Question: What do rotator cuff tears, plantar fasciitis, Achilles tendon tears, bursitis, and iliotibial (IT) band syndrome have in common?
Answer: Each of these pathologies may be treated with Platelet Rich Plasma (PRP) injection therapy, a relatively new treatment that practitioners are touting as an effective cure for a wide variety of musculoskeletal injuries. If you suffer from one of these injuries, then you may have heard about PRP from a physician or friend. But what is PRP and how can it help you?
What is it?
Platelet-rich plasma (PRP) is blood serum with a high concentration of platelets. Platelets, which are components of blood, contain growth factors. Since PRP has four times the normal platelet count, it is rich in growth factors, which modulate cellular functions and promote healing processes.
“PRP injection therapy” refers to the injection of enriched plasma into affected tissues.
How is PRP therapy administered?
First, your physician will draw a small amount of blood (30-60 ml). Next, this blood will be spun in a centrifuge to separate platelets from other components. Finally, local anesthetic will be applied and PRP (3-6 cc) will be injected into the injured area. Within ten minutes of the injection, growth factors are secreted and the healing process begins.
The withdrawing of platelet rich plasma for injection/graft
(Steven Sampson, et al. Curr Rev Musculoskelet Med. Curr Rev Musculoskelet Med;1(3-4):165-174.)
Who can PRP help?
PRP works best for people with tendinopathies, which are injuries of tendons. Tendinopathies tend to be over-use injuries involving microtears in a type of connective tissue called collagen. These areas of damage are likely to have poor vascularization, which impedes the healing process. PRP can counteract this lack of blood flow.
PRP has been shown to be effective on:
- Rotator cuffs
- Greater trochanter bursitis
- Hamstrings tendons
- IT band syndrome
- Pes anserine tendons
- Lateral epicondyle
- Plantar fasciitis
- Achilles tendons
- Peroneal tendons
- Flexor hallucis tendons
- Posterior tibialis tendons
Do I still need physical therapy?
Following a PRP injection, your physician will likely recommend physical therapy to facilitate your recovery process. Depending on your particular injury and the movement restrictions recommended by your doctor, you might not be able to use your affected limb for a week after injection. You will typically be able to resume normal activities at a reduced level during the second week following treatment, and over the course of the next eight weeks will implement a strength training program, with the goal of regaining full use. Throughout the recovery process, your physician will work with your physical therapist to design a treatment plan that is optimal for you.
Will PRP work for everyone?
If your physician has diagnosed you with a full-thickness tear of a tendon, then PRP might not be the best solution. PRP works by speeding the healing of partially torn tissues, but full tears will not benefit from PRP. PRP works well for tendons, and also ligaments, but its efficacy on the labrum and menisci (cartilage) is unknown. PRP has also been used in wound care for diabetic ulcers, but its effectiveness in this application has yet to be proven.
For more information on PRP and if it is a good treatment option for you see an Orthopedic MD.