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PRP for athletes and sports injuries at NovaGenix

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Platelet Rich Plasma experts in Palm Beach and Broward County help professional athletes and MMA fighters in Jupiter and Fort Lauderdale.


Having spent years working in the medical field, I had not heard much about PRPuntil a relatively short time ago, after having read about platelet rich plasma being used in oral maxillofacial surgery(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683340/). PRP is described as an autologous procedure, which means that it comes from your body’s own tissues and cells, which I found interesting, but because I don’t focus much on oral surgery I didn’t pay much attention to PRP at the time. My interest in plasma injections quickly changed however, after learning more about its benefits in treating athletes to help them recover faster after injuries. I learned that it can accelerate the healing of damaged tendon, ligaments and muscle, so my curiosity was piqued. As a lifelong martial artist and Black Belt in Brazilian Jiu Jitsu, I was constantly dealing with injuries, either my own or those of my students and training partners, so I began to do some more research on the topic of bio-regenerative medicine.

I learned that overseas, in Europe, PRP had been widely used for many years, with one of the first documented uses being in cardiac surgery in 1987 (https://www.ncbi.nlm.nih.gov/pubmed/3570542). Countries like Spain and Italy are largely credited for its development, and in Düsseldorf, Germany, Dr. Peter Wehling, ( http://cemor.clinic/peter-wehling/) a spinal surgeon, developed a method of PRP that was so cutting edge at the time, that the L.A Laker’s future hall of famer, Kobe Bryant flew to Europe during the off season for treatment. He was so impressed with the results that he convinced former New York Yankee, Alex Rodriguez to go to Germany for treatment as well. Unfortunately, due to FDA regulations back then, PRP had not been seen much in the united states for the treatment of chronic pain and spots injuries and athletes needed to travel abroad to get these services. Doctors were afraid of strict government regulations that only allowed for “minimal manipulation” of human cells and tissue, and since there wasn’t very specific language as to what “minimal manipulation” actually meant, PRP was avoided due to fear of what government FDA, DEA and federal healthcare regulators might do. The FDA has recently eased off the restrictions for autologous use of PRP and Stem Cell therapy (https://www.ncbi.nlm.nih.gov/pubmed/25268794 ), so it’s only recently that PRP has started to gain some notoriety in the sporting world with athletes like PGA legend Tiger Woods and tennis star Rafael Nadal and others all having been treated with PRP for various injuries. Conditions like sprained knees, partial tears and chronic tendon injuries were all being treated with tremendous success and this started to get people talking. Today, a simple search online for PRP in the news will bring up articles about dozens of professional athletes in all major sports having had successfully undergone treatment, which in the past had been traditionally treated with physical therapy, medication, time off to recover or even major surgery. Several athletes who’ve had PRP have attributed it with their faster recovery and swift return to training and competition. So just exactly what IS platelet rich plasma and how does it work to get athletes to recover faster?

Platelet Rich Plasma, or PRP is the name given to the sample of blood that a doctor will prepare that separates and concentrates the platelets to a much higher percentage than would be normally contained within a normal sample of blood. According to researchers in the United States, an analysis of a PRP sample showed a 76% recovery of platelets and an 8X greater concentration of platelets. (https://www.ncbi.nlm.nih.gov/pubmed/16192851). This is important because platelets are the cells that are most commonly known for causing blood to clot and forming scabs. But what is less commonly known by most people is the process of what else the platelets do, which is release growth factors. These growth factors, also called “cytokines” are proteins that when come into contact with injured tissue, will release growth factors through their cell membranes.  There are several different types of growth factors contained within the alpha-granules of platelets, which include platelet-derived growth factor (PDGF), insulin-like growth factor IGF, vascular endothelial growth factor (VEGF), transforming growth factor (TGF), platelet factor interleukin (IL), platelet-derived angiogenesis factor (PDAF), epidermal growth factor (EGF), and fibronectin. During a typical injury, vasodilatation occurs, which is an increase in the diameter of blood vessels to allow for inflammation to begin and other healing factors like platelets, cytokines and growth factors to be brought into the area surrounding the injury. This swelling is the body’s attempt to bathe the area in healing cells. These healing cells stimulate the repair of damaged tissues, including ligaments, tendons and muscles. The idea of PRP is to induce inflammation and by providing a concentration of growth factors into the area, we accelerate the process of cellular repair. Stubborn injuries that just don’t seem to want to go away will start to show dramatic improvement. Pain will be reduced, range of motion increased, and stability restored in a relatively short period of time. The entire science behind PRP is not completely known and PRP is not a cure all for everyone or every condition, yet there is much promise as the results have been incredibly encouraging thus far.

In our clinic we have worked closely with many high-level athletes and have a very good track record and understanding of how PRP works for today’s amateur and professional athletes. Specifically, we have worked with a large number of mixed martial artists and combat sport athletes, and due to the unpredictable nature of fighting sports, we’ve seen a wide variety of injuries sustained by these athletes from both training and competition. This has given us insight on the capabilities of PRP and the process of recovery. Obviously, all athletes want to recover as quickly as they can, but for fighters it’s different. The clock is certainly against them as they usually have a shorter professional career and scheduled bouts that don’t come along on a regular basis. Missing a single fight may lead to a 6-month layoff or more, until the next opportunity comes around.  A baseball player has a long season that they can jump back into at their convenience, but fighters have specific days and even specific times that they need to be ready for. We get emergency requests from guys that have fights scheduled in some cases just 5 weeks away, and they need to not only be healed for the fight but need to be ready and recovered before the fight so that they can train properly and end their camp on a strong note. This is a tough task and PRP may not be able to live up to those time lines, but we have seen it happen. The standard procedure for when a fighter needs PRP is that we get a call from a coach or a fighter explaining that they got hurt in training and need to come in for a platelet rich plasma injection. Sometimes they have x-rays and MRI’s other times, they do not. Since we inject a large volume of platelets into the site of injury and the platelets are naturally attracted to the injured and damaged tissue, it’s not always necessary to have imaging. Our physician’s experience and knowledge of anatomy is enough to provide accurate treatment for the injured athlete. They come in and we take about 3-5 test tubes of their blood. The fighters are instructed to stay off of all anti-inflammatory medications, like Advil and Aleve for at least a week prior to the procedure and come in for the appointment well hydrated. Once we draw their blood samples, we prepare it in a centrifuge which will spin and separate the blood into the various layers based on density. We spin the blood at increasingly higher speeds, so that we minimize damage from the initial centrifugal forces slamming the cells together, thus increasing the number of viable cells that we’re able to inject. The higher the concentration of platelets, the more effective the treatment is. Once the blood is separated into the red and white blood cells, buffy coat, and plasma, the doctor extracts the portion of the blood, most rich in platelets, and is ready to inject the PRP sample back into the fighter. Depending on the site of the injury and the number of injections needed, the process takes about an hour to an hour and a half from start to finish. The athlete is then instructed to take 72 hours off from physical activity and training, and keep movement to a minimum to let the platelets adhere to the damaged tissue and begin the process of repair. For the fighter, this is usually the hardest part, since they’re always working out and training. Former All-American wrestler and UFC veteran Chas Skelly called me a few hours after his procedure asking if it “…cool to go on a light bike ride” which to him meant around 25 miles

We’ve learned that if we get the procedure done on a Friday, after the fighters morning training session, they have the entire weekend to rest and recover and then it’s back to work on Monday. Now, everyone is different in their reaction to healing and rate of recovery, however we typically see the following. Day one they experience a little soreness from the injection itself, but nothing too severe. The next day or so that muscle soreness goes away, and the healing slowly begins. PRP is different from a cortisone shot so the relief is not instantaneous. Some people have reported feeling relief in as little as 4 days and others will gradually improve over the course of up to 6 weeks. The degree to which they heal depends on several factors, such as their age, severity of injury, genetics and more, but patients always seem to show improvement. UFC fighter and Brazilian Jiu Jitsu Black Belt and World Champion Gilbert Burns had PRP on multiple occasions to treat injuries that were making it impossible for him to train for upcoming fights. His arm was so bad that he was unable to wrestle or train BJJ prior to his UFC fight night 116 contest against Jason Sago. He had heard about PRP and came in for treatment after one of his students at the Combat Club, in Lantana, Florida had received PRP injections and made an unprecedented recovery. After he had received the therapy, I followed up with him in person at his gym and asked, “how he was progressing?” He immediately came up to me with a huge smile and said in a thick Brazilian Portuguese accent “You know, after one week I was not so sure how it was feeling, but then after two weeks…Man! I feel like I have a new arm. Is perfect now!” He then went on to win his next fight with a 3rd round knockout with the same arm he had treated. After his successful experience with PRP, we soon were approached by his brother, professional MMA fighter and fellow BJJ Black Belt nogi world champion Herbert Burns, who had an injured leg that needed treatment. He received one round of PRP that healed the injury about 70%, so he came in for a second round of injections that was able to help him recovery fully. When asked about his experience with PRP and if he would recommend getting treatment to other fighters, he stated “PRP works 100% I’m a guy who doesn’t like to take drugs or medicine, so for me it’s gotta be all natural, and PRP it’s natural and definitely works!”

It’s not just the athletes themselves who are starting to realize the benefits, but their coaches and trainers are seeing the value in therapy as well and sending their fighters in for treatment. One of the most respected coaches of professional athletes in the word is Dr. Corey Peacock PHD, CSCS, CISSN, FRCms, Performance Coach and Exercise Physiologist. He is the head strength and conditioning coach to dozens of UFC fighters and trains guys like Rashad Evans, Anthony “Rumble” Johnson, Stefan Struve, Volkan Oezdemir, Kamaru Usman others. He is a big believer in PRP and when asked his thoughts on platelet rich plasma, the coach said, “Our athletes are being treated with PRP injections for both acute training injuries and chronic overuse injuries that have accumulated over their MMA careers. The success of the therapy has been seen in both in-and out- of competition fighters. Our improvements and healing rates have increased drastically following the treatment. The ability to strengthen both the damaged and surrounding tissues has been improved as a result of PRP.”

He’s not the only world class strength and conditioning coach who understands the benefits to keeping their fighters healthy. Recently named one the most respected strength and conditioning coaches by “Fight Camp Conditioning” (http://FightCampConditioning.com),  Head Strength and Conditioning Coach for American Top Team and Owner of Daru Strong Training, Phil Daru spoke to us about his thoughts on PRP for his athletes. The coach to MMA superstars Tyrone Woodley, Joanna Jedrzejczyk and Dustin Porier stated “I have trained hundreds of fighters and have been a competitive athlete all my life, so aches and pains have always been apart of my life. I’ve done many things to try and heal my body from myofascial release treatment, chiropractic, cortisone, acupuncture, cupping…you name it. The only thing that has been proven to work for me at the moment has been PRP, a lot of my fighters vouch for it and so do I. If you’re looking to heal and feel great I highly recommend it.”

 

As the research on PRP advances and more is learned about Platelet Rich Plasma, it will become more and more prevalent for helping all types of athletes recover. Whether it’s professional athletes, college teams, amateur or recreational sports enthusiasts or anyone with chronic pain or injury, PRP will offer a non-surgical, drug free alternative that is both effective and affordable. The best part about PRP is that it works. It’s the preferred treatment by those individuals who rely on their body functioning at 100%, and for good reason. Wen factoring in costs and recovery times, many men and women are choosing to try a natural alternative rather than go under the knife.

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