What Is a Rotator Cuff Tear?

The rotator cuff is a group of muscles and their respective tendons that attach to the bones of the shoulder joint. This so-called cuff allows the shoulder to move and while maintaining it stable. Tendonitis of the rotator cuff can lead to inflammation of these tendons and if continued activity and stress is applied on these tendons, they can tear, resulting in a rotator cuff tear. The shoulder joint is a ball and socket type joint that encompasses the top part of the arm bone where it forms a joint with the shoulder blade. The rotator cuff holds the head of the humerus into the scapula, limiting its mobility so that the head of the arm bone does not dislocate and thereby controls the movement of the shoulder joint.

The tendons of the rotator cuff pass underneath a bony area on their way to attaching the top part of the arm bone. When these tendons become inflamed, they can become more frayed over this area during shoulder movements. Sometimes, a bone spur may narrow the space even more. Prior to the cuff muscles or tendons completely tearing, the problem is called rotator cuff tendinitis, or impingement syndrome. This impingement or trapping and may be due to keeping the arm in the same position for long periods of time, sleeping on the same arm each night thereby placing direct pressure on they socket, playing sports where moving the arm over the head is done repeatedly as in lifting weights above your head, swimming, tennis, baseball, and using the arm overhead for many hours or days.

Rotator cuff tears may occur in two ways. A sudden tear may happen when you fall on an outstretched arm, or after an abrupt, jerking motion such as attempting to lift something heavy. The pain with a sudden tear after a fall or injury is usually intense. This injury is commonly associated with a weakness of the shoulder. Occasionally a snapping sensation of movement can also be felt. Chronic tears of the rotator cuff tendon occur slowly over time. This is more likely in individuals with impingement syndrome. At some point, the tendon frays or splits and tears. Symptoms of a chronic rotator cuff tear include a gradual worsening of pain, weakness, and stiffness or loss of motion. The exact point when a rotator cuff tear begins in someone with chronic shoulder tendinitis may or may not, be noticed.

There are partial or full rotator cuff tears. The partial tear is when a tear does not completely sever the attachments to the bone. A full thickness tear refers to a through and through tear. It may be as small as a pinpoint or the entire tendon or tendons. Complete tears detach the tendon from the site and will not heal very well on their own or with minimally invasive techniques. Pain at night is common in people with rotator cuff tears. The pain may be severe enough that it can wake you up.

We at REGENERATIVE MEDICINE INSTITUTE OF NEVADA have found that our Cytokine Growth Factor Therapy enhanced with PRP can often shorten the recovery time of a Rotator Cuff injury. Brining into the joint a concentration of growth factors not normally in the joint can help the healing of the partially torn or well-opposed Rotator Cuff tendons. This can avoid surgery in many cases and involves no anesthesia. A quick in office procedure where the cytokines and growth factors are mixed with PRP and then injected directly into the injured shoulder can lead to a faster recovery with no surgery.

Things to Know About Stem Cell Treatments

Knee osteoarthritis is a common medical condition in the elderly and the obese. Although there are several treatment options, in recent years, stem cell therapy has been applied in an ever-increasing number of clinical cases. Knee osteoarthritis is a chronic, indolent disease that will affect more and more people every year increasing number of patients. The pain, tenderness and stiffness is caused by degeneration of the cartilage substance inside the knee. Estimates are that by 2030, only in the United States, this medical condition will partially or completely disable 67 million people. Conventional options like physiotherapy or drugs offer only temporary relief of clinical symptoms and can have side effects. A complete healing of normal cartilage function does not come from those treatments alone. In severe cases of knee osteoarthritis total knee replacement may be required. These surgical interventions come together with high effort and costs and are not always successful.

Self-healing of the cartilage can take a prolonged period in those patients lucky enough to be able to produce the healing components. The fluid inside the joint contains mesenchymal stem cells (MSCs) which can differentiate into chondrocytes. This newly formed cartilage is very weak as well as soft and can be destroyed with a small amount of stress within the joint. Normally, there are a limited number of MSC’s in the joint at any time.

The purpose of using stem cells is to support the body’s own process to heal the cartilage which will lessen the pain of osteoarthritis relief from OA. Although repairing the cartilage can occur, at the present time there is no permanent cure for osteoarthritis.

The stem cell candidates for use in these therapies are multipotent adult MSCs, because they are available in several tissues. MSCs can be harvested from bone marrow and adipose tissue that the patient with osteoarthritis has. A big advantage in harvesting the treatment substance from the patient themselves is that MSCs and platelet-rich plasma ensures that the patient’s immune system will not reject the cells. After this procedure, it is important that the joint is limited in its’ weight bearing for a period as little as possible because the newly differentiated cartilage is highly susceptible to damage. MSCs treatment offers a quick and relatively uneventful recovery.

The MSC treatment should only be used if the degeneration of the cartilage is not complete. If there is cartilage and joint fluid is available, stem cells can differentiate because of necessary growth factors are present in the joint fluid. In cases where there is bone-on-bone contact, stem cell treatment is not indicated. It is crucial for the patient is to limit physical activity and pressure on the involved joint in the immediate period after the therapy so there can be limited stress on the joint improve the chance of successful recovery. It is common that more than a single session is required to get the amount of cartilage needed to regenerate enough cartilage to accomplish full healing.

Stem Cell Therapy Treatment Las Vegas

Stem cell therapy is the use of stem cells to treat a medical problem or to prevent further deterioration of that problem. Stem cells in bone e marrow was the first type of stem cell therapy utilized. It was used to help the patient with cancers of the blood such as leukemia. Stem cell therapy has been controversial and is apolitically charged topic. The attempt of scientists to isolate and culture embryonic stem cells, to create new stem cells and their use of techniques to create induced pluripotent stem cells has been condemned by those that are worried about people using embryos. This controversy is due to the politics of abortion clinic and their possible sale of embryos as well as concerns about human cloning

Bone marrow transplant is the most widely used stem cell therapy, but some therapies derived from umbilical cord blood as well as from adipose-derived sources are also in use. Research is underway to develop various sources for stem cells. There are many clinical case reports in the treatment of joint problems reported. The main focus in the medical literature of joint issues has been on mesenchymal stem cells. Stem cells are believed to assist in repair via five ways: 1) providing an anti-inflammatory effect, 2) attaching to damaged tissues and then attracting other cells that are necessary for tissue repair, 3) promoting tissue remodeling instead scar formation, 4) inhibiting cell death, and 5) differentiating into different kinds of tissue.

To further enrich blood supply to the damaged areas, and consequently promote tissue regeneration, platelet-rich plasma could be used in conjunction with stem cell transplantation.[74][75] The efficacy of some stem cell populations may also be affected by the method of delivery; for instance, to regenerate bone, stem cells are often introduced in a scaffold where they produce the minerals necessary for generation of functional bone.

We at the Regenerative Medicine Institute of Nevada are proud to say that we offer these new innovative options and have had good success in many individuals that are seeking mesenchymal stem cell therapy. Running the full gamut from platelet-rich plasma (PRP) alone to adding cytokines and growth factors to the PRP, to adipose-derived mesenchymal cells, or mesenchymal cells from a donor, the options available at the Regenerative Medicine Institute of Nevada to potentially treat a diverse patient population so treatments are customized for each patient.

Types of shoulder Pain

Most shoulder problems are categorized in most commonly four types. These are tendon inflammation or tendon tear, instability, arthritis of some type, or a fracture. A less common cause for shoulder pain can be bursitis, or an inflammation of a sac of fluid that is surrounding the joint of the shoulder. The sac is meant to lessen or eliminate any friction that might occur with the gliding of tendons in the shoulder. The tendon looks like a cord and its’ purpose is to connect muscle to bones. This is in contrast to ligaments that connect bones to bones. Tendonitis is an inflammation of that cord. When it has been inflamed for a long period, it is referred to as tendinosis. This inflammation or tendonitis is very similar to the manner in which the sole of a shoe can wear down over time from wearing that shoe.

In the shoulder joint, four tendons make up what is referred to as the rotator cuff. The function of the rotator cuff is to keep your arm bone, referred to as the humerus, in the socket of the shoulder. The rotator cuff allows the arm bone to move in all of the direction it does. At the same time, it gives stability to the joint so that the bone does not pop out of place. These same tendons can in certain cases tear. The usual cause of a tearing of a rotator cuff tendon is progressing age, over-use over a long period of time, or a sudden injury like a fall, or blow to that shoulder. When the shoulder blade puts pressure on the tissues of the shoulder, you can develop a problem called should impingement and this can lead to significant shoulder pain. The most common type of arthritis that can cause shoulder pain is osteoarthritis. This usually begins in middle age and progressively gets worse. This can be due to a distant injury or from just normal wear and tear of the shoulder joint. The fracture that can cause shoulder pain is a broken bone of the collarbone, the humerus, or the shoulder blade.

We at the Regenerative Medicine Institute of Nevada are proud to say that we offer these new innovative options and have had good success in many individuals that are trying to avoid surgical options to relieve shoulder pain. Running the full gamut from platelet-rich plasma (PRP) alone, to adding cytokines and growth factors to the PRP, to adipose-derived mesenchymal cells, or mesenchymal cells from a donor, the options available at the Regenerative Medicine Institute of Nevada to treat your shoulder pain are wide and may help you avoid a surgery that can have its series of potential limitations and complications.

Stem Cell Treatment Las Vegas Garcia

In describing stem cell therapy, the first step is to define and explain what a stem cell actually is. A stem cell is frequently referred to as a “blank” cell. It is capable of changing or growing into another more definitive type of cell in the body, such as a skin cell, a muscle cell, or a nerve cell. A stem cell is microscopic in size and can only be seen under a microscope. Stem cells are exciting news in both medical and scientific circles. These cells they can be used to replace or repair damaged tissues and cells in the body. They can serve as a built-in repair system for the human body, replenishing other cells as long as a person is still alive. A collection of stem cells can be harvested and stored for future use. The stem cell is essentially free of genetic defects and it is so immature in its form that they can be transplanted into people of all types without worrying about rejection such as in a blood transfusion or an organ transplant. Stem cells have the potential to multiply and create more of the same cells, but this can only be done in a lab where culture media and other chemicals are added to promote this growth in numbers. With proper techniques, the stem cells can be caused to mature, forming more definitive cells such as muscle, nerve or liver cells. While still in the early research phase, these techniques show huge promise. Now a patient cannot go to a physician and receive these differentiated cells to treat their medical issues. Although this all sounds like it is brand new, therapy with stem cells has been around for many years. The fist example of stem cell therapy was the treatment of people with blood-system cancer, like leukemia, where they were first treated to kill off all of the diseased cells with chemotherapy and then they received stem cells form a matched donor to replenish the lost cells. These transplanted cells originated from human adult donors or form umbilical blood collected during childbirth.

Using stem cells to repair certain parts of the body is commonly referred to as stem cell therapy or regenerative medicine. Researchers can grow stem cells in a lab for use in clinical trials. There are many clinical trials going on around the world about the potential future uses of stem cells. Practicing physicians can presently do what are referred to as autologous stem cell transplants. In this case, stem cells are collected form the patient and returned to the patient into a specific area in a higher concentration. How this can be performed is through what is commonly referred to as adipose-derived stem cell therapy. In this procedure a small amount of fat, or adipose tissue, is harvested from the person’s body. The fat cells are then separated from the tissue between them that holds the fat cells together. Think of the fat cell being a tile on the floor and the tissue I am referencing is the grout that holds the tiles together. In this case, that grout is called stromal vascular fraction (SVF). It is in the SVF where the stem cells reside. The SVF contains other proteins in it besides just stem cells. These are cytokines, growth factors, and mesenchymal cells. Mesenchymal cells are, like stem cells, multi-potent, and can differentiate into other types of tissue such as cartilage or bone cells. The SVF with its healing properties can be the administered to the patient directly into an injured area such as into a knee joint or given through an intravenous line. In cases such as this, the patient is treated in one day with no manipulation of the cells. It is an autologous transplant, coming from the same person, so there is no risk of rejection or allergy. The SVF provides the elements need for tissues to heal as it contains stem cells, mesenchymal cell, cytokine and growth factors. At the Regenerative Medicine Institute of Nevada we provide SVF therapy as well as Cytokine Growth Factor Therapy with Platelet Rich Plasma (PRP) therapy to assist our patients heal from a myriad of different medical problems or acute and chronic injuries.

Rotator Cuff Injuries - Causes, Symptoms and Treatment

Reduction of pain and a restoration of function is the goal of any Rotator Cuff treatment. There is no one perfect option for all patients. In cases where an MRI, a common imaging modality, has shown a tear of the Rotator Cuff, some type of treatment will be required beyond just ice and a short period of rest. The most common tendon of the Rotator Cuff injured is the supraspinatus. Prompt diagnosis of a Rotator Cuff tear is essential to lessen the invasive nature of any treatment option. When a tear of the Rotator Cuff occurs, the surrounding muscle often atrophy, or shrink, losing strength This finding points to the need for physical therapy to keep the range of motion as well as to rebuild the muscles without further damaging the tendons of the Rotator Cuff. There are specific exercises that a physical therapist can help you with that can strengthen the Rotator Cuff tendons. These exercises help to maintain movement and attempt to slow the atrophy or loss of muscle around your shoulder. Many physicians believe that stronger muscles can help avoid further Rotator Cuff damage. The first steps in treatment and physical therapy combined with OTC NSAIDs. The risks of surgery, namely infection, permanent stiffness, complications related to anesthesia and in many cases a lengthy recovery time as well as a recurrence of the tear, prompt many who have a Rotator Cuff injury to seek out non-surgical option.

A Rotator Cuff partial tear is often treated by an orthopedic surgeon with something called a debridement. This is where frayed edges of the tendon are trimmed and if a bone spur is causing the injury, it can be burred down. The debridement of the tendon does not make the tendon heal any faster though. If the edges of the tendon are torn but sill adjacent to one another there can be different options available. Unfortunately, if the Rotator Cuff tendons are completely torn and widely separated, usually a major surgical intervention is called for.

We at REGENERATIVE MEDICINE INSTITUTE OF NEVADA have found that our Cytokine Growth Factor Therapy enhanced with PRP can often shorten the recovery time of a Rotator Cuff injury. Brining into the joint a concentration of growth factors not normally in the joint can help the healing of the partially torn or well-opposed Rotator Cuff tendons. This can avoid surgery in many cases and involves no anesthesia. A quick in office procedure where the cytokines and growth factors are mixed with PRP and then injected directly into the injured shoulder can lead to a faster recovery with no surgery.

Rotator Cuff Tear Las Vegas Garcia

A tear of the rotator cuff in a patient leads to pain and in most cases a limitation of motion and activity. On average, there are yearly about 2 million people that seek out and evaluation by a physician for shoulder or rotator cuff pain. The shoulder is a ball-and-socket joint. The actual rotator cuff is a group of four muscles around the arm bone that allows you to lift and rotate your arm. There is a sack of fluid, called a bursa, in this area. This bursa may be inflamed or painful when an injury to the rotator cuff tendons occurs. The tendons of the rotator cuff often become partially torn with injuries or over-use. This can cause pain and limitation of motion. Unfortunately, this fraying of the tendons can result in a complete tear of the tendon when a quick motion is performed or a heavy object is lifted. At times, a rotator cuff tear can occur from a fall on an out-stretched arm. Over-use of the rotator cuff, like that seen in athletes or people that do repetitive motions at work, can result in rotator cuff injuries. Signs and symptoms patients should look for when they think they may have a rotator cuff injury are pain while resting or sleeping, in particular when laying on the shoulder, pain with moving your arm in certain directions, loss of strength in the arm during certain motions, as well as crackling sounds when using your arm in certain movements. Some patients may eventually require surgery to repair the rotator cuff but is a large percentage of patients, therapy and anti-inflammatories will help the patient function. Caution should be taken with cortisone injections into the area as while it can temporarily decrease the pain, it can allow faster degradation of the tendons and speed the partial tear converting to a full tear. In cases where surgery is required, the post-operative course can complicated by infection, permanent stiffness, anesthesia complications, a lengthy recovery period, as well as a failure of the repair and a return of the pain.

We at the Regenerative Medicine Institute of Nevada use alternative methods and have had great success in staving off the need for surgery and the use of some of the medications that can have serious side effects. We offer options to the patient that utilize adipose derived stromal vascular fraction, (SVF) components. The SVF is derived from the patients’ own fat cells and their supporting structures and contains Cytokines, Growth factors, Stem cells, as well as Mesenchymal cells. This SVF is harvested using a small liposuction procedure under local anesthesia and then the SVF is prepared and either injected directly into the joint or given through an intravenous line. These treatments, because they use the patients’ own tissue, offer no chances for rejection or allergic responses. We also offer additional options with Cytokines and Growth Factors from a tissue bank and mix it with Platelet Rich Plasma (PRP). This Cytokine Growth Factor Therapy in combination with the PRP involves no fat harvesting. This procedure, like the SVF, has no fear of rejection no allergic response. Both of these options provide choices for the patient looking to avoid prescription medications, cortisone injections, or surgery. The SVF or Cytokine Growth Factor Therapy with PRP can be repeated as the aging process allows continued damage to the tendons and burs in the rotator cuff.