Marc Darrow, MD Joint Rehab & Sports Medical Center 800 300 9300 www.JointRehab.com 8-31-24 Part 1

are you living in pain is it joint pain or muscle pain if so stay tuned welcome to living painfree with Dr Mark Darrow MD and Dr Thomas Grove do from The Joint rehab and sports Medical Center in West Los Angeles this is the program that can give you effective solutions for the pain you've been living with Dr Darrow is a medical doctor board certified through his studies at UCLA and Dr darl uses stem cell and plat rich plasma to heal your body he teaches about the use of stem cells PRP and Prolotherapy Dr Grove is a regenerative medicine specialist and an expert in ultrasound guided injections with extensive experience as an athlete and strength and conditioning coach today's program could open up a new life without pain for you to speak with Dr daro and Dr Grove call 866 870 krla that's 86 6870 5752 ask for a copy of Dr darl's book stem cell and platelet therapy regenerate don't operate now here's Dr Daryl with his co-host Dr Thomas Grove hey hey good morning everybody happy Labor Day weekend we're coming to you from West Los Angeles this is living painfree uh dr's away from us here this weekend but we are excited to talk to you about healing your Orthopedic injuries your muscular scal skeletal issues using something called regenerative medicine that's where we use things like platelets PRP which is platelet rich plasma and stem cells uh to heal the body instead of doing surgery uh on these issues which is uh pretty neat so we can use the benefit of using these injection techniques instead of surgery uh much shorter downtime uh much less complication risk and again we're healing tissue instead of doing further damage with the with the surgery would love to talk with you live here in the studio you can give us a call our number to talk to us live 866 870 5752 that's 866 870 5752 give us a call we'd love to give you a copy of Dr Daryl's book it is fantastic great place to start to learn about regenerative medicine lots of great studies I think we have close to 300 studies in that book it's called stem cell and platelet therapy regenerate don't operate love the title of that book again we rather heal that tissue up uh rather than doing surgery uh which again comes with its own complication risks much longer downtime Physical Therapy time away from work and again a much more natural way to heal the body is using injection therapy which is a pretty amazing uh thing that we can do nowadays using the benefit of muscular skeletal ultrasound which we'll talk about here in a moment and again if you want to get a consult with our staff for free over the phone not with us but with our staff that number to call is 8003 300 9300 again that's 800 300 9300 we also have a fantastic website please check it out lots of great videos of us actually doing these procedures take the fear out of what these injections actually look like uh they're very quick again use really small needles because we can use muscle skeletal ultrasound it's like a kind of a real time uh look at what that tissue looks like we can guide that needle directly where we need to place it lots of great studies as well on that website that's called www.join rehab.com that's www.j n tab.com lots of great studies spot on every page now to email us uh we just had a pretty fun review come through um Google uh talking about a gentleman who had an injury we got to him within 24 hours and actually got them treatment so uh we really pride ourselves on being available uh it's a big frustration we have in the medical system I don't know if you've ever you know had a a tough time getting in with a specialist right or maybe you get an Imaging uh test done or you get some labs done and then you can't get a hold of your physician it's really hard to see them and then when you do get in uh to see your your provider uh they're kind of rushed through that appointment right they uh they've got to see a ton of patience every single day uh it's a huge benefit we have one of my favorite favorite Parts about uh my job that I have is I get to spend all the time in the world with a patient I get to make sure that they're in in a good position to understand what's going on I can lay out their treatment options whether that's the go with injections with us or not uh making sure we're getting our questions answered going through your Imaging and again the benefit too of using muscle skeletal ultrasound now in the clinic tons and tons of training over a decade of scanning people caver work uh learning how to do these injections by the best minds and hands uh on planet Earth I've done around the world trying to find the best techniques uh the best mentors to learn from Dr darl included uh making sure that we can give you the best possible care and treatment the benefit of using ultrasound now is it's non-radiating meaning I don't have to use x-rays right so if you ever had an x-ray or fluoroscopy CTS there can be a lot of radiation in addition to that it's right there in the clinic so I don't have to send you out I can actually sit you down put the ultrasound directly on that area that's injured and use that as another piece of information to try and diagnose what I think your problem is so a huge challenge in the muscular skeletal world is trying to line up the pathology right the the stuff that we see on Imaging that's not uh completely normal with what the reality is right what is the actual cause of your pain so we say that uh pretty frequently around the office what's the pathology versus the reality uh we just think it's it's very incomplete to make a judgment uh based off of just what the image says you got to make sure that you're uh getting somebody to put their hands on you making sure you're stressing those tissues uh making sure that we're validating where we think that pain is coming from from so you might be thinking like why is that a big deal you know why can't we just go off of Imaging well it's a really big deal because if you end up having a an invasive surgery right God forbid you had a joint replacement when the cause of your pain wasn't your joint so in our minds that's a really big deal right so the things like joint Replacements come with their own complication risk right you've got anesthesia right some people unfortunately just don't wake up from that um or they get you know long-term brain fog um you know proper anesthesia too some of these high doses can have their own side effects um in terms of just being down right you think about things like um blood clots right things like a DVT that's a deep vein thrombosis that's where you get a clot in one of your uh your vessels um that can lead to something called a PE or a pulmonary embolism that's where the clot travels to the lung that's a really big deal and then God forbid it got into your your brain right that's where we call stroke um so those are very real complication risk of having surgery and again every week we talk about surgery and then the the dangers of it at the end of the day though some people do need surgery we certainly do refer out it's just not very often but when we do think it's appropriate um we don't we don't throw any any bad energy towards surgeons we're very very uh thankful that we have these amazing individuals that can provide uh very good care it's extremely challenging I did a lot of surgery through my training uh all over the country uh in the operating rooms I have the utmost respect it's very challenging tall order to to do a surgery not to have a complication risk so pretty amazing that the complication RIS RIS are low but again they're they're real right so we'd much rather go the conservative route right everyone's got their own biases we'd much rather go conservative and and try to you know decrease someone's chances of having a bad complication risk but we can chat a little bit about you know what do these injections look like for you so if you come in you know certainly you can bring your Imaging in but I'm always going to put that ultrasound on in real time to see what that tissue looks like you know today so if you come into the office and you're having some pain you know if you have an MRI a couple years old you know you might have new injury going on so I don't want to base my clinical judgment off of an old image like that um in addition to that we're doing a Hands-on Physical exam so what does that look like we're making sure we're putting hands on you right we're stressing those tissues out we're really pinpointing uh where that Pain's coming from we do things like provocative Maneuvers meaning we're going to try to stress that tissue and put those pieces of information together uh to give the best care plan right from there we can make a decision whether we want to go with platelets uh or we can mix in some stem cells with that uh if you want the fastest healing in order to try to get you some uh healing on the tissue level now so lots of great studies out there looking at before and after even with the microscope that we've got new tissue being laid down if you are looking at things like a joint replacement right what's the issue there well you had some arthritis and arthritis is where you've got some wearing down of the articular cartilage so when that cartilage gets worn down you get some nerve endings getting exposed that's an area that can potentially cause some pain for you so what we try to do is try to put some cells into this area the healing cells of the body stem cells and platelets and we actually show that we can actually regrow some of this cartilage uh we can actually down regulator kind of decrease the amount of these bad inflammatory proteins and these cyto kindes that are floating around these joint spaces that we think also lead to arthritis so pretty neat also some interesting studies looking at how they slow down the wearing down of that cartilage so does a couple of things that we think contribute to getting our patients really good results um but very straightforward we come in if you want to do PRP or platelet rich plasma we just do a simple blood draw like you're given a blood test we take that blood put it down in a centrifuge right so this machine that spins it really fast we're going to separate out all those blood components leave behind the red blood cells take away all the good grth factors and platelets that we think contribute to Healing uh we put that into a syringe using very small needles aiming with ultrasound guidance pretty neat I always encourage patients hey take a look at the screen you can actually see the needle going directly into these areas right whether that's going to be a ligament which attaches a bone to a bone a tendon which attaches a muscle to a bone or any other soft tissue structure uh we also inject joints obviously but we go head to toe uh very very happy and very fortunate that I've had some training by some of the best in the world uh we were talking about it with some patients this week of you know how I got into this uh whole field and I'm very very fortunate so I was uh you know blessed with some athletic ability ended up playing uh football for the University of Nebraska go big red Corners playing I think this week um and then from there it really exposed me to the whole world of you know Sports Science Sports Nutrition Sports Medicine uh psychology orthopedic surgery uh so was exposed to some really great minds after that I got into strength conditioning I wanted to dive really deep into the world of you know professional sports and Human Performance and how do we get people you know to lose weight uh and you know increase the the muscle mass that they have uh you know improve their sleep just overall uh you know Improvement in performance from there I you know got some really awesome exposure so at that point you know I'm living with professional athletes I'm traveling the world um really surrounded by some of the best mins in these fields and that's when I originally got exposed to regenerative medicine so I found a couple of my my athletes my clients had some injuries from there they ended up getting some injections and they were back in Action didn't have to you know quit the season didn't have to have a season ending surgery and from there I was really really peaked with my interest I'm like what the heck is this stuff I got to learn about this um at the same time you know you want to make sure that you're still getting exposure to the other side right of uh Sports Medicine which is the operative part right orthopedic surgery so I did a ton of shadowing ton of sisting I was very fortunate to match some of the best programs in the country I was in Pittsburgh and Dallas and then Virginia uh really really awesome experience in the operating rooms looking what these amazing surgeons can do and again certainly sometimes with traumatic situations broken bones you know really gnarly stuff right surgeries 100% needed uh really the role that we're playing here with regenerative medicine is these elective procedures right so maybe you've got an old strain or an old uh you know ligament strain maybe you've got some some arthritis that you want to get taken care of and so we're in this elective sort of mode right you don't have to have these surgeries so maybe you want to take a look and see hey is there something else that we can do without having to go underneath the knife right Retta medicine is amazing uh we've got lots of great now long-term studies on certain surgical procedures things like menis tears or uh certain rotator cuff right in the shoulder uh surgeries that we we know now some of these long-term outcomes aren't the best right even at the six month or the oneyear Mark we find that regena medicine can do much better uh in terms of complication rate speed to recovery right if you're an athlete obviously you know putting some some years in your career getting you back sooner uh but you know we treat every single age I think in the last couple weeks I had like a 15-year-old and I think I had someone they were close to 100 or over 100 years old so again this stuff works uh on almost everybody age is not a limiting factor um if you're a human and you're walking around on Earth you are an athlete your body is meant to move right so we want to make sure we can play a role to getting you back to to being active again right holding on to muscle mass trying to gracefully uh go through age making sure we're giving you the best quality life that we can let me give out that phone number again guys love to chat with you here live in the studio again you give us a call if you're driving be safe okay pull over uh if you're shy uh make sure that you know give a fake name if you need to we're friendly over here give us a call our number live is 866 870 5752 that's 866 870 5752 you can talk to me right now in the studio we'll give you a copy of Dr Daryl's book stem cell and platelet therapy regenerate don't operate we'll even pay the postage for you right if you are a loved one or someone you know might bet benefit from uh a non-operative treatment right maybe there's even scheduled for surgery uh make sure you're giving us a call and we'll get you that book give you some great information there again surgery is uh is not needed 100% of the time a lot of these elective procedures we think can be handled now with regenerative medicine so making sure you're at least giving it a look right you don't want to make sure that you're you're getting rushed to a big decision like an invasive surgery uh we'd love to get you a call here you can also get a consultation over the phone with our office staff for free okay that's with our staff over the phone now with Dr Dar and I but with our staff we're at 8003 9300 that's 800 300 9300 check out our website tons of great studies lots of good videos of us actually doing these procedures take the fear out of uh what these injections look like uh our our website here is www.join rehab.com that's www.join rehab.com great studies great videos great opportunity for you to uh get some information before you come in right again don't feel like you're going to be rushed to that first appointment every week someone's surprised at how much time we can actually give them uh in those initial visits and we want to make sure that we're giving you the best quality care that we can so that's again one of my favorite parts of the job is having the opportunity to communicate trying to learn who you are what are you about what are your goals uh what have you done so far you know make sure we're doing a proper thorough medical history uh getting you a position that we can give you the best information right we're not trying to tell you what you need to do uh we certainly want to encourage you to go the the conservative route first but we want to make sure we're laying out your options right we want to make sure that you have the information that you need and make an educated decision uh and feel good about it right there's no guarantees in medicine I wish that there was uh same thing with surgery same thing with regenerative medicine uh you know we can't guarantee that someone's going to get a certain result at a certain time um but again we treat a ton of patients we got a really busy Clinic uh we get to help a lot of people so we want to make sure that we're we're giving you an opportunity to heal uh anytime anyone's looking to have a procedure done or have a surgery done I always say hey man go to the the person who does the most of it they're going to have the the most amount of experience and they're going to see a whole lot of variations of whatever your symptom is and that's going to be something that gives you I think the best opportunity to heal so making sure that you're you're given your best uh option to move forward with that but we've got a lot of great cases to to discuss today uh first of all we're going to talk to a patient here we've got Mark coming to us from Paramount Mark good morning Dr Thomas Grove here how are you sir I'm doing just great what can we do for you mark well I'm actually a former patient uh you guys uh did the uh stem cell and PRP on my left shoulder when I tore two of the uh tendons the spinatus and the super spinatus in my uh left shoulder oh fantastic how you doing now well I'm doing great the uh shoulders healed up nicely the only thing I had to do was some physical therapy um on it uh the muscles kind of atrophied and so I did some did some exercises and built the muscles back up but other than that it was a pretty painless and uh operation to get my shoulder back together yeah it's pretty surprising right you compare it to things like surgery right where it's you know it's a long road it's a pretty invasive process and you can come in and and get injections right I mean how long were you actually you know having the injections then a minute or two maybe cleaning you up getting the injections done walking out of the clinic yeah well it was it was about an hour to an hour and a half each time I was there um but uh yeah I mean I drove in and I drove out and uh uh it certainly wasn't like having surgery I I had torn the rotator cuff in my right shoulder 10 years earlier and had surgery on that and uh that was a year and a half recovery from the surgery to get all the range of motion and all the uh um mus muscles back Cu uh muscles had atrophied pretty badly when I did that but what I'm calling about today is actually my uh left ankle I had a ski accident a few years back uh and uh my ski binding did not release so I uh fell over forward and I had my basically my nose touching the tip of my ski oh wow so my uh left ankle was pretty stressed out and uh blew up like a balloon it took months and months to heal uh but it's never been right since then and uh I'm I'm not having major trouble with it but I am having uh some problem with it it uh tires easily and it swells up every day when I uh perform normal walking and activity so I was think thinking about coming in and having uh stem cells or PRP on that yeah again like ski accidents can be pretty high velocity injuries I mean these can be as much as car accidents right so yeah fortunately you didn't have a bunch of broken bones and you're and you're still functional sounds like U but we see a lot of ski accidents where yeah that foot kind of gets immobilized and the whole body kind of decides to go and the ankles going to stay put um so a lot of times what you can get is you know things like traumatic arthritis meaning that uh that High Velocity can actually disrupt some of that cartilage uh in addition to that I'm I can't guarantee it but I'm pretty sure you stretched out some ligaments of that ankle as well uh you know the ligaments around that ankle there's a lot of them there there's some on the inside outside front and back um very very important that we're looking at things like ankle injuries that you're doing a good Hands-on Physical exam just because there's so many structures around that spot I actually did I think about three or four ankles yesterday similar mechanisms I had someone coming off a curb someone off a ladder uh someone with tennis injury and then with a ski injury as well uh but that can be something that can be very debilitating when you look at things like biomechanics right how that body moves if that ankle not able to properly you know flex and extend right or move around uh that's going to affect the knee typically it's going to affect you know the hip could be affecting the back all the way up to the neck so the ankle can be a really tough thing if it's not addressed can lead to other issues down the line so hopefully we can get to you soon uh would love to get you into the clinic and take a look at it uh but the ankle is a very common injury uh and I spent about 8 years years being as a part of the medical staff for division one colleges uh we get lots of professional athletes a lot of high-end athletes coming through and ankle sprains are extremely common in the athletic population so that's probably one of the most common things that I treated especially in the athletic population but again it could be a ski injury coming be you know having a a funny step off of a curb and typ what happens is as we uh sprain that ankle we have an injury like that a lot of times we're more prone to have uh injuries down the line because again those ligaments get a little stretched out they get a little loose uh which means that the ankle could have what we call laxity it's a little extra stretchy and so what we can do is again this is the benefit of ultrasound because there's so many structures in that small area right hands and feet tons of anatomy in that area uh we can really pinpoint now and diagnose where we think that issue is coming from so I'd love to get you in the clinic and take a look at you mark that's fantastic well I'm looking forward to it I uh I've been kind of putting up with uh the pain in my ankle for about 3 to four years now since I had that ski accident and uh when I first had it it was really bad and uh but with some Chiropractic adjustment it's gotten a lot better and now I'm down to where I don't have any real pain with it most of the time but if I spend all day on my feet if I go to Disneyland or just do a lot of walking or hiking then it gets to the point where the ankle is just blowing up like a balloon and and and uh I'm in I wouldn't say a lot of pain but it's definitely uncomfortable yeah it give me something that limits you a little bit Yeah and again like I said a lot of times when you have that initial injury uh again you're more likely to you know further injure that area down the line so we'd love to break that cycle right get a little inflammation in there with these cells get some healing going you know you got to do a short period of offloading that area and and hopefully get you back to action here Mark so I really appreciate your call thank you so much uh again another great example here of how we can use regenerative medicine uh to heal injuries so he mentioned he had a rotator cuff uh injury it's you know one of the most common things that I see in the clinic someone has shoulder pain uh and they think maybe they have some arthritis they get an x-ray which again doesn't really show rotator cuff now right rotator cuff is a soft tissue structure x-ray is good for things like bones so we're ruling out things like fractures and dislocations uh but in terms of the um the soft tissue now that's where ultrasound is such an amazing tool higher definition than MRI again for me I get way more information from that ultrasound especially for rotator cuff tears a lot of times we can find things uh that aren't showing up on on MRIs because it's Dynamic right ultrasound is dynamic I can move the body around as I put my probe over that tissue uh meaning we can kind of put some stress on it if I have a a really little tear we put some stress on it or have the patient activate uh that tissue right trying to maybe use that muscle that can reveal a lot more information for us uh and it's a very superficial structure I can use very small needles uh and really pinpoint exactly where that tear is introduce themselves that area get some healing going so that's the the break here guys again we'll go to the break make sure you give us a call here our number live in the studio 866 870 5752 call us live in the studio 866 870 5752 free consultation over the phone with our office staff 800 39300 that's 800 39300 our website www.j joint rehab.com see you after the break you're listening to living painfree with Dr Mark Daryl and Dr Thomas Grove their practice is located at the Joint rehab and sports Medical Center in West Los Angeles to schedule an appointment call 18003 9300 that's 1 800 300 9300 Dr darl and Dr Grove will be back in just a moment stay tuned