popliteus/biceps femoris tendinosis

[fishtaco]

ATTIreland - thanks for your reply. I've only been doing the eccentric strength exercises for ~6 weeks. So I don't think it's been long enough to judge if that's working. My plan for now is to continue with the strength exercises, since they don't seem to aggravate the pain. And to continue to avoid biking and running, since they do aggravate the pain. It's helpful to hear that the eccentric strength work often takes 12 wks or more - I think I just needed some sort of general time frame to reference. It's frustrating to be off the bike for so long without any sense of when or if things may get better.

I have thought of PRP - an orthopaedic surgeon suggested it at a recent visit. It sounds interesting and promising. But as I understand it, it's also not very well studied. Since it's a new therapy, my insurance will likely not pay for PRP, and I would have to pay $1000+ out of pocket. At this point, I would be happy to pay $1000 for a complete fix. But it's a lot of money for something that's experimental and not sure to work.

Do you have any experience with PRP or sclerosing therapy?

Again, thanks for the reply!

[ATTIreland]

Hi fishtaco,

Its not really my area as I'm not an orthopaedic surgeon or sports physician but I've heard some good things about PRP. Your right though about the lack of evidence for it at the moment so best thing would be to see does your insurance cover it. Worst thing they can say is no!

However (and this is only my viewpoint) I think that PRP may not be as effective for tendinopathies as it is for treating acute or some other chronic inuries due to the fact that most tendinopathies are actually tendonosis (degeneration of the tendon - replacment of 'good/normal' collagen with 'poor/abnormal' collagen) and you don't need more collagen (tendon tissue) but rather the right type of collagen. Also there is a theory that tendinopathy pain is largely due to ingrowth of blood vessels and nerves into the tendon in responce to prolonged overuse, in this case sclerosing or high volume injections may be more effective.

As is said injections arn't really my area so you'd need to talk to a specialist. Personally I'd give it the 12 weeks and see how it is then.