The Olympics are upon us. It’s amazing to see high level athletes pushing the boundaries of what the human body is capable of. Even on a recreational level amateur athletes push themselves as well. Invariably, on occasion any level of athlete can be injured. Traditionally rest and physical therapy were used to recuperate injuries, and corticosteroid injections and anti-inflammatories were used for pain relief. It’s becoming more clear that anti-inflammatories and steroid injections do not help heal injuries. That’s where cell based therapies such as platelet rich plasma (prp) and stem cells come into the picture.
You hear lots of stories about athletes receiving prp for acute injuries. What about treatment for regular folks and amateur athletes with chronic injuries. The mechanism of action and benefit of prp is likely different depending on the nature of the injury. The full understanding behind cell based therapies is still a work in progress. But some concepts are becoming clear. For acute muscle and tendon injuries, the increased growth factors produced by prp may accelerate the healing process. For chronic injuries, the mechanism of action and benefit is less understood. Perhaps the increased growth factors produced by prp kick start a stalled healing process in chronic injuries as well. In addition another possibility is an anti inflammatory effect or some other diminution of cytokines involved in pain. The entire story about why prp can help chronic injuries is not entirely understood, but the evidence of its effectiveness continues to grow.
The best type of prp utilized is not entirely understood as well. That’s right, there are different types of prp that can be used. The degree of concentration of platelets can vary, inclusion of white blood cells and red blood cells is another variable, and it’s even possible to exclude platelets all together and only include their intracellular contents (this is called platelet lysate). Is a higher concentration of platelet concentration always preferred? Probably not. Does the high level of white blood cells make some prp preps too inflammatory? Possibly, and that might be a problem. There is a lot more to learn over the next few years. The type of prp used should be based on the type and severity of injury. Bottom line is that a nuanced approach to regenerative medicine is needed. Anything less is not worthy of your time.