PRP Therapy

A centrifuge and a little of your own blood may be all you need to heal your next injury.

By Nathan Koch PT, ATC, and Anthony Lee, M.D.
From Lava Magazine, June/July 2011

Using your own blood for anything other than a donation might cause concerns in the endurance sports community. However, recent medical advances in the treatment of chronic injury are creating a viable and legal option for using an athlete’s own blood to promote healing, especially in soft tissue (muscles, ligaments and tendons). One of the most promising new procedures for treating soft tissue injuries is platelet rich plasma therapy, or simply, PRP.

Most soft tissue injuries are self-limiting and will heal over time with minimal interventions, such as rest, ice and heat, and over-thecounter anti-inflammatory medications. This conservative approach does not necessarily speed the healing process or allow for a more complete recovery, but it’s usually sufficient to alleviate the acute symptoms. These treatments are aimed at decreasing the pain and reducing the inflammatory process. Unfortunately, recovery is not always complete. The injury can become chronic, leading to longterm impairment.

Platelet rich plasma therapy (PRP) has emerged as a popular regenerative option among many physicians. PRP uses the body’s natural healing process to restore function and activity levels. Research shows that by injecting portions of the patient’s own blood (PRP) directly into an area of injury, it’s possible to stimulate the body’s own mechanisms for repairing the injured tissues.

Currently, the treatment regimen prescribed by physicians consists of rest, ice and/or heat, and non-steroidal anti-inflammatory medications (NSAIDs), or a referral to physical therapy. If the pain and limitations continue despite conservative treatment, or if pain is severe, local steroid injections have traditionally been used. As beneficial as they are in reducing pain and improving function, steroid injections can become harmful if overused. Steroid injection has been shown to be effective for acute injuries, but there is widespread concern in the medical community about its safety as a long-term solution. In addition, some studies indicate that a tissue rupture can occur following steroid injection.

Platelet rich plasma has surfaced as an alternative treatment of soft tissue injuries, especially those that have become chronic. The PRP process begins by withdrawing a small sample of the patient’s blood, and then separating the blood into its various components using a centrifuge. The plasma portion of the blood is rich in platelets, which are responsible for initiating and maintaining the body’s natural healing process. The centrifuged plasma has a concentration of platelets up to eight times that of normal blood. PRP therapy therefore delivers a concentrated dose of growth factors directly into the injured tissue, enhancing the body’s natural healing process. This may contribute to a faster, more efficient and complete restoration of the tissue to a healthier state.

Musculoskeletal ultrasound is used to visualize the affected area and to assist in delivering the PRP to the exact location. A local anesthetic may be injected before the PRP injection to maximize patient comfort. Once the area is localized, the previously collected sample of the patient’s PRP is injected into the injured area under ultrasound guidance. Following an injection, the patient may experience soreness that can last for several days. This is similar to the discomfort of the normal inflammatory process. To follow up, the patient will begin an extensive rehabilitation program under the guidance of an experienced physical therapist. Complete regeneration of collagen may take up to six months. In many cases, the patient may require more than one injection to achieve complete muscle regeneration.

The risks associated with PRP injections are minimal. Because PRP is derived from the patient’s own blood, there is no concern for adverse reactions such as rejection or disease transmission.

Although it is becoming more mainstream, PRP therapy is still in its infancy with regards to research. Very few well-controlled human studies are available. In addition, more information is needed to determine ideal concentration, application and appropriate conditions. In particular, there is a question as to the effectiveness of platelet rich plasma in the joint itself. There are also investigational studies in progress to determine the effectiveness of platelet rich plasma within the vertebral discs.

While the process may sound more complex than traditional therapy methods, research suggests that PRP therapy may be an extremely effective method of eliminating nagging soft tissue injuries, one of the most common injuries among endurance athletes. For more information, contact your physician or physical therapist.