Injury and surgical Recovery Strategies

Figured we should have a thread to discuss strategies to recover from injuries and surgeries. Physical therapy, CBD creams, nutritional supplementation, PRP, Stem Cell, SARMs, AAS, Peptides, avocado toast, meditation and praying to whatever god you believe in... all fair game.

Ill start. I am getting shoulder surgery- it will be at a minimum cartilage transplant and microfracture, but depending on the condition of the other damaged tissue the ortho might be able to repair my labrum and capsule, along with a biceps tendonesis. Wont know the extent of what gets fixed till i wake up. I plan to use the following nutritional supplementation, along with BPC157, TB500, and MK667.

Nutritional Supplements i usually take and will continue to take:
Whey Protein
Vitamin D3
Fish Oil/Omega3
The Ol' Costo brand Multivitamin

Nutritional Supplements i will be adding:
L-citrulline
Collagen peptides
ZMA (will add in if the MK doesnt help my sleep as much as expected)


BPC 157
BPC 157 is a synthetic peptide consisting of 15 amino acids, based on a protein found in human gastric juice. It has been studied for its potential to treat stomach ulcers, inflammatory bowel disease (IBD), and promote soft tissue healing. Some key benefits of BPC 157 include:

Accelerating the healing process
Healing ligament damage
Improving blood flow
Healing organ damage
Providing almost immediate results
Healing bone fractures

Possible side effects are generally negligible, with the only one to be concerned about being the ability to grow tumors quickly because of the peptides effect on increasing blood flow to new tissues.

TB500
TB500, also known as Thymosin Beta-4, is a peptide that has been researched for its potential therapeutic benefits, including wound healing, tissue repair, and reduced inflammation. Some benefits of TB500 include:

Enhanced recovery
Reduced inflammation
Improved flexibility
Aiding recovery of slow-healing injuries (e.g., tendons and ligaments)
Boosting muscle injury recovery
Promoting healing of skin injuries

MK-667
Stimulates the grehlin receptors in your brain, which signal your pituitary to release additional growth hormone and IGF-1. Growth hormone and IGF-1 help repair and build connective tissues (big reason why young people heal quickly), and many users also report significantly better sleep (which is likely caused by the increased GH). 3 main side effects are significantly increased hunger (could be good or bad depending on goals), an increase in anxiety in some linked to triggering the grehlin (hunger) receptors which then can trigger the fight-or-flight system, and it can cause problems with insulin sensitivity if used for extended periods (think 6+ months), you are already pre-diabetic and your diet is already carb/sugar heavy.


Most people who are actively using supplements like the above for surgery/injury recovery are also usually fit to begin with, and are attacking Physical Therapy and recovery with enthusiasm, so they are likely to see much better results even with placebo than the general public. It will be interesting to see how this goes, and i think it will also be helpful to have this to keep me engaged and break up the monotony and pain of rehab.

Just eat good food, keep up with PT and try and stay positive. Don’t overdo it. Your post looks like some junk science advertisement in a tabloid.


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Originally Posted by MagnificentUnicorn

try and stay positive.

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There is pretty good science backing up the effects of pretty much all what im doing (excepting TB500 which only has a few studies, but lots of anecdotal evidence and a pretty sound understanding of how it should help). And FWIW, i made this thread because another mag suggested i make it.

That said, i agree that what you say above is hugely important. I am a BIG believer in the power of lowered stress and a positive/motivated mindset to heal... from viral infection or from an injury. For me, one of the ways i know i can stay positive and engaged is to nerd out and try to maximize my recovery strategies with new interesting methods. The biggest benefit will for sure be found from prioritizing PT, and good nutrition/rest... but ill happily take any placebo effect or the mental boost i get from the additional supplementation (if that's all they end up offering).


I know you are in the medical profession. Have you had any experience around PRP or stem cell treatments in your patients?

Post surgery don't forget the laxitive, get off the heavy duty pain killer as fast as you can and suffer thru with extra strength IBU

I used a cryocuff once and figured it wasnt worth the hassle, just use peas or ice YMMV

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Originally Posted by californiagrown

There is pretty good science backing up the effects of pretty much all what im doing (excepting TB500 which only has a few studies, but lots of anecdotal evidence and a pretty sound understanding of how it should help). And FWIW, i made this thread because another mag suggested i make it.

That said, i agree that what you say above is hugely important. I am a BIG believer in the power of lowered stress and a positive/motivated mindset to heal... from viral infection or from an injury. For me, one of the ways i know i can stay positive and engaged is to nerd out and try to maximize my recovery strategies with new interesting methods. The biggest benefit will for sure be found from prioritizing PT, and good nutrition/rest... but ill happily take any placebo effect or the mental boost i get from the additional supplementation (if that's all they end up offering).


I know you are in the medical profession. Have you had any experience around PRP or stem cell treatments in your patients?

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The sports guys that I’ve worked with have had mixed results with PRP and stem cell treatments. They don’t do it anymore.

I’m sure you can find evidence that some of those supplements work but you can get everything you need by eating a healthy balanced diet for recovery and save your money.

My own experience with surgery and injuries is to rest, keep your flexibility, eat well and follow your post op instructions and pt plan.




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BPC 157--from wikipedia: "There are some tentative pre-clinical studies on animals and in vitro suggesting possible benefit in wound healing and bowel disorders although all of these studies come from a single research group." Not FDA approved for clinical use.

TB500--some very small clinical trials showing benefit, none of them for orthopedic surgery. Not FDA approved

MK667--may increase muscle mass. No studies on recovery from ortho surgery. No FDA approved.

While one or more of these might turn out to have some clinical usefulness, that needs to be confirmed by studies on significant numbers of actual patients. There are thousands of promising drugs that have turned out not to be beneficial. More importantly, when you obtrain non FDA approved drugs ("supplements") from a health food store, at the gym, or online you have no idea what you are buying. Supplements are not regulated or tested by any govt agency or independent lab for composition.

As far as pain medicine--too much is bad. too little is bad. You need to be comfortable enough to be up and about, breathe deeply, cough to clear the lungs (prevent pneumonia and blood clots) and to carry out the prescribed PT and other rehab. You need to be awake enough to do those things. I'm a big fan of mixing pain meds--opiates, acetominophen, NSAIDs. They have different side effects. By combining them you reduce the risks of the drugs while still getting adequate pain relief.

The constipation is no joke. After I broke my back, hip and a bunch of ribs I went home on 80mg/d of oxycodone (a lot). I don't think I shit for 10 days. When I finally did it broke the sewer line. (OK, the sewer line was on the way out but the massive shit didn't help.)

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Originally Posted by old goat

The constipation is no joke. After I broke my back, hip and a bunch of ribs I went home on 80mg/d of oxycodone (a lot). I don't think I shit for 10 days. When I finally did it broke the sewer line. (OK, the sewer line was on the way out but the massive shit didn't help.)

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If you really read that shitty little photo-copy of a photo copy instruction sheet you were given it told you to take the laxitive as anesthetist bro pointed out to me

instead you ended up in pain AND constipated

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Originally Posted by XXX-er

If you really read that shitty little photo-copy of a photo copy instruction sheet you were given it told you to take the laxitive as anesthetist bro pointed out to me

instead you ended up in pain AND constipated

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Oh, I took plenty of laxative.

Technically, yes, you can get everything you "need" from food, but for some things it's easier and cheaper to just take a supplement (D3, fish oil).

There's other things you don't "need" but have so much efficacy and safety data that even WADA says they work and allows them in competition, but are basically impossible to get enough of through food (creatine, beta alanine).

Peptides are one of the most interesting things to arise in the last decade or so. Really promising animal data, but almost no controlled human trials AFAIK. Probably pretty safe though, especially for short term use.

I don't even know what to think of stem cells. There's some well documented problems, like a bunch of people at a Florida clinic going blind after getting stem cells injected in their eyes. On the other hand, there's all kinds of crazy stories about people healing serious injuries.

A guy I know through work was telling me about going to a clinic in Tijuana (can't remember the name). Apparently he has a a partially collapsed lung and the other lung has some kind of fibrosis and only has 50% capacity. He said he was at the point where he couldn't climb two flights of stairs without stopping to rest. After the treatments he's been getting he's riding his bike 20 miles per day. Supposedly things start to fade after a few months and he has to go back and re-up, so it's a treatment but not a cure.

I've been loosely following Shane Dorian's experience after getting a *shitload* of stem cells injected at CPI (also in Tijuana). He seems to be feeling better overall and has been surfing a lot, but apparently not a completely new man (yet). After the treatment he supposedly wasn't supposed to do anything but walk for months and that was supposed to be followed by months of intensive PT. He openly admits to never giving his injuries enough time to heal, so it begs the question of what if he just did the extensive rest and PT?

Quote:

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Originally Posted by old goat

BPC 157--from wikipedia: "There are some tentative pre-clinical studies on animals and in vitro suggesting possible benefit in wound healing and bowel disorders although all of these studies come from a single research group." Not FDA approved for clinical use.

TB500--some very small clinical trials showing benefit, none of them for orthopedic surgery. Not FDA approved

MK667--may increase muscle mass. No studies on recovery from ortho surgery. No FDA approved.

While one or more of these might turn out to have some clinical usefulness, that needs to be confirmed by studies on significant numbers of actual patients. There are thousands of promising drugs that have turned out not to be beneficial. More importantly, when you obtrain non FDA approved drugs ("supplements") from a health food store, at the gym, or online you have no idea what you are buying. Supplements are not regulated or tested by any govt agency or independent lab for composition.

As far as pain medicine--too much is bad. too little is bad. You need to be comfortable enough to be up and about, breathe deeply, cough to clear the lungs (prevent pneumonia and blood clots) and to carry out the prescribed PT and other rehab. You need to be awake enough to do those things. I'm a big fan of mixing pain meds--opiates, acetominophen, NSAIDs. They have different side effects. By combining them you reduce the risks of the drugs while still getting adequate pain relief.

The constipation is no joke. After I broke my back, hip and a bunch of ribs I went home on 80mg/d of oxycodone (a lot). I don't think I shit for 10 days. When I finally did it broke the sewer line. (OK, the sewer line was on the way out but the massive shit didn't help.)

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The "conspiracy theory" is that because BPC/TB/MK are all naturally occurring, they are not patentable and therefore not profitable for bigpharma, so they dont spend the money going through the trials to get the stuff FDA approved. I think it might be partially that, but mostly that the stuff (BPC/TB specifically) is just relatively new and so there hasnt been time for lots of studies. And i agree that it would be preferable if there were a ton of studies for my specific use case for these peptides, but there arent. Based on clinical and the large amount of anecdotal evidence online i am comfortable running what effectively amounts to a study on myself. My biggest concern as well is the quality and safety of product, and i have done what i can to be comfortably safe, but it would be nice to have full medical backing/testing (maybe in 10-20 years it will be SOP?). Rightly or wrongly, part of my calculus for stuff like this is asking myself "what is the worst that could happen, and how easy would it be to immediately catch and correct that?". Ive got one chance to get this surgery and recovery right and hopefully build a shoulder that lasts for another 15 years before full replacement (full arthroplasty is what i was looking at previously, and what i will be looking at in the future).


As for opiates, i have always been really sensitive to uppers and downers, and so 5mg-7.5mg of hydrocodone at one time is all i can handle. I projectile vomit when theyve given me ocy or percocet. Ive got a gallon of prune juice and some metamucil ready to go just in case though.

Stem Cell and PRP are not covered by my insurance, and are really expensive. I have heard stories of them being a wonder cure, and know other people who say they saw little to no benefit. To me, it sounds an awful lot like the stories i hear from people who use CBD cream- which is something i find entirely useless. So, i am really hesitant, at this time, to give it a try.

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Originally Posted by Dantheman

it begs the question of what if he just did the extensive rest and PT?

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My buddy had bad elbow tendonitis from golf that he couldnt get rid of. He got a PRP injection and rested it for 2 months straight with only light PT exercises and the tendonitis cleared up. Thing is, he hadnt rested his elbow for more than 2 weeks prior, so it begs the question was it the PRP or the enforced rest and PT that cleared up the tendonitis?


Without extensive medical trials and studies done over decades its so hard to quantify the actual benefit from these things vs placebo effect, the fact that people are resting and/or taking PT seriously in conjunction with it, eating better, etc. Its like when an NFL athlete returns from an injury super quickly- how much was it his recovery methods vs the natural superphysiological recovery ability inherent in a world class athlete in already incredible shape?

I took a amino acid and minerals test, about$60, and it revealed deficiencies in a number of amino acids, copper, selenium, etc.

For a lot of supplements it's ready to test before to know if they are needed

Then you can supplement for the ones where you are deficient.

I also got the amino acids that i needed in powder form, for me it's easier to mix all the powder with water and take it so at once, instead of swallowing a whole bunch of pills.

Also, it's good to do a blood test for vitamin deficiency

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I had plantar fasciatis and elbow tendonitis, pt didn't help, so i had prp injections, they cured both

However, in the last few years i had wave shock therapy which i they was more effective than prp, certainly quicker.

I used it for Achilles, elbow, wrist, knee and hip flexor tendonitis. And it cured all of them, in 5 sessions each

I mountain bike, climb and ski a lot, in addition to lifting, so tendinitis for me is a regular occurrence, once a year or so

Even though i get plenty of sleep and rest



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Originally Posted by rod9301

However, in the last few years i had wave shock therapy which i they was more effective than prp, certainly quicker. I used it for Achilles, elbow, wrist, knee and hip flexor tendonitis. And it cured all of them, in 5 sessions each

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Is that similar to using a TENS unit?

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Originally Posted by californiagrown

My buddy had bad elbow tendonitis from golf that he couldnt get rid of. He got a PRP injection and rested it for 2 months straight with only light PT exercises and the tendonitis cleared up. Thing is, he hadnt rested his elbow for more than 2 weeks prior, so it begs the question was it the PRP or the enforced rest and PT that cleared up the tendonitis?


Without extensive medical trials and studies done over decades its so hard to quantify the actual benefit from these things vs placebo effect, the fact that people are resting and/or taking PT seriously in conjunction with it, eating better, etc. Its like when an NFL athlete returns from an injury super quickly- how much was it his recovery methods vs the natural superphysiological recovery ability inherent in a world class athlete in already incredible shape?

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His elbow got better because of the rest, PT and they poked holes in his tendon initiating a healing response. A lot of orthopedic surgeons will treat tennis elbow by poking a needle multiple times into the tendon no steroid just local anesthetic. When they do surgery for tennis elbow they open the tendon longitudinally and cut and scrape out the diseased tissue until it bleeds and then suture the tendon closed. You know those bands that people wear for tennis elbow? They shorten the insertion for the extensor tendon giving the native insertion time to rest.


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Quote:

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Originally Posted by rod9301

I had plantar fasciatis and elbow tendonitis, pt didn't help, so i had prp injections, they cured both

However, in the last few years i had wave shock therapy which i they was more effective than prp, certainly quicker.

I used it for Achilles, elbow, wrist, knee and hip flexor tendonitis. And it cured all of them, in 5 sessions each

I mountain bike, climb and ski a lot, in addition to lifting, so tendinitis for me is a regular occurrence, once a year or so

Even though i get plenty of sleep and rest



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Tendinitis is caused by overuse….


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Quote:

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Originally Posted by californiagrown;[emoji[emoji6[emoji640

[emoji638]][emoji640][emoji639]][emoji637][emoji639][emoji640][emoji6[emoji640][emoji638]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji6[emoji640][emoji638]]]Is that similar to using a TENS unit?

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It’s ultrasonic and some PTs have used them for decades. I had my first AC joint separation in high school and the PT used that as part of the treatment. That was [emoji637][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji6[emoji640][emoji637]].

I don’t think many PTs are still using ultrasound


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The stuff CG mentioned is all banned by WADA, even though there's no proof it does any good. Glad to see WADA being so tough, unless you're a Chinese swimmer.

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Originally Posted by old goat

Glad to see WADA being so tough, unless you're a Chinese swimmer.

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Or a Sinner... (jannik)

Personally, i do not think that substances used to treat/recover from injuries should be banned. I think an athlete should be able to use things out of competition to heal from injury, and then have to complete a few month "clean" period prior to rejoining competition. So, what that would look like is the athlete stopping usage about 2 months before being fully rehabbed so that they can rejoin competition ASAP, and not experiencing any performance enhancement during the "get strength back" phase of rehab, just enhanced healing during the initial phases of injury recovery.

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Originally Posted by MagnificentUnicorn

You know those bands that people wear for tennis elbow? They shorten the insertion for the extensor tendon giving the native insertion time to rest.


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I don't play tennis but I've used the band just below the elbow for tennis elbow and they helped, I've had tennis elbow 5 times from WW kayaking once I had it in both elbows at the same time so it would go away over the winter when I didn't paddle but thats not an option for a drywaller or carpenter

Since I got rid of a big club of a paddle for a shorter paddle with smaller blades/ smaller diameter shaft I have had NO re-ocurrances

so my theory is that the paddle is just laying there in my hands instead of me having to constantly grip it

I had it in both elbows from shoveling snow, and it's not like you can just stop shoveling to rest it. The bands got me through the winter. I never needed injections or surgery. WW kayaking is no problem since I just hold my paddle up in the air and scream.

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Originally Posted by californiagrown

Is that similar to using a TENS unit?

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Not at all, Google it

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Quote:

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Originally Posted by MagnificentUnicorn

It’s ultrasonic and some PTs have used them for decades. I had my first AC joint separation in high school and the PT used that as part of the treatment. That was [emoji637][emoji[emoji6[emoji640][emoji638]][emoji640][emoji6[emoji640][emoji637]]][emoji[emoji6[emoji640][emoji638]][emoji640][emoji640]][emoji6[emoji640][emoji637]].

I don’t think many PTs are still using ultrasound


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It's not ultrasound. There is a percussion instrument that irritates the tendon

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Originally Posted by rod9301

It's not ultrasound. There is a percussion instrument that irritates the tendon

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Like Theragun?


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I googled it, it’s the same tech to treat kidney stones Extracorporeal Shockwave Therapy. Interesting, not surprised it works. Just like more invasive treatments it stirs up irritation initiating the healing response.


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Originally Posted by MagnificentUnicorn

it stirs up irritation initiating the healing response.

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Im gonna quote this to my wife next time, and tell her that im healing her.

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Originally Posted by old goat

I had it in both elbows from shoveling snow, and it's not like you can just stop shoveling to rest it. The bands got me through the winter. I never needed injections or surgery. WW kayaking is no problem since I just hold my paddle up in the air and scream.

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When I got this place THE 1st thing I did was buy a snow blower, I am also a big fan of wood splitters

or even better just pay someone

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Originally Posted by californiagrown

Or a Sinner... (jannik)

Personally, i do not think that substances used to treat/recover from injuries should be banned. I think an athlete should be able to use things out of competition to heal from injury, and then have to complete a few month "clean" period prior to rejoining competition. So, what that would look like is the athlete stopping usage about 2 months before being fully rehabbed so that they can rejoin competition ASAP, and not experiencing any performance enhancement during the "get strength back" phase of rehab, just enhanced healing during the initial phases of injury recovery.

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GTFO with reasonable nuanced opinions. You're either a cheater or not a cheater ;)

Let's not even get into the fact that short term use of real PEDs confers long-term benefits and the suspension periods for positive tests are a joke.

Quote:

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Originally Posted by old goat

I had it in both elbows from shoveling snow, and it's not like you can just stop shoveling to rest it. The bands got me through the winter. I never needed injections or surgery. WW kayaking is no problem since I just hold my paddle up in the air and scream.

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Get a snow blower , I'm also a big fan of electric wood splitters

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Originally Posted by californiagrown

Im gonna quote this to my wife next time, and tell her that im healing her.

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It works on more than one level


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Originally Posted by XXX-er

Get a snow blower , I'm also a big fan of electric wood splitters

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I HEARD YOU THE FIRST TIME!!!
(I do pay someone to do the drive. The only shoveling I do is the berm, if the town plow comes by after my guy, and the deck if the snow is over the rail. I got one of those big show scoops that you push for both of those jobs. No more tendinitis.
And don't tell me about shoveling. I was a professional, union-card-carrying shoveler in my younger days. I've forgotten more about shoveling than everyone on this forum put together knows.)

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Originally Posted by old goat

I HEARD YOU THE FIRST TIME!!!
(I do pay someone to do the drive. The only shoveling I do is the berm, if the town plow comes by after my guy, and the deck if the snow is over the rail. I got one of those big show scoops that you push for both of those jobs. No more tendinitis.
And don't tell me about shoveling. I was a professional, union-card-carrying shoveler in my younger days. I've forgotten more about shoveling than everyone on this forum put together knows.)

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Sound like you are definaltey shoveling something

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Originally Posted by XXX-er

Sound like you are definaltey shoveling something

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I'm going into rehab next week. Or the week after. Probably.

The biggest challenge (and benefit) in my experience is staying motivated, disciplined and committed through the sheer monotony of physio exercises, especially when going through multiple or longer term or more complex recoveries.

And the best supplement I have found for that is micro dosing shrooms. I was going through a pretty rough injury/surgery/recovery cycle in 2022-2023 and this really helped kill any procrastination and boredom, and kept me pretty focussed and upbeat during what was proving to be a pretty dark and lonely rehab journey.

For context: I had been waiting for a right hip resurfacing surgery after being crippled by impingement and arthritis, but then suffered two back to back left Achilles ruptures whilst waiting for my hip surgery date. Achilles rupture one was in March 2022 ending my ski season. Achilles rupture two was in June 2022 ending my bike season (managed to rupture a different part of same tendon). I then had surgery to rebuild my Achilles in July, a nose surgery in Sept (fixing old breaks), and then finally got my hip done in Dec 2022.

Recovery and rehab from one Achilles rupture is bad enough, but starting from scratch and having to do it it all again whilst still having the hip ahead of me was a pretty big head fuck at the time - was hard to stay energized for the amount of rehab I still had ahead of me, especially when all my fun activities had been taken away. The MD really helped me power through and come out the other side.