What is your specialty and how is it different from other sports medicine physicians?
I am a medical doctor (M.D.) who specializes in physical medicine and rehabilitation. We are known as physiatrists. I am board certified and took extra curricula and tests to get certifications in sports medicine, electromyography, spinal cord injury and pain medicine. Physical medicine and rehabilitation is different from most other specialties because of its emphasis on function. Although it is a nonoperative medical specialty, many physiatrists including myself are well-trained in procedures such as joint and spine injections and electromyography.
How do you do my platelet rich plasma (PRP) procedure?
Once your condition has been diagnosed and we have determined it has a good chance of a beneficial response to PRP, we schedule you for an appointment. The appointments take about an hour. We have you sign informed consent for the procedure. An average series is two to three injections with injections being separated by about three to six weeks. At the time of your injection appointment, your blood is drawn (up to 60 mL-about six normal size test tubes) much like when you donate blood or have a blood test drawn. Then your blood is centrifuged for 15 minutes before 3-10 mL of the part of the plasma containing most of the platelets is siphoned off. This is your own platelet rich plasma and it is what we use for your injections (in addition to some local anesthetic). Using the ultrasound machine, we identify the problem areas and inject your platelet rich plasma into the problem areas.
Is it painful?
The injections involved needlesticks which as we all know are not pleasant, however I use anesthetics to numb the areas which are to be injected. In addition, before the procedure you will be offered the option of using a light sedative (if you choose this option, you must have someone drive you to and from the procedure for your and others' safety). Most patients notice mild to moderate soreness after the procedure which persists for two to three days, occasionally up to a week.
When can I resume normal activities?
Pain and soreness should act as your guide. If the activity you are engaging in is causing pain and increasing your soreness, you should refrain from that activity for the time being.
When can I resume my sports activity?
Generally, I recommend taking two weeks off from your sport after PRP injections to give the tissues the best chance of fully healing. After this, your activity can be ramped up to full participation in the next two weeks. If you are going to be having multiple PRP injections, pain and soreness should be the guide for participation in your sports activities and should mediate how aggressively you participate.
Are there any special instructions after my injections?
Yes, please avoid NSAIDs like Motrin, Naprosyn, Aleve, Advil and aspirin for six weeks after your injection. These are anti-inflammatory medications and it is counterproductive to take them when receiving PRP injections. The reason it is counterproductive is the PRP injections begin the process of inflammation which is integral to full healing. In taking medications which suppress inflammation, you run the chance of interfering with complete healing. Also, you should expect ups and downs in your recovery, this is normal. While you are resting your treated body part, start to work on core strengthening to functionally retrain the rest of your body to prevent recurrence of the injury.
What are the risks?
As with any needle procedures, infection is possible. The frequency of infection is estimated at 1 in 50,000 people. Fainting is another possible risk and could be due to having your blood drawn or from the PRP injection itself. If you have a tendency to faint please let us know. Another possible risk is allergy to the anesthetic, but this is very rare. Let us know of all your allergies prior to your injection(s).
What are the benefits?
One of the benefits is that your own tissue is being used to promote healing within your own body. Also your tissue heals with minimal scar and normal tissue is regenerated. Furthermore this treatment is inexpensive when compared to surgery.