PRP Injection for Tennis Elbow

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What is Lateral Epicondylitis/Tennis Elbow?

Tennis elbow is recurrent tearing and inflammation of the common extensor origin. This is the site at which many of the extensor tendons insert, making them prone to injury. These tendons are responsible for wrist and finger extension, and these movements will trigger pain and discomfort when you have tennis elbow.

What is PRP?

Platelet Rich Plasma (PRP) is an injection of your own blood, which has been spun down to increase the concentration of platelets. It is concentrated with growth factors, proteins, cytokines and other bioactive molecules that initiate and regulate the basic cellular aspects of wound and tissue healing. The goal is to induce an inflammatory process into the diseased tendon to promote long term healing.

Things to Avoid Before and After Your Procedure

Over the Counter Medication	Non Steroidal Anti-Inflammatories – such as Ibuprofen/Nurofen, Voltaren, Celebrex or Mobic. These drugs can increase the risk of bleeding and impair healing. Avoid for two weeks before and one week after your procedure Aspirin – fine to continue You shouldn’t need stronger opiate pain relief like Endone/Targin/Palexia
Smoking	Cease where you can – smoking impairs your ability to heal
Eating and Drinking	You do not need to fast prior to a PRP injection

Post Injection Information

Sling	It is recommended that you wear a sling – only for your comfort – for the first 2-3 days after the injection You do not need to wear the sling to sleep You can drive, with your arm out of the sling
Discomfort	Some discomfort after the procedure is expected in the first few weeks Local anaesthetic is injected into the area and will typically wear off about 12-24 hours after the procedure Paracetamol should be taken regularly in the first few days to stay ahead of the pain Applying ice for the first 2-3 days can be helpful as well If you are concerned about your pain levels – please contact Mr Lau’s rooms
Dressings	A sticky dressing is applied over the needle injection site with an overlying bandage The bandages can be removed from 24-48 hours The dressing can be removed at 7 days
Bathing	It is fine to shower 24 hours after the procedure – just keep the dressing dry
Follow up	You will be scheduled a follow up appointment approximately 1 month after the procedure
When to Call?	Please call Mr Lau’s rooms if there is increasing redness, warmth, pain and fever, or if there is excessive discharge

Timeframes for Recovery

Your rehabilitation will follow these principles:

Phase 1 – Inflammation: 3-5 days after the procedure there will be localised inflammation which will feel hot and potentially more irritable through the elbow. The purpose is to increase blood flow to the lateral epicondyle, to promote healing

Phase 2 – Proliferation: 1-4 weeks after the procedure, which can last up to 8 weeks. The cells at the elbow will begin to repair damaged tissue. This process can be promoted with physiotherapy as healing tissue actually responds better to mobilisation and strengthening (stress) rather than rest

Phase 3 – Remodelling: 1-3 months after the procedure, ongoing remodelling, strengthening and cellular re-organisation will occur

Treatment of lateral epicondylitis with PRP is not a “quick fix” and it is important to remember that tendon healing takes time. It is also not a guarantee of success, although there is some evidence to support the use of PRP in tennis elbow specifically (as opposed to other conditions). It can take up to three months to see whether the results of the injection have been helpful.

Post Operative Rehabilitation

Day of Procedure	Plan for a family member or friend to drive you home You will be given a sling after your procedure Rest for the day and elevate the arm once you’re home
Day 2-3	Keep your arm in the sling – for comfort, but you can come out of it as needed Remove the bulky dressings No need to sleep with the sling Passively range the elbow, wrist and hand
Day 4-7	Discontinue the sling Activity restrictions: no heavy lifting but use the elbow and arm for normal daily activities Do not perform sustained gripping actions like opening a jar
Week 1-4	See a physiotherapist No heavy lifting Maximise range of motion passive and active without restriction Isometric wrist and elbow strengthening
Week 4-6	Increase strengthening Begin concentric/eccentric wrist and elbow extension Aim to maintain a neutral wrist position during strengthening exercises
Beyond 6 weeks	No restrictions Progress to integrated movements and sports specific activities

Concerns or questions?

If you have any concerns post operatively, or you would like further information, please contact Mr Lau through the VBJS on 03 5752 5020 or via email at admin@vbjs.com.au

If you need urgent medical help, call 000 or go to your nearest emergency department.

These notes have been prepared by Mr Simon Lau. They are general overviews and information aimed for use by his patients. They reflect Mr Lau’s views, opinions and recommendations. They do not constitute medical advice. The contents are provided for information and education purposes only. Please seek Mr Lau’s specific advice with any questions regarding medical conditions and treatment.