Athletes get some of the most surgically aggressive care ever imagined. In fact, for most, it’s a rite of passage. Case in point is this patient, a cross fit competitor who was ripe for surgery in any local orthopedic surgery clinic. All of that would have meant big downtime away from competition, so she wondered if there was a way for her to have her cake and eat it too? Could she get a highly advanced procedure that was less invasive, but that would allow her to continue training?
Despite three injured rotator cuff tendons in her shoulder and a problem in her cervical spine, Stine, a CrossFit regional competitor and coach, got to keep training while she healed. How did she do it with this rotator cuff injury? Before I have her tell her story in the video above, let’s review the injuries she had.
The rotator cuff is what we call the muscles that help guide and stabilize the shoulder ball in its socket. These muscles and tendons (i.e. subscapularis, supraspinatus, etc.), connect the shoulder end of the humerus (the upper-arm bone) to the scapula (shoulder blade). The rotator cuff, along with capsular ligaments, provides stability and support for the shoulder joint as the joint is otherwise a shallow ball and a socket. This design allows the shoulder a greater range of motion than any other joint in the body.
While rotator cuff injury and tears are common in lifting athletes, such as CrossFit competitors, they also tend to occur in those reaching middle age and older. In fact rotator cuff tears in this age group are more often than not incidental wear and tear that occurs with aging, not a cause of shoulder pain and certainly not a reason for surgery. Most dedicated, competitive athletes who sustain an rotator cuff injury know, as well, that surgery is a game changer, and not for the better, as surgery comes with lengthy recovery times, a high risk of not achieving their preinjury levels of shoulder strength and function, and even ongoing pain and discomfort. In addition, rotator cuff surgery for traumatic tears has been shown to be no more effective than no surgery for many types of tears.
If there’s anyone who can put the rotator cuff through the ringer, it’s a competitive CrossFit athlete. Just take a look at Stine’s video, and the force placed on the shoulders is obvious. So let’s review Stine’s story and how Dr. Schultz was able to treat her rotator cuff injuries without surgery.
Stine first qualified for the CrossFit Regionals in 2017, quickly climbing from 41st in her division in the state of Colorado in 2015 all the way up to an inspiring 2nd in 2017. Shoulder pain, however, threatened to derail her goal of qualifying a second time, at the 2018 CrossFit Regionals. When an MRI revealed a rotator cuff injury and conservative treatments weren’t helping, Stine knew the long recovery after shoulder surgery would stop her in her CrossFit-training tracks. So surgery simply wasn’t an option.
Stine made her way to Dr. Schultz in late October of 2017, who found that she not only had injuries to three of the major tendons of the rotator cuff, but she also had an issue in her cervical spine that had never been diagnosed. This was an important discovery as nerves that branch off of the cervical spine supply the shoulder, so when there is a problem in the cervical spine, it can create dysfunction and pain in the shoulder.
Stine had a big goal—to qualify for regionals at the CrossFit Open in February of 2018. Dr. Schultz’s treatment plan consisted of precise ultrasound-guided injections of a high dose of Stine’s own platelets (which would facilitate her own healing aka high-dose PRP or platelet-rich plasma) into the rotator cuff. Dr. Schultz also used the growth factors extracted from her platelets (platelet lysate) to inject around her irritated neck nerves that were wrecking havoc with her rotator cuff.
Stine had her platelet treatments in November and January. While she would normally be in a huge sling and shoulder pillow, recovering from invasive rotator cuff surgery, she was training. The result? She qualified, once again, for the CrossFit Regionals on February 22, 2018. Way to go, Stine!
The upshot? Interventional orthopedics is a game changer for athletes. No longer are they at the mercy of invasive surgeries that can take them out for an entire season. Now, about 70% of the time, they can bypass orthopedic surgery altogether and opt for less invasive interventional orthopedics with a much quicker recovery. Many can train through treatments and lose little if any progress. Stine is a great example of what’s possible when you avoid the surgeon!
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Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…