Every year, nearly 2 million people seek emergency care for sports injuries, including professional athletes, serious amateurs and “regular” people who enjoy sports or other physical activity as a casual pastime. While some injuries can be relatively minor, others can involve significant tissue injury and require extensive therapy for recovery.

According to the U.S. National Library of Medicine (MedlinePlus), the most common sports injuries in the U.S. include [1]:

  • Sprains and strains
  • Knee injuries
  • Swollen muscles
  • Achilles tendon injuries
  • Pain along the shin bone
  • Rotator cuff injuries
  • Fractures
  • Dislocations

The majority of sports injuries involve muscles, cartilage or tendons that become torn, strained or sprained.

Many injuries occur because of improper use of equipment, poor or improper technique, contact with another player or structure, lack of preparation before participating (such as neglecting to warm up or stretch) or simply poor body mechanics that cause unnatural or significant stress or strain on a joint, bone or other musculoskeletal component.

In recent years, sports injuries have become more prevalent as active baby boomers begin to experience more injuries related to the aging process. In fact, a survey from national Ambulatory Medical Care found sports injuries to be the second most common reason for doctor’s office visits in the U.S. (the common cold ranked number one). [2] As sports injuries have become more prevalent, researchers have been seeking novel ways of treating them to correct injuries and preserve tissue health long term.

Symptoms of Sports Injuries

Because sports injuries can affect so many tissues and cause so many different types of injuries, the symptoms associated with them can be diverse. Symptoms occur most often at or near the site of the injury, and the most common symptoms include:

  • Pain or tenderness
  • Swelling
  • Bruising
  • Diminished range of motion or inability to move a limb or digit
  • Pain when pressure is applied to the site of injury (including standing on an injured leg)
  • A body part that appears out of alignment, as in dislocation
  • “Popping” noise at the time of injury
  • Grating or grinding sensation in a joint
  • Grating or “creaking” sensation in a tendon (crepitus)

Injuries that involve the head and neck, though rare, can also cause seizures, loss of consciousness, confusion, mood changes, paralysis, vomiting, vision loss and other symptoms related to nerve damage or brain swelling.

Traditional Management

Minor sports injuries may respond to the traditional approach abbreviated as RICE – rest, ice, compression and elevation – as well as nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. [3]:

More serious sports injuries can require rehabilitation including physical and occupational therapy to restore strength, range of motion and mobility, and hopefully, to enable the patient to resume regular physical activity including the sport that initially caused the injury. Some injuries require surgery to repair broken bones, torn tendons or ligaments or dislocations.

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STEM CELL THERAPY AND SPORTS INJURIES

The interest in stem cell therapy for sports injuries has focused primarily on the use of adult mesenchymal stem cells derived from bone marrow or from adipose (fat) tissue. Mesenchymal stem cells are able to divide and to replicate other types of cells, including bone cells, muscle cells, cartilage cells and tendon and ligament cells. Once stem cells are extracted, they can be concentrated to form enriched products for reinjection, and they can also be combined with growth factors for faster healing.

In addition to being able to replicate other types of cells, stem cells have strong anti-inflammatory properties and promote the formation of new blood vessels, two factors that provide significant advantages for healing. Nearly half of all sports injuries involve damage to muscle tissue, and several studies have examined the use of stem cells in muscle tissue repair. [4]

Cartilage damage is another common result stemming from sports injuries. Because cartilage tissue has a limited blood supply, the body is unable to repair it as efficiently and effectively as other types of tissue. Several studies have focused on the use of stem cells in creating cartilage grafts for implantation as well as the use of injected enriched stem cells to promote cartilage repair at the site of injury. Additional research has explored the use of stem cells – either grown on scaffolding in a lab setting or injected directly into patients – for the repair of bone, tendon and ligament damage common in many sports-related injuries. [5] [6] [7]

Finally, stem cells’ ability to thwart the negative effects of inflammation have also been explored in studies of sports-related injuries. Inflammation plays a major role not only in the original injury and healing processes, but also in the long-term health of an injured tissue. Joints especially are prone to inflammation following an injury, leading to the development of osteoarthritis in the post-treatment period. Research has shown the advantages of using adult stem cell injections in treating osteoarthritis of the knee, resulting in decreased pain and increased joint mobility. [8]

Suggested Reading:

5. Pak J, Lee JH, Lee SH. Regenerative Repair of Damaged Meniscus with Autologous Adipose Tissue-Derived Stem Cells. BioMed Research International. 2014;2014:436029. doi:10.1155/2014/436029.

6. Kushida, T, Iida, H. Bone marrow cell transplantation efficiently repairs tendon and ligament injuries. Frontiers in Cell and Developmental Biology. 2014. doi:10.3389/fcell.2014.00027.

7. Rizzello G, Longo UG, Petrillo S, et al. Growth Factors and Stem Cells for the Management of Anterior Cruciate Ligament Tears. The Open Orthopaedics Journal. 2012;6:525-530. doi:10.2174/1874325001206010525.

8. Koh, Y-G, Jo, S-B, Kwon, O-R, et al. Mesenchymal Stem Cell Injections Improve Symptoms of Knee Osteoarthritis. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2013;29(4):748–755. doi:10.1016/j.arthro.2012.11.017.

Combination of Intra-Articular and Intraosseous Injections of Platelet Rich Plasma for
Severe KneeOsteoarthritis: A Pilot Study.
Sánchez M, Delgado D, Sánchez P, Muiños-López E, Paiva B, Granero-Moltó F, Prósper F,
Pompei O, Pérez JC, Azofra J, Padilla S, Fiz N.
Biomed Res Int. 2016;2016:4868613. doi: 10.1155/2016/4868613.

Adipose Mesenchymal Stromal Cell-Based Therapy for Severe Osteoarthritis of the Knee: A
Phase I Dose-Escalation Trial.
Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, Sensebe L, Casteilla L, Fleury S,
Bourin P, Noël D, Canovas F, Cyteval C, Lisignoli G, Schrauth J, Haddad D, Domergue S,
Noeth U, Jorgensen C; ADIPOA Consortium..
Stem Cells Transl Med. 2016 Jul;5(7):847-56. doi: 10.5966/sctm.2015-0245

Intra-articular treatment of knee osteoarthritis: from anti-inflammatories to products of
regenerative medicine.
Richards MM, Maxwell JS, Weng L, Angelos MG, Golzarian J.
Phys Sportsmed. 2016;44(2):101-8. doi: 10.1080/00913847.2016.1168272. Review.

Stem cell therapy: a promising biological strategy for tendon-bone healing after anterior cruciate
ligament reconstruction.
Hao ZC, Wang SZ, Zhang XJ, Lu J.
Cell Prolif. 2016 Apr;49(2):154-62. doi: 10.1111/cpr.12242. Review.

Adipose derived mesenchymal stem cell therapy in the treatment of isolated knee chondral
lesions: design of a randomised controlled pilot study comparing arthroscopic microfracture
versus arthroscopic microfracture combined with postoperative mesenchymal stem cell
injections.

Freitag J, Ford J, Bates D, Boyd R, Hahne A, Wang Y, Cicuttini F, Huguenin L, Norsworthy C,
Shah K.
BMJ Open. 2015 Dec 18;5(12):e009332. doi: 10.1136/bmjopen-2015- 009332.

Adipose-Derived Mesenchymal Stem Cells With Microfracture Versus Microfracture Alone: 2-
Year Follow-up of a Prospective Randomized Trial.
Koh YG, Kwon OR, Kim YS, Choi YJ, Tak DH.
Arthroscopy. 2016 Jan;32(1):97-109. doi: 10.1016/j.arthro.2015.09.010.

Mesenchymal Stem Cells for Enhancing Biologic Healing after Anterior Cruciate Ligament
Injuries.
Jang KM, Lim HC, Bae JH.
Curr Stem Cell Res Ther. 2015;10(6):535-47. Review.

Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients.
Davatchi F, Sadeghi Abdollahi B, Mohyeddin M, Nikbin B.
Int J Rheum Dis. 2016 Mar;19(3):219-25. doi: 10.1111/1756-185X.12670.

Efficacy of mesenchymal stem cells injection for the management of knee osteoarthritis: a
systematic review and meta-analysis.
Xia P, Wang X, Lin Q, Li X.
Int Orthop. 2015 Dec;39(12):2363-72. doi: 10.1007/s00264-015- 2785-8. Review

Meniscus repair using mesenchymal stem cells – a comprehensive review.
Yu H, Adesida AB, Jomha NM.
Stem Cell Res Ther. 2015 Apr 30;6:86. doi: 10.1186/s13287-015- 0077-2. Review.

Treatment of Knee Osteoarthritis With Allogeneic Bone Marrow Mesenchymal Stem Cells: A
Randomized Controlled Trial.
Vega A, Martín-Ferrero MA, Del Canto F, Alberca M, García V, Munar A, Orozco L, Soler R,
Fuertes JJ, Huguet M, Sánchez A, García-Sancho J.
Transplantation. 2015 Aug;99(8):1681-90. doi: 10.1097/TP.0000000000000678.