Platelet Rich Plasma Injections

Sorry for the title, at least to me is sounds very clandestine. It conjures up images of injecting fetal stem cells illegally in an underground Frankenstein-esq laboratory. First I will explain what it is, I will then relate to you my experience with it, and finally my results. 

I first heard of platelet rich plasma injections (PRP from here on) after a friend of mine completely tore his bicep while doing mixed grip deadlifts. A bicep tear is normally a pretty arduous recovery, but he was back at it pretty fast. A friend had recommended he try PRP and he was raving to me about the results. I was shocked at how fast he had recovered when I saw him, I fully expected for his arm to still be in a sling. I started to look into PRP. The theory behind PRP is pretty simple, muscles have good blood flow so they tend to heal faster than tendons and ligaments, which have a limited blood supply. To help ligaments and tendons repair faster the doctor draws out your blood, puts it in a centrifuge to separate the plasma form the red blood cells, then injects it directly into the injured or inflamed tissue. This can be used on tears and strains, as well as conditions of inflammation such as tendonitis and tedonosis. 

I have never had bad injuries from training, mostly nagging bits of tendonitis which slowly developed, and also slowly went away with proper rehabilitation exercises. My first training related injury was this summer at the strongman event at the Carp fair. I was performing a farmers walk for 200 feet with 200 pounds per hand. It was heavy but I managed to finish it in a respectable time. About 30 feet from the finish line I felt what at the time felt like someone running their finger up the back of my calf. No real pain, just some light pressure moving towards my knee. I spend some time rolling and stretching it after that event while waiting for the next event, the tire flip. The tire was fairly light, about 600 pounds, I picked it up, threw it up to my knee, went to step forward and felt some very sharp pain. My adrenalin was going so I knew this was going to hurt more once I had stopped. To be smart I switched to flipping with my left leg leading. This was definitely awkward, and cost of a lot of distance, but did not hurt. I knew something was up, I started to ice it. I knew it was not a complete tear as I still had full movement and no immediate bruising.

I made an appointment with my local sports doctors to get it looked at. as I had thought, it was a diagnosed as a grate 1 tear/strain. What this means is about 10% of the calf had detached from the achilles. Fairly minor as far as tears go, but something to worry about. I started doing tons of physio and rehab exercises, over the next couple weeks the pain level definitely went down. After that it seemed to plateau. The pain level was non-existent in daily activity, but certain activities like running, skipping, and jumping would cramp my calf up pretty quickly and my calf made it abundantly clear it was wanted me to stop. I reached out to a local doctor and set up and appointment for a PRP consultation. 

Upon arriving at the clinic I filled out the standard paperwork while waiting for the doctor. I have heard of this doctor as I know he had treated several athletes. To my surprise everyone in the waiting room (it was a small waiting room) I knew as part of the Ottawa exercise community. The doctor then called me into his office. Nothing in the office really stood out, standard fare for a doctors examination room. What did stand out to me was that the doctor was wearing Reebok Nanos, instant credibility for understanding sporting injuries in my book. Too many doctors who do not exercise do not understand the desires of an athlete to continue to train. I gave him a brief history of my injury and he explained to me what could be expected with PRP. 

The first couple days after PRP can be a little painful as it will actually cause inflammation in the injected tissue. After the initial shock subsides you can expect a gradual healing. This is something that will progressively get better for 8-12 weeks. The timelines are still a little bit of guesswork as it depends on the kind of tissue injected into and the damage to the tissue. Regardless, it takes some time and don't expect to wake up the next day and for it to feel 100%, it is also a very new procedure that is only recognized by the most progressive medical plans, so expect to pay out of pocket, and its not cheap. 

First the doctor palpates around to find the main site of trauma, for me it was pretty easy as I still had a large knot and tenderness at the side of the tear, he marks it with a marker. If you are squeamish, or dislike needles, this is definitely not the procedure for you. It first starts off with some blood being drawn and then placed in a centrifuge. It spends maybe 5 minutes getting spun to separate the plasma from the red blood cells. The syringe they use has a special attachment which allows them to draw out the plasma and leave the red blood cells at the bottom of the syringe. After this they normally inject a little topical painkiller. I opted against this as I am too tough for that. Just kidding, I actually have a pretty severe allergy to pain killers to I am used to dealing with the discomfort as most places have to special order pain medication for me. The doctor then injects the PRP into the inured muscle, there is a significant amount of fluid being ijkected, in my case about 8ml, which you can definitely feel some pressure buildup inside the muscle. The pain in my case was non-existant. After that it was payment and I was sent on my way saying it might be a little sore for a couple days. 

I hesitantly walked out of the office fully expecting my calf to cramp up or be burning in pain. Nothing. It felt exactly the same as when I walked in the office. My workout the next day had an ungodly amount of double unders in it. I was mentally going over what I was going to substitute it with. I warned my coach that I might be down for this week for anything lower body, and I would have to play it by ear. The next day I started trying some double unders, felt fine. I proceed to do approximately 300 double unders in the workout with no pain whatsoever. None the next day either. 

Fast forward several weeks, no pain, no knotting, works just as good as before my injury. I sometimes even forget that I was injured. It was been about 6 weeks, so according to the doctor, it is still healing. Would I get it done again, without a moments hesitation. Hopefully as it becomes more commonly used the price will drop. If I ever have another injury, or some nagging form of tendonitis that I cannot resolve I would choose this option. Its not a miracle cure. If you are injured or have tendonitis, you should understand what caused these injuries to prevent them from happening if it is a chronic versus an acute condition. 

Yours in fitness
  Coach Everett

Crossfit Bytown