Services: Exercise, Nutrition and Lifestyle
Unlock your potential for improved metabolic and musculoskeletal health through targeted exercise, nutritional guidance, and lifestyle adjustments. Our comprehensive program is designed to enhance your well-being and performance, offering personalized solutions that fit your individual needs.
Exercise: Engage in a tailored fitness plan that prioritizes strength training, flexibility, and cardiovascular health. Our expert trainers will support you every step of the way, ensuring that your exercise routine is effective and enjoyable, leading to sustainable improvements in strength and endurance.
Nutrition: Discover the power of proper nutrition with meal plans crafted by nutritionists who understand the balance of macronutrients and micronutrients essential for optimal health. Our approach emphasizes whole foods, portion control, and the right timing of meals to boost metabolism and support muscle recovery.
Lifestyle Modifications: Small changes can lead to significant results. We focus on integrating healthy habits into your daily routine, from sleep hygiene and stress management to hydration strategies, all aimed at promoting a balanced lifestyle that fosters lasting change.
Take the first step towards a healthier you. Together, we can transform your approach to fitness and nutrition, laying the foundation for a resilient body and a thriving life. Join us today and experience the difference that a holistic approach can make in your health journey.
Orthobiologics
Orthobiologics, also known as regenerative medicine, is a rapidly advancing field that offers new options to treat acute orthopedic injuries and chronic or degenerative conditions without surgery. It is one of multiple promising treatments for muscle, joint, and soft tissue injuries. Orthobiologics are therapies developed from natural biologic substances that promote healing. They can be categorized into “Autologous” (i.e. you yourself provide the tissue or blood) or “allograft” (donated by another individual). For orthopedic applications in the U.S., the FDA only allows orthobiologics that are autologous. The main advantage of using autologous products over allografts is safety; these benefits include the innate decrease in immunologic side effects, tissue rejection and reduced possibility of disease transmission.
Autologous orthobiologics include many products including platelet rich plasma (PRP), platelet lysate (PL), alpha-2 macroglobulin, interleukin-1 receptor antagonist protein (IRAP), bone marrow aspirate (BMA) and micro-fragmented adipose tissue (MFAT). They help reduce musculoskeletal pain and promote a healing response through growth factor and cytokine (signaling molecule) activation. They essentially can help change the biologic environment within a degenerative joint or tendon to favor repair and regeneration. They can help naturally reduce pain and inflammation without using steroids. This is accomplished by a variety of mechanisms including immunomodulation, angiogenesis (increases blood flow locally to tissue), and cellular regeneration, differentiation and apoptosis (repairs and remodels tissue). These products either help activate or contain progenitor cells (i.e mesenchymal “adult” stem cells) that can help accelerate tissue healing and slow the progression of degeneration.
PRP is an autologous preparation of concentrated platelets isolated from whole blood by centrifuge. Platelets are our “First Responders” to a site of injury and once activated, help to initiate our body’s naturally own healing mechanisms. More than 3,000 bioactive proteins are released from activated platelets when injected into damaged tissue which help to synergistically regulate multiple pathways involved in cell proliferation and repair, recruitment of progenitor cells, modulation of inflammation, stimulation of protein synthesis and angiogenesis. PRP can be injected into multiple musculoskeletal tissues including joints, bone, tendons, ligaments and intervertebral discs. Although deemed an experimental treatment, the medical evidence for orthopedic applications is evolving quickly and we have good research studies that support its use for conditions like tennis elbow, gluteal tendonitis, plantar fasciitis and knee arthritis. Since there can be tremendous variation in the composition of PRP, the efficacy of PRP is highly dependent on the quality of PRP, experience of the health care provider administering it, and the conditions you are using it for.
Micro-fragmented adipose tissue or MFAT is another orthobiologic product used for musculoskeletal conditions. Subcutaneous adipose tissue is a common reservoir of progenitor cells, such as mesenchymal stem cells or MSC’s. MFAT initially was used in cosmetic and reconstructive medical procedures but more recently has been used to help treat musculoskeletal injuries or degenerative conditions such as arthritis. MSC’s have vast potential in regenerative medicine due to their ability to proliferate and differentiate into multiple lineages, including adipocytes, chondrocytes, myocytes, and osteoblasts. These cells home in on sites of injury and secrete bioactive factors that are immunomodulatory and trophic, meaning that these cells make therapeutic drugs called “exosomes” that are medicinal and secreted at a site of injury. This can have a powerful paracrine effect on the surrounding tissue to help activate cellular genes to promote healing and repair. Furthermore, MSC’s are free radical scavengers that promote cell survival and help remove toxic substances which help mediate inflammatory response. Current musculoskeletal applications have included shoulder, hip and knee osteoarthritis, osteonecrosis of the femoral head, and tendon or ligament tears such as in the rotator cuff.
MSC’s can be obtained from different sources including bone marrow, adipose tissue, synovial tissue and muscle but the most common harvesting techniques involve either aspirating bone marrow from the pelvis (called BMA) or performing a liposuction procedure to the abdomen or flank (called MFAT). There are many FDA-compliant devices that can harvest bone marrow aspirate or from adipose tissue. The adipose derived MSC kits can create MFAT with intact stromal vascular niche and MSC’s (cells remain viable in their natural environment) that can be safely injected back into patients for orthopedic applications. This helps promote cell viability that will allow the MSC’s to act locally on the injured tissue helping to synergistically regulate multiple pathways involved in cell proliferation and repair, modulation of inflammation, stimulation of protein synthesis and angiogenesis. As with PRP, MFAT and BMA procedures are deemed experimental but the medical evidence for orthopedic applications is evolving quickly and we are beginning to see more studies to support its use in orthopedic degenerative conditions such as osteoarthritis and tendinopathies. It is a promising therapy to help treat common degenerative orthopedic conditions in a safe and less invasive way.
Tenotomy with Tenex Health TX System
Tendinopathy is a clinical condition characterized by pain and dysfunction related to mechanical loading of the tendon. It is a chronic overuse injury. Chronic tendon pain is due to a progressive breakdown of collagen fibers; characterized by collagen disorganization, paradoxical ingrowth of nerve endings, and in some cases integration of calcium into the tendon fibers. While most tendinopathies respond well to conservative treatment, a small subset of tendinopathies are recalcitrant and require more invasive treatment. Minimally invasive ultrasound guided mechanical treatments have shown favorable results such as percutaneous needle tenotomy.
The basic principle of percutaneous needle tenotomy is to stimulate a healing response within a region of disorganized non-healing tendon tissue via local acute trauma produced by multiple needle fenestrations. The Tenex Health TX system (Tenex Health, Lake Forest, CA) is an ultrasonic cutting instrument designed to debride (or remove) the unhealthy tendon fibers without adversely affecting the healthy fibers. Tenex can remove pathologic tissue and stimulate an acute process, introducing inflammatory growth factors thus promoting healing of the tendon. Recent advances in the Tenex Health TX system include the TX-2 and TX-bone device which can now remove hard calcifications and even small bone spurs without having to undergo a surgical procedure where a long surgical incision is required. Furthermore, the minimally invasive procedure allows for less post-procedure pain and faster recovery than traditional surgical approaches.
Percutaneous tenotomy and debridement with Tenex Health TX System is always performed using ultrasound guidance to accurately target the diseased tendon tissue with precision to maximize safety and efficacy. Occasionally, more than one incision/entry site is required to effectively target the pathologic tissue. Upon completion of the procedure, a small adhesive bandage is used to close the incisional wound followed by a gauze and transparent film dressing. A compression sleeve may be used in some cases. Post-procedure rehabilitation will vary slightly by the site, the severity of injury, and functional goals of the patient. The duration of rehabilitation period varies but typically takes between 6 to 12 weeks to return to activities.