How can I make sense of a treatment claim?

What does the research mean for me?

First, check which body part the people had hurt. An Achilles tendon result may not fit a shoulder. Then check whether people walked, lifted, or slept better. Less soreness matters, but easier daily movement matters too.

Next, look at when the change was checked. Relief after a short time may fade later. One check is like one photograph during a long year. It can't show every better or worse day.

Platelet-rich plasma (PRP) uses some of your blood. A clinic spins it to gather more platelets in one part, then gives that part as a shot. Clinics don't always prepare PRP alike. Ask exactly how people moved better and how long that lasted.

A scan shows bones or soft tissue. It doesn't show how easily you can climb stairs or lift a cup. Ask whether the reported change was large enough for people to notice.

Research can't promise your result from a group result. Your exam, medicines, daily needs, cost, and risks still matter. Don't accept a promise based on one scan or number.

After an exam, QC Kinetix offers regenerative treatments, or non-surgical office care from the clinicians who examined you.

Sources

1. In a small single-blinded randomised cross-over study of six volleyball players with patellar tendinopathy, a single bout of ISOMETRIC contractions cut single-leg decline squat pain from 7.0 to 0.2 out of 10 and the relief was still present 45 minutes later, while isotonic contractions cut pain from 6.3 to 3.8 and the effect was not sustained. Maximal voluntary isometric contraction strength rose 18.7% after the isometric bout. The sample is six athletes - this is a mechanism signal, not a treatment trial.

   Rio E, et al. — Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy.. Br J Sports Med, 2015. DOI: 10.1136/bjsports-2014-094386.

2. A network meta-analysis of 37 randomised trials in patellar tendinopathy found that focused extracorporeal shockwave therapy was NOT superior to sham shockwave for short-term pain (MD +0.1, 95% CI -0.8 to 1) or function (MD -1.8, -8 to 4.4) when both groups did eccentric exercise, and that isometric exercise was about as effective as isotonic exercise for immediate post-exercise pain relief (MD -1.03, -2.6 to 0.5). Most of the 33 interventions assessed were represented by a single study and the strength of evidence was low to very low; the authors conclude eccentric loading with or without adjuncts should remain first-line.

   Challoumas D, et al. — Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies.. BMJ Open Sport Exerc Med, 2021. DOI: 10.1136/bmjsem-2021-001110.

3. This systematic review of loading programmes for Achilles and patellar tendinopathy found LIMITED (Achilles) and CONFLICTING (patellar) evidence that isolated eccentric loading outperforms other loading programmes, and noted that up to 45% of patients may not respond to it - explicitly questioning the entrenched clinical default. Combined eccentric-concentric loading (Achilles) and heavy slow resistance (patellar) had equivalent or greater evidence. Improved imaging appearance was NOT associated with clinical improvement in the Achilles studies, including all the high-quality ones.

   Malliaras P, et al. — Achilles and patellar tendinopathy loading programmes : a systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness.. Sports Med, 2013. DOI: 10.1007/s40279-013-0019-z.

4. Forty-eight patients with ultrasound-verified plantar fasciitis were randomised to shoe inserts plus daily plantar-specific stretching, or shoe inserts plus high-load progressive heel-raise strength training every second day. At three months the strength group's Foot Function Index was 29 points lower (95% CI 6-52, p=0.016). By 6 and 12 months the groups had converged - the benefit was a faster recovery, not a different endpoint.

   Rathleff MS, et al. — High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.. Scand J Med Sci Sports, 2015. DOI: 10.1111/sms.12313.

5. A systematic review of 105 clinical orthopaedic PRP studies found that only 11 (10%) described the preparation protocol well enough for another investigator to repeat it, and only 17 (16%) gave any quantitative measure of what was actually in the final PRP product. Without that, trials of 'PRP' cannot be meaningfully compared with one another - which is the single largest reason the tendon and joint literature disagrees with itself.

   Chahla J, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature.. J Bone Joint Surg Am, 2017. DOI: 10.2106/JBJS.16.01374.

6. FDA states verbatim that stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products have not been approved 'for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' Tendonitis and tennis elbow are named explicitly. No exosome product holds FDA approval at all, and the only stem cell products with FDA approval in the United States are blood-forming cells derived from umbilical cord blood, cleared only for disorders of blood production. FDA also states it has received reports of blindness, tumour formation and infections following treatment with unapproved products.

   U.S. Food and Drug Administration — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. FDA (Center for Biologics Evaluation and Research), 2020.