Another technique is an injection of platelet rich plasma (PRP), a concentrated dose of healing platelet cells that exist in the patient’s blood. In a recent study published in Physical Medicine & Rehabilitation, Mayo Clinic researchers reported that the combination of tenotomy and PRP injections produced significant improvement in patients with long-standing tendon injuries.

“These disorders can be hard to treat, and patients tend to receive one therapy or the other, depending on what a doctor happens to offer. Our study was the first clinical study to investigate the combination of both treatments in injured tendons,” says study author Jay Smith, M.D., of Mayo Clinic’s Department of Physical Medicine & Rehabilitation.

The study included 34 patients with a wide range of tendon and soft tissue injuries, from rotator cuff tendinitis to plantar fasciitis, an inflammation on the bottom of the foot. In the first stage of the two-part treatment, researchers used high-resolution ultrasound technology to guide a needle to the injured area, and the physicians repeatedly poked the tendon with the needle, inducing minor bleeding within the tissue.

“The needle breaks up nonhealing, degenerative tissue and induces bleeding, hopefully converting a chronic, degenerative injury into an acute injury that has healing potential,” Dr. Smith explains. Afterward, patients received an injection of concentrated platelets from their own blood. The platelets release growth factors into the area to start the healing process.

Researchers found maximum benefits tended to occur within four months after the procedure. More than 70 percent of patients had better use of their tendons, and 76 percent reported improvement in pain. In addition, researchers found some indication of tendon healing, which was detected with sophisticated ultrasound imaging. 

“Larger studies are still necessary to determine whether the combination is particularly helpful for certain injuries or types of tendons, but this investigation showed these therapies together are safe and effective for some people who have an ongoing tendinopathy,” says Dr. Smith.

Whether you’re a black-diamond skier or a novice on the bunny slope your day can be spoiled by an injury that happens on the last run of the day.  End-of-the-day tweaks and spills are more common than you’d think, says physical medicine and rehabilitation specialist Ed Laskowski, M.D., of Mayo Clinic.  Muscle fatigue at the end of the day can lead to sloppy technique and injuries such as a tear of the anterior cruciate ligament (ACL) in the knee, which can require surgery and intensive rehabilitation. Dr. Laskowski, a former elite skier who turned his career to medicine, says that recreational skiers can take steps to optimize their protection from injury.

Physical preparation before a big ski weekend can go a long way, according to Dr. Laskowski, who specializes in fitness, wellness, strength-and-stability training, and sports injury prevention strategies. To gear up for a ski holiday, people can do conditioning exercises that make the sport safer: 

• Endurance exercises, especially with an aerobic component, can help train the muscles so fatigue doesn’t lead to injury at the end of an 8 hour ski day.
• Strength training that focuses on the major muscle groups in the legs, especially those used in skiing, can help skiers stabilize and control their bodies. Core exercises to help link upper and lower body movements are also important, as are balance exercises that emphasize stability.
• “Ski specific” exercises can help train for the side-to-side motions required by the sport. One simple but effective exercise to prepare for skiing is to practice jumping from side to side over a line of tape on the floor, using both feet and then using one foot at a time.

Dr. Laskowski specializes in Physical Medicine and Rehabilitation and serves as co-director of the Mayo Clinic Sports Medicine Center. A former competitive alpine skier, he served on the Olympic Polyclinic Medical Staff for the 2002 Winter Olympics in Salt Lake City. In 2006, President George W. Bush appointed Dr. Laskowski to the President’s Council on Physical Fitness and Sports.

To schedule an interview with Dr. Laskowski, contact Bryan Anderson (507) 284-5005 or newsbureau@mayo.edu.

Journalists:  The following video and audio clips with Dr. Laskowski are available for your use. 

Being in shape for skiing:    MOV     MP3

Knee Injuries and Skiing:    MOV    MP3

Learn from an Instructor:    MOV    MP3

Skiing B-Roll:   MOV   (MANDATORY COURTESY:  Squaw Valley, USA/Tahoe-TV)

“All too often, strength training programs don’t take into account correct biomechanics or even individual body types,” says Mayo Clinic’s Ed Laskowski, M.D., of the Department of Physical Medicine and Rehabilitation. Some strength training exercises, if performed with poor technique, can cause injuries ranging from spontaneous twinges to the aches that come from months of cumulative stress.

The key to safe, effective strength training is doing it right. Dr. Laskowski is available to talk about techniques that get results and help avoid injury. Among his strength training advice is:

• Core stability is essential to upper body, lower body and trunk strengthening. Training the core involves not only activating abdominal muscles but also training back muscles. Workouts need to progress beyond fitness balls to upright positions that are similar to life and sport movement patterns.
• Many people focus on training the muscles in the chest and in the front of the shoulder. For balanced strength in the shoulder, a training program should emphasize strengthening the muscles in the upper back as well as the back of the shoulder.
• Physical medicine and rehabilitation specialists can help people review their workouts to optimize benefit and point out potentially dangerous flaws that may cause injury. Novice or seasoned athletes can ensure a proper foundation by making an appointment to review the appropriate biomechanics of a workout, a football throw, or even a golf swing.

Dr. Laskowski is co-director of the Mayo Clinic Sports Medicine Center. In 2006, he was appointed by President George W. Bush to the President’s Council on Physical Fitness and Sports. He was a member of the Olympic Polyclinic Medical Staff for the 2002 Winter Olympics in Salt Lake City. A specialist in fitness, wellness, injury “protection,” conditioning, and strength and stability training, his strength training workout tips are among the most visited health videos on the Mayo Clinic’s website.

To schedule an interview with Dr. Laskowski, contact Bryan Anderson at 507-284-5005 or newsbureau@mayo.edu.

According to research released by the Battelle Technology Partnership Practice in 2010, Mayo Clinic and the University of Minnesota have a combined $18.5 billion economic impact on the state of Minnesota. Mayo Clinic, an academic medical center, is the state’s largest private employer, and the University of Minnesota is the state’s largest institution of higher education.

“Truly, the histories of our institutions are intertwined. Mayo Clinic’s collaborative partnership with the University of Minnesota began in 1907, representing our first external collaboration, and remains a priority today,” says John Noseworthy, M.D., president and CEO of Mayo Clinic. “We are proud to work with the University of Minnesota to educate and conduct groundbreaking research. President Kaler’s visit today is the continuation of a relationship that has flourished for more than 100 years and that will continue to be important for our institutions for generations to come.”

“The University of Minnesota’s partnership with Mayo Clinic represents an incredibly powerful combination that is and will be a force for improving health outcomes in Minnesota and around the world,” says Dr. Kaler. “I am deeply gratified to renew this partnership that builds on our shared history and invites a future of imagination and innovation.” 

Examples of the century-long collaboration include:

• 1907 – William J. Mayo, M.D., becomes member of University of Minnesota Board of Regents, beginning generations of Mayo Clinic service on the Board
• 1915 – $1.5 million gift from Mayo brothers establishes Mayo Foundation for Medical Education and Research at University of Minnesota
• 2003 – University of Minnesota, Mayo Clinic and State of Minnesota announce the Minnesota Partnership for Biotechnology and Medical Genomics (Partnership)
• Published 94 peer reviewed papers in scientific journals as of July 2011
• More than $82 million in external funding, resulting in an eventual estimation of
  2,464 jobs
• 2008 – University of Minnesota and Mayo Clinic create new, innovative models of education through Memorandum of Understanding
• 2010 – Partnership announces “Decade of Discovery” with the goal of preventing, treating and curing Type 1 and Type 2 diabetes

Drs. Noseworthy and Kaler renewed the memorandum of understanding to plan and implement collaborative education programs to support the state and region. Since the memorandum was first signed three years ago, Mayo Clinic and the University of Minnesota have begun numerous collaborative efforts, including the Bachelor of Science in Health Professions educational collaboration and the Biomedical Informatics and Computational Biology consortium.

Mayo Clinic and the University of Minnesota are also engaged in the Partnership to position the state of Minnesota as a world leader in technology. As part of the Partnership, “Decade of Discovery” was born in 2010, where Mayo Clinic and University of Minnesota scientists committed to curing diabetes in 10 years. Yogish Kudva, M.B.B.S., and Ananda Basu, M.B.B.S., M.D., of Mayo Clinic, and Steven Koester, Ph.D., of the University of Minnesota, presented an update of their Partnership research to Mayo Clinic and University of Minnesota leaders during the visit.

Mayo Clinic also hosted its Medical Edge Radio program live from AAPMR, where hosts Tom Shives, M.D., and Tracy McCray spoke with specialty leaders about hot topics, including concussion, technology, and clinical improvements.

Below are some of the discussions had during the annual meeting.

Kate Stolp, M.D., of Mayo Clinic, interviewed Murray Brandstater, M.D., of Loma Linda University. Dr. Stolp is the incoming president of the Academic Association of Physiatrists, and Dr. Brandstater has held numerous leadership posts within the specialty. The two discussed key topics in the field. Video.

Carmen Terzic, M.D., chair of Mayo Clinic PM&R, chatted with Dr. Stolp about the annual meeting, and her new role as president of AAP. AAP is the academic arm of the specialty, representing research and education. Video.

Mary Pyfferoen, P.T., of Mayo Clinic, discussed her AAPMR poster presentation. In the video, she provides an interesting step-by-step look at the research process.

Steve Wisnieski, M.D., of Mayo Clinic, interviewed Paul Lento, M.D., of Temple University School of Medicine about the clinical advances of ultrasound. Dr. Lento was also a guest on Medical Edge Radio. Video.

Dr. Terzic and Walter Frontera, M.D., editor of the American Journal of Physical Medicine & Rehabilitation, discussed the challenges and opportunities in the specialty. Dr. Frontera said, “This is a great time in PM&R” due to the increasing number of people who can benefit from advances in the field.

Drs. Terzic and Frontera in English. In Spanish.

Wenchun Qu, M.D., Ph.D., of Mayo Clinic, discussed his role as president of the American Association of Chinese Rehabilitation Medicine as well as his research examining the associations between muscle strength and pressure pain threshold for fibromyalgia sufferers. Video.

Tom Rizzo, M.D., of Mayo Clinic, visits with Kristjan Ragnarsson, M.D., of Mount Sinai Hospital and the Foundation for PM&R. Dr. Ragnarsson, past president of AAP, discusses his 35-plus years of research and clinical work in the field. Video.

Tanya Brown, Ph.D., of Mayo Clinic’s Department of Psychology, and Shari Wade, Ph.D., of Cincinnati Children’s, discuss pediatric and adolescent traumatic brain injury, and emerging trends in TBI care. Video.

Michael Stuart, M.D., of Mayo Clinic’s Sports Medicine Center and chief medical officer of USA Hockey, discusses the summit’s call to action.

The researchers presented their findings during the American Urological Association Annual Meeting in Washington.

“We are doing a much better job of identifying and expanding candidates for surgery, which results in better, longer outcomes for so many of our patients,” says R. Jeffrey Karnes, M.D., of Mayo Clinic’s Department of Urology. “We have confirmed that patients diagnosed with locally advanced prostate cancer can enjoy a long, cancer-free interval.” 

The 80 percent survival rate for cT3 diagnoses at 20 years compares to 90 percent for cT2, or cancer confined to the prostate. This long-term follow-up of patients who underwent surgery between 1987 and 1997 is an important advance in understanding the quality outcomes for cT3 patients. The study sample included patients diagnosed and operated on between 1987 and 1997. Ongoing research will examine contemporary data.

Below is a link to an edited youtube video with Dr. Karnes discussing the study

Mayo Clinic researchers presented their findings during the AUA Annual Meeting in Washington.

“There is wide variability in how renal masses are managed. We must recognize these discrepancies may be due to different perceptions of technical feasibility in performing a partial nephrectomy,” says Christopher Weight, M.D., of Mayo Clinic’s Department of Urology. “What we’re encouraging is a discussion between physicians and patients about all options available. Some patients may benefit from a referral to surgeons with more experience with renal tumors.”

Below is a link to an edited youtube video with Dr. Weight discussing the study.

Judy Boughey, M.D., Mayo Clinic breast surgeon, notes this is a practice-changing study, but patients must meet specific criteria:

Study statistician Karla Ballman, Ph.D., of Mayo Clinic’s Cancer Center, discusses study methodology and concerns about the study’s sample size below:

In addition to Drs. Boughey and Ballman of Mayo Clinic in Rochester, Minn., Mayo has numerous experts who are available for comment on this study, including Sarah Ann McLaughlin, M.D., of Mayo Clinic in Florida, and Barbara Pockaj, M.D., of Mayo Clinic in Arizona.