Noah’s Return to Ultra Marathons

Noah has two young children and they play catch in the yard. His shoulder hurt him so much that he could not even throw the ball overhand to his child. He has had back surgery and reconstructive surgery on his left arm and was not interested in going under the knife again. He went to two different orthopedic surgeons who recommended surgery for his shoulder. He was turned off by their recommendation. He tried PT, but felt it was a band-aid on the problem because the pain would always return if he aggravated the shoulder. Dr. Chris Hall and Noah take their children to Jiu Jitsu at the same location. Dr. Hall noticed Noah stretching his right arm and wincing as he moved it. He asked Noah about his shoulder and Noah told him about his pain and weakness. Dr. Hall asked Noah if he had any films of his shoulder and would he mind if he took at look at them. Noah sent them to DOC. Dr. Hall noticed that the shoulder sat in front of the joints which usually indicates a rotator cuff tear, but requested an MRI to see the soft tissues to confirm the diagnosis and determine the location and size of the tear. Noah had a rotator cuff tear and another unknown injury, a bicipital tendon tear. The shoulder is made up of three bones: upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The shoulder is a ball-and-socket joint. The ball or head of the upper arm bone fits into a socket in the shoulder blade. The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the upper arm bone and attaches it to the shoulder blade. The biceps muscle is in the front of the upper arm and is attached to the bones in the shoulder and elbow by tendons. The rotator cuff helps to lift and rotate the arm or to help Noah throw a ball. The biceps tendon enables the arm to rotate from palm down to palm up, a motion called supination. Noah’s torn rotator cuff and torn biceps tendon caused pain, weakness, and diminished range of motion. Surgery was necessary. Dr. Hall re-attached the rotator cuff tendon to the head of the upper arm bone and re-anchored the biceps tendon to the bone. The goal was for Noah to regain his shoulder and arm strength and function. Noah asked Dr. Hall about alternatives to surgery because he visited Dr. Google and read about regenerative therapies, stem cells and PRP. Dr. Hall is an advocate of both procedures. Noah was curious about the healing properties of the therapies for his shoulder and arm and another possible application for his knees. Noah is an ultra marathon runner. His right knee was stiff and it was difficult to even go up and down the stairs in his home. So while under anesthesia, Noah elected to have stem cells and PRP injections in his shoulder, arm, and both knees. Stem cells came from Noah’s own bone marrow. Dr. Hall believes that stems cells are ideal to help treat and heal rotator cuff conditions and tendonitis. Recent studies indicate that stem cells can also help accelerate the healing process after surgery. Platelet-Rich Plasma (PRP) comes from a simple blood draw. A PRP injection promotes healing of injured tendons, ligaments, muscles, and joints, and can be applied to various musculoskeletal conditions. Noah is six months into his recovery and just ran a 50-mile ultra marathon. After two tendon repairs, stem cell and PRP therapies in his shoulder, arm, and knees, Noah explains: “I am 100% better. I wish I had done all of this a long time ago. I am convinced that the stem cells and PRP made a big difference. I have recommended DOC to my father-in-law who has shoulder problems. I had no wait at the DOC office. I followed up with the DOC physical therapist, who had a great personality and provided at-home exercises to speed my recovery.”

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