By Dr. Ben
have a chronic musculoskeletal injury that isn't responding to appropriate
rest, stretching, and other rehab measures, you might consider platelet-rich
plasma (PRP) therapy.
involves extracting a small amount of blood from your arm, using a
centrifuge to collect the platelets in your blood, and then injecting
concentrated platelets into injured tissue(s).
is that natural growth factors that are secreted by your platelets
can promote healing that would otherwise be difficult because of inadequate
blood flow and healing capacity.
has been utilized by surgeons since the 90's to help aid recovery
from various surgical procedures. More recently, it has become popularized
by world-class athletes looking to accelerate healing of torn ligaments
and tendons that would normally keep them on the sidelines for lengthy
periods of rest and rehab. Tiger Woods and Rafael Nadal are two prominent
recipients of PRP therapy, and coincidentally, both of them have reportedly
utilized this procedure for knee injuries.
known three patients who have undergone PRP therapy - one for chronic
patellar tendonitis, one for a ligamentous injury in the inner elbow
region, and one for hip dysfunction that displayed classic signs of
a labral tear.
of my clients improved enough with their PRP injections for me to
feel that it's a therapy that merits consideration with the following
thoughts in mind:
receiving PRP therapy, I think it makes sense to rest the injured
area, and when you're able to do so, stretch all of the muscles
and ligaments surrounding the affected tissue(s).
inflammation and poor healing of injured tendons, muscles, and
ligaments are sometimes due to these tissues having to take on
more work than is normal because surrounding tissues are tight
the same reason as above, whenever possible, it can be immensely
helpful to apply deep massage to the injured tissue(s) and surrounding
tissues. Deep pressure can help lengthen shortened muscles, and
can also help bring more blood into the area, which is critical
for optimal healing.
is where use of a foam roller can be immensely helpful - for more
on foam rolling, view:
and Foam Rolling Archive
of the beneficial effect of PRP therapy may be from the simple
act of inserting a needle into the affected area. Though meant
to help accelerate healing via injection of concentrated platelets,
a needle can promote healing simply by causing some bleeding in
the area, as bleeding attracts platelets and other substances
involved in the natural cascade of events that characterize inflammation
is partly why acupuncture can be helpful for promoting healing.
And because acupuncture carries less risk than PRP therapy, I
think it's worthwhile to try acupuncture first. Acupuncture offers
the benefit of being able to stimulate healing deep within a joint
- a skilled practitioner can even stimulate ligaments surrounding
and within your hip and knee joints.
of PRP therapy for musculoskeletal injuries is in its infancy.
No one knows long term effects, if any, of injecting a concentrated
glob of platelets into one area of your body. The desired effect
is acceleration of healing. But where there is a predisposition
for abnormal growth, could PRP trigger unwanted conditions? There
are ongoing clinical trials, but we won't have too many answers
on long term effects and safety for a good while, I imagine.
with all procedures that involve injections, there is always a
small risk of infection, so if your immune system is compromised
for any reason, it may be best to avoid PRP therapy.
injections are not painless. All three of my clients reported
some degree of soreness at their sites of injection, with discomfort
lasting for up to about a week. This makes sense, of course, as
sticking a needle into a ligament or tendon shouldn't happen without
your nervous system being fully aware of it.
of today, health insurance programs don't cover Platelet-Rich
Plasma therapy, and with procedures starting at around four to
five hundred dollars, it's a significant out-of-pocket expense
- more incentive to really work at stretching and foam rolling
and getting into the best shape you can, and then reassessing
potential need for PRP therapy.
decide to pursue Platelet-Rich Plasma therapy, be sure to consult
only with licensed medical practitioners who have experience with
this procedure. It's becoming more readily available at high performance
sports medicine clinics.
outcomes of clinical trials are published, I'll update findings and
thoughts on Platelet-Rich Plasma therapy here. In the meantime, please
remember that you can greatly support self healing of various soft
tissue injuries with regular rest, stretching, foam rolling, strengthening,
and a nutrient-rich diet that is devoid of large quantities of animal
protein that can cause chronic inflammation. Whenever possible, it's
always best to do all you can with non-invasive therapies when looking
to fully recover from injuries.
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