Treatment of tendon and muscle using platelet-rich plasma.

Treatment of tendon and muscle using platelet-rich plasma.
Mishra A, Woodall J Jr, Vieira A.

 

Department of Orthopedic Surgery, Menlo Medical Clinic, Stanford University Medical Center, 1300 Crane Street, Menlo Park, CA 94025, USA. am@totaltendon.com

 

Tendon and muscle injuries are common in elite and weekend athletes. Treatment of these injuries in both groups is rapidly evolving. Sports medicine patients are demanding better and less invasive solutions for all types of musculoskeletal disorders. In this context, platelet-rich plasma (PRP) has emerged as a potential solution. PRP is a fraction of whole blood containing concentrated growth factors and proteins. These cytokines direct tissue healing through autocrine and paracrine effects. The number of basic science, animal, and human investigations of PRP for tendon and muscle injuries worldwide has risen sharply in recent years. These studies are helping clinicians better understand the mechanisms of PRP and are guiding novel treatment protocols. In this paper, the value of PRP as a treatment for acute or chronic tendon and muscle disorders is explored.

 

 

---http://cafe.daum.net/bshealthclub/JCgj/157?docid=1CPp5|JCgj|157|20100520074251&q=plasma%20muscle

 

The Process Of Exercise-Induced Muscle Cell Damage

When a muscle fiber develops sufficient tension for sufficient time, increasing fatigue impairs the actin/myosin cross-bridge cycling necessary for the contractile filaments to maintain force production. This impaired cross-bridge cycling under load results in trauma to the contractile filaments as some cross-bridges are subjected to tensions greater than they can structurally support.

Additionally, training leads to post-workout breaches in plasma membrane integrity that allow calcium to leak into the muscle cells (there is much more calcium in the blood than in the muscle cells). This intracellular increase in calcium levels activates enzymes called 'calpains' which remove pieces of the damaged contractile filaments (called 'easily releasable myofilaments').

A protein called 'ubiquitin' (which is present in all muscle cells) binds to the removed pieces of filaments thus "identifying" them for destructive purposes. At this time, neutrophils (a type of granular white blood cell) are chemically attracted to the area and rapidly increase in number. They release toxins, including oxygen radicals, which increase membrane permeability and phagocytize (ingest and destroy) the tissue debris that the calcium-mediated pathways released. Neutrophils don't remain around more than a day or two, but are complimented by the appearance of monocytes also attracted to the damaged area. Monocytes (a type of phagocytic cell) enter the damaged muscle and form into macrophages (another phagocytic cell) that also release toxins and phagocytize damaged tissue. once the phagocytic stage commences, the damaged fibers are rapidly broken down by lysosomal proteases, free O2 radicals, and other substances produced by macrophages. The muscle is now in a weaker state than before it was trained. Incidently, macrophages have an essential role in initiating tissue repair. Unless damaged muscle is invaded by macrophages, activation of satellite cells and muscle repair does not occur.

Also, increased intracellular Ca++ concentrations are known to activate an enzyme called phospholipase A2. This enzyme releases arachidonic acid from the plasma membrane which is then formed into prostaglandins (primarily PGE2) and other eicosanoids that contribute to the degradative processes.

 

 

Muscle plasma

(definition)
An alkaline fluid in muscle that coagulates spontaneously, separating into myosin and muscle serum.
Physiol.)  the fundamental part of muscle fibers, a thick, viscid, albuminous fluid contained within the sarcolemma, which on the death of the muscle coagulates to a semisolid mass.

 

 

* hanngill

Bodybuilding weight exercse 에서 80% 정도의 무게로 12회 1세트로 여러 세트를 반복실행하면

강한 펌핑으로 근육이 터질 것 같은 맹만감이 느겨지는 데 이것은 혈액속의 plasma 가 근육속으로 들어가기 때문이다.

또한 burning 느낌이 있는 것은  lactic acid가 축적되기 때문이다. 이 두 물질은 근육에 해가 된다고 생각해 왔다.

종전 이론으로는 위 두 경우에 운동을 쉬어 주어서 이런 현상이 가라 앉기를 기다려야 한다고 했다.

그러니 지금 새로 나온 이론으로 볼 때 Platelet Rich Plasma(PRP) 를 근육 인대 힘줄 관절에 주사하여 강화한다고 할 때 근육내 plasma는 파괴된 부분을 재생 성장하게 하는 중요한 역할을 하고 있다고 믿어야 한다.  또한 젖산도 강한 힘을 낼때 재 연소물질로 이용된다고 하니 많이 쌓이지 않고 곧 풀어 줄 것이라면 조금은 강하게 운동을 해 주어야 한다고 본다.

2011.8.2.