Stem cells for Sports Injury Treatment

Achilles tendon is the largest tendon present in body. It is a strong fibrous cord stretching from the bones of heel to the calf muscles. It is a springy band of tissue at the back of the ankle, above the heel, allowing the toes to point towards the floor and to be raised on tiptoes. This tendon is very prone to injury though because of poor blood flow causing disrupted healing. Rupture or injury to the tendon happen due to a sudden increased stress and could be mild or moderate causing inflammation or stiffness in the leg. Tendon rupture mostly happens within 6 centimeters of the point where the tendon is attached to the heel bones. After being injured, a person would be unable to bend the foot downward or push off the injured leg while walking.

Ligament is a short band of tough fibrous connective tissues made up of long, stringy molecules connecting the bones in body to other bones and around joints. A ligament could be injured through a sudden, sharp change in direction or landing a wrong jump or a blunt force hit to the knee. The injury happens due to sudden movement at a high speed. Also weakness in muscles or non-coordinated movement leads to sprain or tear in ligament. There are basically four ligaments in the knee that are very sensitive to injury: Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligaments (PCL), Lateral Collateral Ligament (LCL), and Medial Collateral Ligament (MCL). Ligaments control the mobility of a joint and preventing certain movements.

Ankle injuries are classified according to the type of tissues injured. Injury in bones is fracture, injury in ligament is sprained ankle, injury in muscles is strain or tear, injury in tendons is tendinopathy/tendonitis.  The ankle joint is a point where three bones meet- the tibia (shin), fibula (thin bone outside the leg), and the thalus (ankle bone) above the heel. Ankle joint is passively stabilized by ankle ligaments that are semi-elastic bands made up of connective tissues limiting the normal motion of the ankle joint. The tendons and muscles of ankle control the movement of ankle joint, protecting it from injury by stabilizing the ankle joint and preventing overstretching of ligaments. In the ankle, two tendons are very sensitive and often get strained. One of them is the peroneal tendon that stabilizes and protects the ankle and can become inflamed due to overuse or trauma. Acute tendon tears are caused by sudden trauma or force. Tendinitis is a condition of inflammation of the tendons. Tendinosis is a condition when microscopic tendons accumulated over time; do not heal from tears because of being repeatedly over stretched. Tendons could rupture too and subluxation is a condition when tendons get displaced from their place. Traumatic ankle ligament sprains, ankle fractures (broken bones), tendinopathies, degenerative arthritis, biomechanical disorders are the most frequent reasons of ankle pain.

The Shoulder is a ball-and-socket-joint: the ball or head of upper arm fits into a shallow socket in the shoulder blade. Shoulder consists of 3 bones: upper arm bone (humerus), shoulder blade (scapula), collarbone (clavicle). Rotator cuff keeps the arm in the shoulder socket. Rotator cuff is made of four muscles that unite together as tendons forming a covering around the head of the humerus and helping in raising and rotating the arm and stabilizing the shoulder joint. Bursa, a lubricating sac, present in between the rotator cuff and the bone on top of the shoulder(acromion), helps in rotator cuff tendons to glide freely while moving the arm. Inflammation or pain is caused in bursa due to injury in the rotator cuff tendons.

It is an inflammation of the tendons called tendinitis. Tendons are a band of tough tissues, joining the forearm muscles on the outside of the elbow. Pain occurs when the tendons are overloaded by repetitive motions of the wrist and arm. Repetitive gripping activities especially involving the thumb and first two fingers could lead to tennis elbow. Elbow joint is composed of 3 bones: the upper arm bone-the humerus, the two bones in the forearm-radius and ulna. There are bony bumps at the bottom of the humerus-epicondyles and on the outside i.e., at lateral side-lateral epicondyle. Muscles, ligaments and tendons are keeping the elbow joints together. The forearm muscles extend the wrist and fingers. The forearm tendons (extensors) attach the muscles to bones. Extensors attach on lateral epicondyles. Extensor Carpi Radialis Brevis (ECRB) is the tendon involved with tennis elbow. In lateral epicondylitis, the dominant arm is mostly affected.