How to Treat Chronic Sports Injuries Using Minimally Invasive Methods

Kimberly Harmon, MD, is board certified in Family Practice with a Certificate of Added Qualification in Sports Medicine. She is the Head Football Team Physician for the University of Washington Huskies, as well as a UW Professor in the Departments of Family Medicine and Orthopaedics and Sports Medicine. Kimberly has lectured nationally and has authored numerous peer-reviewed papers on topics relating to sports injury and novel approaches to treatment.

In this podcast with Dr. Tommy Wood, MD, PhD, Kimberly draws from her own research and experience to describe options for the treatment of sport-related tendon and joint injuries using minimally-invasive procedures. They discuss interventions ranging from physical therapy techniques to platelet-rich plasma to relieve pain and improve function. She also discusses some of the main medical and safety challenges faced by today’s college athletes.

Here’s the outline of this interview with Kimberly Harmon:

[00:01:15] Non-surgical approaches to sport-related joint and tendon problems.

[00:04:16] Assessment and treatment; eccentric exercises.

[00:06:48] Early intervention; Physical therapy techniques: Astym and Graston.

[00:07:10] Extracorporeal shockwave therapy.

[00:07:43] Nitrous Oxide; nitro patch.

[00:10:27] Tenotomy.

[00:10:52] Injecting whole blood into the tendon; Platelet-rich plasma (PRP).

[00:12:54] Reviews of PRP studies: 1. Salamanna, Francesca, et al. "New and emerging strategies in platelet-rich plasma application in musculoskeletal regenerative procedures: general overview on still open questions and outlook." BioMed research international 2015 (2015). 2. Barile, Antonio, et al. "Anaesthetics, steroids and platelet-rich plasma (PRP) in ultrasound-guided musculoskeletal procedures." The British journal of radiology 89.1065 (2016): 20150355. 3. Jeong, D. U., et al. "Clinical applications of platelet-rich plasma in patellar tendinopathy." BioMed research international 2014 (2014).

[00:14:03] Kim’s research on PRP - about 80% of people respond Mautner, Kenneth, et al. "Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review." PM&R 5.3 (2013): 169-175.

[00:15:35] Cortisol vs. PRP.

[00:17:12] Working treatment into recommendations for athletes.

[00:18:40] Joints; treatment with PRP.

[00:20:02] PRP improves joint pain and function; Studies: Bousnaki, M., A. Bakopoulou, and P. Koidis. "Platelet-rich plasma for the therapeutic management of temporomandibular joint disorders: a systematic review." International journal of oral and maxillofacial surgery 47.2 (2018): 188-198; and Tietze, David C., Kyle Geissler, and James Borchers. "The effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review." The Physician and sportsmedicine 42.2 (2014): 27-37.

[00:21:00] Joint replacement.

[00:21:40] Viscosupplementation; brands: Synvisc, Orthovisc, Euflexxa, Supartz; hyaluronic acid.

[00:22:12] PRP vs. hyaluronic acid; Study: Ye, Ye, et al. "Platelet rich plasma versus hyaluronic acid in patients with hip osteoarthritis: A meta-analysis of randomized controlled trials." International Journal of Surgery (2018).

[00:24:00] Stem cells.

[00:28:00] Ablations of the nerves for arthritis; radiofrequency ablation (RFA).

[00:29:36] Being the on-call doctor for the University of Washington Husky football team.

[00:31:23] Problems seen in college athletes; sleep.

[00:33:20] Chair of the Pac-12 Student Athlete Health and Well-Being Board.

[00:34:42] Injury record database; sports analytics.

[00:37:02] Find Kim: Sports Medicine Clinic at Husky Stadium; see her research on PubMed.