opted to treat her other tear with stem cell therapy at Regenexx.




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January 19, 2009

Sprains, Strains and Tears

Sprains and strains are common injuries. What is the difference?

A sprain is a stretch or tear of a ligament, the fibrous tissue that connects the end of one bone with another.  Ligaments stabilize and support our body’s joints.  A common example is anterior cruciate ligaments in the knee which connects the upper leg with the lower leg.   A moderate sprain partially tears the ligament, producing joint instability.


A strain is an injury of a muscle and or tendon.  Tendons are fibrous tissue that attaches muscles to bone.   A common example is the biceps tendon which attaches the biceps to the shoulder socket (glenoid).   In severe strains, the muscle and or tendon is partially or completely torn.


Why do these occur?

Sprains are typically caused by trauma that displaces a joint out of position and overstretches the supporting ligaments. In severe cases, the ligament tears or ruptures. A common example is a snowboarder who falls on an outstretched arm.

Strains can result from overuse of muscles and tendons, excessive muscle contraction or trauma.

Treatment for torn ligaments and tendons often involves  surgery. At the Centeno-Schultz Clinic these injures have successfully been treated with prolotherapy and stem cell therapy.  Regenexx allows the patient to use their own stem cells to repair torn ligaments and tendons.

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January 17, 2009

Rehabilitation from Shoulder Surgery

Patients with tears in the labrum, biceps tendon and inferior glenohumeral ligament often undergone surgery. Tears to the labrum, the fibrous tissue that surrounds the glenoid socket, involve cutting and removing the damaged tissue. If the tendon is torn it is commonly reattached using absorbable tacks, wires, or sutures.


Rehabilitation can be slow and painful.  After surgery the shoulder is immobilized in a sling for 3 to 4 weeks. During this time there can be loss of muscle strength and tone. Physical therapy aims to restore flexibility and muscle strength which requires weeks of therapy and time.

Ligaments, tendons and the labrum can be repaired using cell stem therapy. Regenexx enables patients to use their own stem cells to repair injuries in the shoulder. Regenexx is a simple needle in-needle out procedure which allows the patient to avoid the risks associated with surgery, anesthesia and the time consuming and painful rehabilitative process associated with surgical options.

To see how stem cell therapy can be used for rotator cuff tears please click video.

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January 5, 2009

Torn Tendon in Foot

Torn foot tendons are a common injury.

Torn foot tendons typically involves one of three tendons: the Achilles’ tendon, posterior tibial tendon, or peroneal tendon.

The peroneal tendon is located on the outer side of the ankle and functions to stabilize the ankle.

The peroneal tendon and muscle pass together through a groove in the outside ankle bone (lateral malleolus). Contraction of the peroneal tendon and muscle results in the foot pointing downward and outward.
Injury to the peroneal tendon typically occurs as a result of a previous ankle sprain.
Patients often complain of pain along the course of the peroneal tendon. They may also complain of snapping or popping on the outer edge of the ankle


Evaluation includes x-rays to exclude fracture. An MRI will demonstrate if a tear in a foot tendon is present.

If a torn peroneal tendon is noted, surgery is often recommended. The surgery involves an incision through which the tendon and muscles are manipulated to allow for the ‘repair’ to be accomplished. This involves the inherent risks of surgery and anesthesia along with a lengthy and painful rehabilitation.


Regenexx affords patients an alternative to surgery for torn tendons in foot. Utilizing your own stem cells a torn peroneal tendon or muscle can be regenerated. There is no need for surgery or anesthesia since this is a simple needle in, needle out procedure.

Please review this video to learn more about the success of Regenexx stem cell therapy for a torn tendon or ligament.

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