Platelet Rich Plasma Therapy (PRP)

//Platelet Rich Plasma Therapy (PRP)
Platelet Rich Plasma Therapy (PRP) 2017-07-20T17:44:46+00:00

What is PRP?

PRP or platelet Rich Plasma therapy is an ingenious therapy which uses your body’s own cells to help repair damage to muscle, tendon and ligaments.  Blood is withdrawn from YOU…not me, not your friend or worse, an animal!  Your blood is withdrawn and then centrifuged (spun) so that the dense white blood cells settle at the bottom.  White blood cells are your “Healers” and “Clotters”.  When you are injured and tissue is torn white blood cells are attracted to the region and begin to clot or seal the wound.  They also release chemicals which attract other cells called Fibroblasts to the area. Fibroblasts are your “builders” and will secrete collagen matrix at the injured site to repair the damaged tissue.  The Platelets are then taken up from the centrifuge into a hypodermic needle and injected into the damaged area that we are attempting to heal.  Once injected the platelets seek out the injury site and do their magic thereby initiating your body’s natural healing response.

Following the PRP injection you will experience 1-3 days of inflammation.  This is NORMAL! Inflammation is your body’s normal response to injury and is actually the first stage of healing.  Do not do anything such as icing or taking anti-inflammatory medications such as Ibuprofen, Advil, Aleve or Motrin.  Let the inflammation run its course.  Trying to stop or reduce it may impede the healing effect.  Watch this video to understand healing, inflammation and how your body repairs soft tissue.

After the first three days it is now time for your body to move from the inflammatory phase to the repair phase.  During the repair phase it is critical to protect the area from further injury as well as begin safe and effective rehabilitation practices.  Gentle stretching, light massage and isometric exercises are typically employed day ten following the PRP injection.  Any exercise or activity that causes an increase in pain is a negative and should be avoided.  Pain is your body’s way of telling you damage is occurring and you should stop it.  There is no cookie cutter rehabilitation program due to the wide variety of injuries we see and the varying fitness and strength levels of the patients we treat.

It is appalling to me how many patients are mismanaged by doctors who either do not care or who do not know or understand what PRP is and how PRP works.  Incredibly many doctors that are injecting people with PRP do not seem to have a good understanding of what PRP is and how it works.  This is inexplicable and inexcusable yet it happens regularly.  I have had patients with torn tendons receive PRP from a local doctor and be told that they can run in three days!!  Let’s get this straight.  PRP is not injecting unicorns and rainbows into your body and has no magical powers.  PRP uses your body’s natural healing agents by directing them purposely onto the injured tissue.  This allows for maximum healing results.  The laws of physics still apply and nothing your uninformed doctor says will change that.  Most muscle, tendon and ligament injuries will require 6-12 weeks for maximum healing assuming no further damage is sustained during the healing period.  Muscle will heal quickest then tendon and finally ligament.  Tendons and ligament heal more slowly due to their relative lack of blood supply compared to muscle.   Since blood has everything your body needs to heal (Oxygen, vitamins and nutrients) efforts are made to maximize blood flow to the injured area during the healing stages.

Do I have to be an Athlete to get PRP?

No. PRP works well for anyone that has suffered muscle, tendon or ligament injury.  It is primarily used in chronic cases concerning tendons and ligaments that are not healing.  PRP can be used for weekend warriors, sedentary folks and athletes.  See list of Pro Athletes who received PRP in 2016

My doctor says there is not enough or no research to support using PRP

No offense but your doctor obviously does not read research nor use progressive, tried and proven techniques to help you avoid surgery.  There is a plethora of positive research regarding PRP and the healing of soft tissue (muscle, tendon, ligament) injuries.  Here is a link to the National Library of Medicine and some PRP research……suggest to your doctor they read it.

Intratendinous injection of platelet-rich plasma under US guidance to treat tendinopathy: a long-term pilot study.

Platelet-Rich Plasma (PRP) in Orthopedic Sports Medicine.

Platelet-rich plasma treatment improves outcomes for chronic proximal hamstring injuries in an athletic population.

Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review.

Platelet-rich plasma as an effective treatment for proximal hamstring injuries.

Effect of High-Volume Injection, Platelet-Rich Plasma, and Sham Treatment in Chronic Midportion Achilles Tendinopathy: A Randomized Double-Blinded Prospective Study.

Long-term beneficial effects of platelet-rich plasma for non-insertional Achilles tendinopathy.

Comparing PRP injections with ESWT for athletes with chronic patellar tendinopathy.

[Evidence-based therapy for tendinopathy of the knee joint : Which forms of therapy are scientifically proven?]

Utilization of Platelet-Rich Plasma for Musculoskeletal Injuries: An Analysis of Current Treatment Trends in the United States.

Platelet-rich plasma therapy big with athletes

How much does PRP Cost?

PRP injections range from $500-$2000 cash in the USA.  Some unscrupulous doctors convince people they need multiple injections which flies in the face of physiology, reason and ethics.

Our clinic uses a specialist that we have made a deal with to perform injections at our directive for $500 cash.  PRP at this time is not covered by insurance and even if it was you would probably have to wait a year or two before you could actually get it.  After our initial exam we can have your PRP appointment set within 2 weeks.

What if I don’t live in San Diego?

Come visit us!  We are conveniently located 15 minutes from San Diego Airport in Kearny Mesa.  We have a 4-Points Sheraton just next door with excellent rates and an airport shuttle. As long as we schedule everything ahead of time you can be seen in our office, diagnosed accurately and receive your PRP injection all in one day.  We can follow up with you via email, telephone or Skype and help manage your rehabilitative process to ensure prompt and proper healing.  Spend the rest of your time exploring beautiful San Diego.

Can’t I just get PRP from the dude down the street from me?

You can do whatever you want but we can’t vouch for them.  Let me tell you something you do not know and would never know or think to ask but that is extremely important.  When getting a PRP injection it is imperative that the doctor use the smallest diameter/gauge needle that they possibly can to avoid damaging the very area they are try to heal with the PRP injection.  Mindless doctors have used large gauge needles to force as much PRP into an area all at once and save time in the process.  Unfortunately this can result in a puncture wound to the tissue and hurt like hell!  How do I know this?  I was victimized and my torn calf was terrorized by a foolish doctor who did exactly that!  Afterwards when I asked him why he did not just use a small gauge needle and perform 3 separate injections he replied “It takes longer”.  Our doctor will take his time and use the smallest possible gauge needle and avoid injuring you further.

Another  compelling reason to use our clinic is we understand the physiology of healing and how to design progressive rehabilitative programs to ensure timely and maximal healing.  Too often patients are lead astray by their well intentioned but misinformed doctors and therapists only to delay healing and reinjure themselves.  There are timelines to healing and no amount of PRP is going to change that.

After I get the PRP how long until I can run (or insert your sport here) again?

Soft tissue (muscle, tendon, ligament) heals in 3 Stages.  Most of these injuries will take 4-12 weeks.  The more specific the diagnosis the more specific I can be regarding how long YOU will take to heal.

Stage 1: Inflammatory Phase – Inflammation last three – seven days assuming you are not continuing to abuse and insult your injury.  Icing and taking Ibuprofen or Tylenol and continuing to cause yourself pain and further injury will only result in…..pain and further injury!

Stage 2: Repair Phase – Lasts three days – three months. The repair phase will only begin once the inflammation phase stops.  During the repair phase your cells will begin to secrete collagen tissue in an attempt to build “scaffolding” and restore your injured tissue to pre-injury condition and function.  During this phase we begin a progressive rehabilitative program using stretching, strengthening, massaging and if applicable the Altered gravity treadmill (AlterG)  If you abuse or insult your injury during this time you will cause inflammation again and you will return to Stage 1/Inflammatory Phase.

************It is these first 2 stages that get most in trouble and result in chronic injury.  People, especially athletes are reluctant to stop their activity or sport and allow enough healing time.  They “rest’ for two days, ice their injury, take Ibuprofen and go back to injuring themselves.  it is critical that your body be allowed to progress through the initial inflammatory phase and get far enough into the repair phase that your tissue can handle the forces exerted upon it, otherwise re-injury is assured.**************

Stage 3: Remodel Phase – Lasts 3 months to a year.  During this phase you can slowly return to your activity or sport.  During this phase your cells are reorganizing tissue making it stronger and better able to withstand the forces you place on it.  This is a great time to strengthen your  body.  Not just the injured site but your entire musculoskeletal system!  By using progressive resistance you will build your body bigger, badder and stronger than it was and hopefully avoid future reoccurrences.

Do I have to come to you for rehabilitation or can I go to McPT Clinic near my house because I have a Groupon?

You can go wherever you want we just can’t vouch for them. Typically you get what you pay for.   We diagnose, treat and fix tendonosis and tendonopathies at SDRI on a regular basis.  Most GP’s. PT’s and Chiropractors don’t even know what it is much less how to fix it.  If you live far away and it is not reasonable for you to come to our clinic for regular therapy we can provide you with home rehabilitation programs and videos.  You can perform the exercises in the comfort of your own home and avoid paying your insurance deductible and co-pay while getting better!   If you want I’ll even friend you on Facebook and nag you to do your exercises every day.  Be very careful if you choose this option because I am relentless.

I have more questions about PRP and my condition.  Can you answer them?

Yes I can.  We can start by setting up a phone consultation if you have many questions….or you can just email me Drrunco@sdri.net

1. A chronological description of your injury.

2. What you have tried thus far that has either helped or hurt.

3. Any X-ray, Ultrasound or MRI Reports.  I do not necessarily need to see the actual images (if I do I will have to charge you to read them).  There is no additional charge to read and interpret the Report only.  Take a picture and email it to me.

4. Any other information you feel might be useful to me.

 

A last thought about PRP

People give doctors undeserved trust and assume they are competent.  Many doctors do not understand PRP and how it actually works.  This results in either poor or a lack of management following the PRP injection.  Without proper management and rehabilitation there is no possible way the PRP is going to work!  Studies have proven that the vast majority of Medical Doctors are incompetent in musculoskeletal diagnosis. If you can’t diagnose it accurately you have no hope of treating and managing it correctly.  Physical Therapists have this warped view that everything is caused by tight muscles or weak muscles and in their run of the mill interventions they often only succeed in hurting the patient more.  Studies have shown that a minimally supervised home rehabilitation program is more effective than a traditional supervised PT program.

Schedule an Appointment

Call 858-268-8525 or email info@sdri.net and provide your insurance card front and back (take a picture and attach it to the email) and your date of birth.  Also provide us with day(s) and time(s) that you are available for an appointment during our normal business hours.  We will

1. Verify your insurance.  We will inform you of how much if any $ is remaining on your deductible and how much your co-payment is.  If you have catastrophic insurance (High deductible) or no insurance we will inform you of our cash fees for all services.

2. Email you back with your insurance coverage and potential appointment times in order to get you scheduled as quick as possible.