Aftercare

Aftercare Instructions for Regenerative Injections

RULE 1: SET YOURSELF UP FOR SUCCESS

Your new Regenerative cells are tender and delicate. They need special care if they are to grow and help heal your injured or degenerated joint or disc. When in doubt, be kind to them. You are your body’s best advocate.

RULE 2: IF IT HURTS – DON’T CONTINUE DOING IT. TRY MODIFYING HOW YOU ARE STANDING, SITTING OR MOVING THEN TRY AGAIN! 

Please use caution with activity. You can be sore from the procedure. Muscle spasms from the injection are not uncommon, and you should be prepared to have some pain or discomfort the first week. Use pain as your guideline and limit activity early in your recovery. Use moderate heat for muscle spasms (deep ache, grabbing pain with transitions), and ice for inflammation (sharp, localized, burning, nerve pain). Each in 10-minute sessions 3-4 times each day, especially before bedtime to optimize the healing time during sleep.  Deep diaphragmatic breathing and gentle movement, gentle stretching with heat can help with the muscular pain.

RULE 3: THE ANTI-INFLAMMATORY EFFECT

The first week after the injection, some people enjoy the anti-inflammatory benefit of regenerative cells, resulting in a dramatic decrease in pain; however, many people have increased pain from the procedure. You must not overdo it! Use caution with activity, no matter how good you feel. The old pain may return in a few days. Do not take anti-inflammatory medication for at least 2 weeks. You need your body’s natural inflammatory process to start the healing process to create the matrix in your tissue/join to gravitate the regenerative cells.

IMMEDIATELY AFTER INJECTIONS:

Every case is unique and side effects differ for each person. Some patients may experience more pain and inflammation than others; please contact us if you have any questions or concerns. Certain joints and body areas can be more painful to inject, such as the spinal discs and the ankles.

• Expect varying degrees of pain in the first few days after the procedure and treat with ice and/or heat and medication if necessary (no anti-inflammatory medication). If your severe pain lasts longer for more than a few days, contact us for advice.
• Treatments that can help with managing the pain and benefit the healing process include gentle myofascial release, core and joint stabilization, stretching, trigger point dry needling, kinesiology tape, massage, ice and heat, and medication (no anti-inflammatory medication).

WEEKS 1 & 2 AFTER INJECTIONS:

• Restrict yourself to light activity and the tasks of daily living. You may be sore, but it is better to move than to be completely sedentary. Use pain as your guideline. In the early weeks of regenerative healing, your body’s natural inflammatory process will use cytokines, leukocytes, proteins and inflammation to create a “scaffold” for the cells to bind to. The cells are just starting to form and divide, so you want to be very cautious and avoid overloading., shearing, or compression on the joint that was injected.
• Avoid too many frequent stairs, if possible (for hip and knee injections), and limit lifting to 5-10 pounds on occasion.
• No running or weight lifting the first 6-weeks! Minimize load, compressive forces, and torque on the joints and discs.
• Range-of-motion and gentle stretching exercises are appropriate. Light and easy walking can be very helpful to minimize soreness for spine patients.
• Manage muscle soreness and spasms with moderate heat (hot shower, heating pad) and inflammation from the procedure with ice.
• Avoid NSAIDs (Ibuprofen, Aleve, and other anti-inflammatory medications). You need your body’s inflammatory process to help with healing.
• Walking in the pool is a nice way to get some motion; it can unload your joints and be soothing. Use a kick board, buoy, or noodle for support in the water.
• Kinesiology tape (K Tape) or additional medication may be needed to help you manage your pain.
• Analgesic creams or gel (Bio Freeze, Traumeel) can help with pain.
• Trigger point dry needling can help with muscle spasms. It is not uncommon to have increased soreness in your tissues and joints from the procedure. Mild to moderate pain is acceptable for a few days, but severe pain is not. If your pain becomes severe, or you cannot manage your pain with the above recommendations, contact us.
• We recommend Physical Therapy starting 2 weeks after the procedure to provide gentle exercise and manual release.
• You may wear a compressive brace for support during activity if it feels good, but don’t wear it when sedentary.
• Begin core stabilization exercises to minimize re-injury.

WEEKS 3 & 4 AFTER INJECTIONS:

• Avoid repetitive loaded exercise, like stair steppers, running, or weightlifting. You may walk, use an exercise bike or elliptical machine or swim/walk in the pool. These exercises have minimal compressive loading or pounding to joints.
• Keep all workouts less than 50 percent of normal/pre-injection distance/weight/reps. Give the new regenerative cells time to implant themselves in the healing tissues.
• Proceed with caution; increase activity only within pain limits. If it hurts, don’t do it!
• Maintain normal range of motion in injected areas with gentle exercise. Yoga, stretching, mat Pilates, tai chi, and easy walking are perfect.
• Continue to manage inflammation with ice and pain medications as directed if needed. If pain persists and doesn’t respond to other medications or treatments, you may start taking NSAIDs, but avoid them if you can.

Contact us if you are still having pain or difficulty with your healing. 

WEEKS 5 & 6 AFTER INJECTIONS:

• You may initiate light running exercise on even and soft terrain, a treadmill, or a track only if coordinated with your doctor or physical therapist. Please be careful with jarring or compressive exercise and avoid shearing.
• No hiking on inclines or difficult, uneven terrain. Going up hills may feel fine, but coming down is difficult, uneven terrain. Going up hills may feel fine but coming down is difficult for an unstable joint.
• Continue with core stabilization and joint stabilization exercises.
• You may start to increase resistance with weightlifting, but please still be cautious. Your regenerative cells are building new tissue oxygen/blood flow through gentle exercise but can’t tolerate being stressed by too much exercise.
• You may continue with stationary bike, elliptical, stretching, yoga, Pilates, and swimming exercise.
• Avoid compressive exercises such as overhead press, calf raises with weights on shoulders, squat rack, supine leg press, prone hamstring curls, twisting, repetitive flexion/extension, dead lifts, clean and jerks, kettle bells over shoulder level, box jumping, etc.

If you still are experiencing pain, please back off on activity and continue to use ice. If you have concerns or questions, please don’t hesitate to call. 

WEEKS 7 & 8 AFTER INJECTIONS:

• If you’re not having pain, you can slowly progress to your normal workout, but never to the point of pain in the injected area.
• Set yourself up for success by maintaining some aerobic capacity without injuring the new juvenile stem cells. Void or shearing or over compressive exercises.
• Continue to increase core and joint strengthening for optimal stabilization.
• Continue to use ice for pain and inflammation as needed.

MONTHS 3-6 AFTER INJECTIONS:

The regenerative cells are now at their peak of healing potential; help them heal you by not overdoing it.

• Walking, biking, yoga, stretching, and light weights are appropriate.
• Be careful with distance running.
• Attain and maintain best alignment postures to  support your joints.
• Continue to use caution with compressive activity, twisting, planting and pivoting, overhead activity, and repetitive motion.
• Consider physical therapy if you need guidance on proper exercise to protect your joints and injection site(s) as you continue to heal.