Bone and soft tissue injuries heal in many stages. One of the most exciting areas of research in orthopedics and sports medicine involves making the most of the initial healing stages: inflammation and an increase in cells, or cell proliferation. Platelet-rich plasma (PRP) treatment is becoming a more popular option for biologically boosting the healing process.
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How PRP Therapy Works?
The platelets within your blood, most commonly used for clotting, contain hundreds of proteins called growth factors. These are essential for the healing process within your body any time there is an injury. Platelet-rich plasma (PRP) is a concentrate of platelet-rich blood proteins derived from whole blood. As a concentrated source of plasma, it contains several different growth factors that can promote healing.
What To Expect During Treatment
During PRP therapy, blood is drawn from the patient and then the platelets are separated from the rest of the blood cells by a process called centrifuge. During this process, the platelet concentration grows exponentially as it is spun and separated. It is then put back into the patient’s own blood supply, precisely delivered to areas of injury by injection, to aid in expedited healing. This is a natural and holistic way to encourage the healing process.
Benefits Of PRP Therapy
PRP has been researched and used for osteoarthritis, tendonitis, and regenerative medicine. Studies have shown favorable results on degenerative cartilage lesions, symptoms associated with knee and hip osteoarthritis, in the meniscus and ligament repair, and in chronic tendon and muscle injuries. It is minimally invasive, and the likelihood of rejection is low as the solution comes from the patient’s own cells. There is no cross-reactivity, immune reaction, or disease transmission in the use of PRP.
How long does it take to get PRP Injections?
The Platelet Rich Plasma therapy takes approximately one to two hours, including preparation and recovery time. Performed safely in our medical office, PRP injections relieve pain without the risks of surgery, general anesthesia, or hospital stays and without a prolonged recovery. In fact, most people return to their jobs or usual activities right after the procedure.
How often should PRP injections be given?
Up to three PRP injections may be given within a six-month time frame, usually performed two to three weeks apart. You may, however, gain considerable to complete relief after the first or second injection.
What are the expected results of PRP Injections?
Because the goal of platelet-rich plasma therapy is to resolve pain through healing, it could prove to have lasting results. Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses. Research studies and clinical practice have shown PRP injections to be very effective at relieving pain and returning patients to their normal lives. Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses and the condition is irreversible.
PRP and pain management:
PRP injections are a new treatment method that relieves pain by promoting long lasting healing of musculoskeletal conditions. This rapidly emerging technique is showing exciting potential with osteoarthritis of the knee, shoulder, hip and spine, rotator cuff tears, chronic plantar fasciitis, anterior cruciate ligament (ACL) injuries, pelvic pain and instability, back and neck injuries, tennis elbow, ankle sprains, tendonitis, and ligament sprains.
Before And After Treatment PRP Advice
3 days pre-PRP to 24 hours post-PRP:
- Avoid NSAIDS and other anti-inflammatory drugs
- REST and avoid loading of the joint and structures where PRP was administered
- Light movement
- Myofascial release and joint manipulation may be done on surrounding joints to farther decompress treated area with PT/MT
24-48 hours post-PRP:
- Avoid NSAIDS and other anti-inflammatory drugs
- Avoid ice and heat unless absolutely necessary
Avoid weight-bearing or loading activities - Keep active range of motion gentle and limited (immobilization during sleep if needed)
- LIGHT soft tissue manipulation to PRP-treated area and surrounding tissue with PT/MT
- Gentle, passive range of motion
- REST
Day 3-7 (beginning the regenerative phase):
- Avoid NSAIDS and other anti-inflammatory drugs
- Begin deep myofascial release to hypertonic muscles and any scar tissue surrounding injury (3x/week) with PT/MT
- Ice and electrical muscle stimulation (3x/week)
- Gentle passive/active range of motion (full ROM should be reached by end of 1st week) (3x/week)
- Light mobilization to any joint restrictions (3x/week)
- Light proprioception/joint stability exercises to associated joints (3x/week)
- Light stretches to shortened muscles
Week 2 through 4 (regenerative phase):
- Avoid NSAIDS and other anti-inflammatory drugs
- Continue myofascial release to hypertonic muscles and any scar tissue surrounding injury with PT/MT (3x/week)
- Grade 1-2 mobilization to any joint restrictions (3x/week)
- Ice and electrical muscle stimulation (3x/week)
- Functional exercises to stabilize associated joint (2-3x/week)
- Continue proprioceptive exercises
- Stretch and foam roll shortened hypertonic muscles
- Medical follow-up at end of 4th week
- Week 5-8 and following weeks as needed:
- Can begin to use natural anti-inflammatory or NSAID’s as needed
- Continue myofascial release to hypertonic muscles and any scar tissue surrounding injury with PT/MT (2x/week)
- Grade 1-2 mobilization to any joint restrictions (2x/week)
- Ice and electrical muscle stimulation (as needed)
- Continue progressing through proprioceptive exercises
- Begin gait, biomechanical, and sport-specific training
- Continue stretching and foam rolling as needed
- Medical follow-up and the end of the 8th week
- Return to a sport when fully functional or as directed by injecting the provider
Research:
Joint Pain-
A paper published in 2013 in the American Journal of Sports Medicine, found that PRP injections helped to reduce knee osteoarthritis pain compared to saline injections. https://journals.sagepub.com/doi/abs/10.1177/0363546512471299
A paper published in 2012 shows the efficacy of PRP for the treatment of osteoarthritis of the hip. https://www.ncbi.nlm.nih.gov/pubmed/24286802
Meniscus or Ligament Injuries-
A paper published in 2013 shows the use of PRP in ligament and meniscal healing.
https://www.ncbi.nlm.nih.gov/pubmed/24212368
A paper published in 2016 that shows multiple injections of platelet rich plasma reduce pain and functional impairment in a canine model of ACL and meniscal deficiency
https://www.ncbi.nlm.nih.gov/pubmed/26403590
Muscle and Tendon Injuries-
Lateral Epicondylitis
A paper published in 2014 that shows efficacy of platelet-rich plasma for chronic tennis elbow. https://www.ncbi.nlm.nih.gov/pubmed/23825183
Patellar Tendonitis
A paper published in 2014 in the American Journal of Sports Medicine, found that 3 rounds of PRP injections reduced symptoms in those with the knee injury chronic patellar tendinopathy. https://journals.sagepub.com/doi/abs/10.1177/0363546513519964
Rotator Cuff Tears
A paper published in 2011 that shows efficacy of platelet rich plasma in arthroscopic rotator cuff repair.
https://www.ncbi.nlm.nih.gov/pubmed/21570659
