I literally tried everything to manage my knee pain and overcome a chronic knee injury with frustrating results. Last year in May my knee cap tracked out of place due to a perfect storm of IT band (Iliotibial Band) tension and post-surgical weakness in my medial quadriceps. My leg muscles literally atrophied over the course of a month and my kneecap continued to track and re-atrophy my thigh several times after that because of my active lifestyle and a buildup of tension. I did what any western minded person would do — I went to the orthopedic specialists to have a physical examination, MRIs and Xrays to see what the problem was and how to fix it. To my surprise I was diagnosed with Osteoarthritis as a young 30-something and also have lost some bone density in my right femur due to a long surgical recovery a few years back. All of a sudden I went from being a full time Yogi and highly productive person to a weakened, slow-moving, painfully injured couch potato.

My doctors and multiple physical therapists gawked at my extreme thigh atrophy in awe; how could someone so young and strong lose so much muscle and not gain it back? The MRI showed no anatomical joint issues, so we ruled out the need for surgery right away. I went to a neurologist to check my muscles and nerves for potential damage and they were all perfectly healthy on the tests. My symptoms of pain were ten-fold: I had arthritic inflammation for the first time in my life (which felt like fire inside my kneecaps) and I had tension radiating up and down my leg from my glute to just below my knee with various points of acute and sharp pain throughout my days, weeks, and months. Physical therapy was my first approach–and though this approach was and is still helpful–it was also harmful in my case.  Some of the basic exercises given to me to strengthen my weakened quad muscle also activated my over-dominant  hip muscles and IT band which literally pull my kneecap right back out of place and start the atrophy all over again. If you have or have heard of IT band syndrome, you know what I am talking about.

About every two months I would gain strength, increase physical therapy exercises and activity and then accidentally track my knee out of place again. I changed my diet to an anti-inflammatory diet right away (the whole30 cleanse, no sugars, gluten, nightshades, processed food etc.). I saw four different PT’s from the start (an Egoscue expert, a myofascial release guy, a classic athletic therapist and a certified kinesio taping PT).  I also implemented a variety of other healing modalities to manage my pain and fix my problem: Foam rolling, structural taping, knee braces, orthotics, rolfing, massage, epsom salt baths, reiki, acupuncture, rest, ice, elevation, heat pads, restorative yoga, chiropractic, supplements, meditation and, if you can believe it, EVEN MORE  healing modalities are now a part of my regular rituals to recover. I recommend many of these options and have had some relief and pain management results from my tireless efforts and commitment to these practices–but more than a year later I am still injured and in pain.

When I met Dr. Jason at Livv Natural in Del Mar,  I had heard about PRP and Prolotherapy in small conversations but no one seemed to be able to tell me what it was or if it was right for me.  I made an appointment to have a consultation in his office and learned all about the treatment — what to expect, how it works, the benefits, and the timeline for improvement.  His demeanor is authentic and informative so my  practical mind was soothed by the confidence behind his wisdom. My fear of needles was slowly diminished because I could sense his innate compassion for wellbeing. I am an open-minded person, but I am also very data and logic based when it comes to my life choices–especially choices that involve personal investments and trust. I researched the web like a madwoman and read everything out there about PRP procedures, results, benefits, and potential side effects. I came to realize that this treatment is one of the potentially most useful and has little to no harmful downsides! In fact, as I was researching a bjillion sites for the most up to date data about PRP, I realized that this was something that I NEEDED to try and that I probably should have done after my first surgery (double meniscal tears 4 years ago) and/or when my knee tracking started. I may not be writing this article had I done PRP sooner in my healing process. And yet PRP works at various stages of an injury in different ways.

We set up a treatment appointment and Dr. Jason reviewed the procedure, calmed my nerves about the needles and let me know step by step what was going to happen. A beautiful doctor on his team came to draw my blood supply to spin in the centrifuge to separate out my platelet rich plasma (that’s where PRP gets its name) for the injections. It was nice to be in a modern and comfortable setting with knowledgeable and friendly staff to keep me grounded while I embarked on what was otherwise a huge fear of mine. (Anyone else out there afraid of needles?) We then moved rooms and went into the treatment room where Dr. Jason administered Prolotherapy to help prepare the locations for PRP and then followed with several PRP injections. I felt comforted knowing that Dr. Jason had listened to my medical history, looked at my MRIs and performed multiple physical examinations to know where the bulk of my inflammation, range of motion and physical atrophy was located before he administered the PRP. He explained to me where and why he was focusing the injections and that gave me a small peace of mind as I was breathing through the shots themselves. For the record, some shots do feel subtle like acupuncture needles and other ones, like the ones we needed to get near the bone, were much less subtle! All in all it was a tolerable amount of discomfort to endure given the potential gain over time.

I had textbook post-procedure symptoms after the session — a fullness to my knee joint and a mild tenderness around the areas he treated. I followed the treatment plan: ice, heat, ice and lots of rest for the next three days. I moved around on day two with relatively no pain or tenderness until the evening time when my body simply reminded me that I had done something different and that my joints were responding. Right away I could see a huge difference in the muscle response and firing pattern. For the first time the whole medial quadricep (where my atrophy is) moved as a whole at the same rate! By day four after my treatment all signs of the initial swelling and inflammation had subsided and I was already starting to move with more ease. Having been injured and re-injured so many times over the course of the year, I am an expert in reading my body and am uber-aware of every sensation in every cell. That said, I witnessed my body slowly improving over the course of the following weeks. By week three I was literally moving around with no limp, no pain and more range of motion than I had in months!

As a certified yoga instructor I have a decent education about the body and understand how the muscles and connective tissue work together for overall movement. Having experienced several injuries to the knees (meniscal tears, surgery and knee tracking), I am now a self-proclaimed burgeoning expert in knee pain managment. Of all the modalities I have tried so far, PRP has had the most impact to date–and I only had one session! For injuries that are chronic or complicated it is recommended to try multiple sessions as the body could benefit from multiple areas treated. Each injury or recovery area needs special attention and intention from your doctor so that the right areas receive the most help with healing.

PRP got me back into the state of strength where I can manage my physical therapy exercises, walk at a moderate pace and return to some of my basic daily activities and work requirements. Of everything I have tried so far, I feel that this modality actually worked wonders on my recovery. In fact by having PRP administered, I have been able to return to my physical therapy regimen with less pain and push back and I am seeing muscle definition return for the first time in months. Besides the natural reservation to experience needles again (there’s that unrelenting fear of mine!) I am eager to return to the office for another session and get even more benefits and healing.