What is it?
It is classified in a category of health called orthobiologics: meaning to merge cutting edge technology with the body’s natural ability to heal itself. PRP Is short for platelet rich plasma. (What the heck are those? You know when you cut yourself? Instead of bleeding constantly the platelets allow the blood to clot and eventually form a scab and heal that cut, therefore PRP is a cocktail of many proteins that collectively stimulate repair and regeneration, because it also carries growth factors with it). It looks very thick or viscous and has a dark purple color. I only know this from asking the friend who took me (she thought it was best I didn’t look, but to this day I think I would have found it fascinating versus nauseating!). If you are super nerdy and want to look it up, the growth factors and cytokines (that thing your body releases that causes inflammation and pain) present in PRP are listed here:
So, I decided it sounded awesome and booked my appointment! Especially since I had read this:
“When PRP is injected into the damaged area it stimulates the tendon or ligament, causing mild inflammation that triggers the healing cascade. As a result new collagen begins to develop. As this collagen matures it begins to shrink causing the tightening and strengthening of the tendons or ligaments of the damaged area. Pain usually lasts only a few days following. The peak of effectiveness is around the 4-6 week mark.”
First they draw a decent amount of blood, which is not a big deal at all. You wait about 20-30 minutes while they prepare it, separating all the platelets. Then…you see an 18 gauge needle! (for your reference a typical needle used for standard blood draws are 25 gauge). I’m fine with needles so it’s still no big deal…until that needle is also long and went all the way between the joint space, once tapping my bone (oops!). I almost passed out and needles don’t bother me at all.
Next, my friend drove me home while I moaned and placed an icepack on my shoulder. It really effing hurt. The doctor told me I would just need extra strength Tylenol. He was so wrong. I couldn’t sleep all night; I thought there were shards of glass in my shoulder. I finally got my hands on pain medication, which just scratched the surface of the pain. I needed help with everything because my arm swelled so much I couldn’t move it, and anytime I did, the “shards of glass feeling” was right there to remind me. I thought it would only hurt “for a few days” so I was scheduled for return to work, 10 hours, at a very physical job, only 4 days after the shot. I realize that was my mistake because the first week back included the most miserable days of my life; so if you get one realize you will need some time off if you have a physical job. In the first 2 weeks my shoulder swelled so intensely it extended all the way down to my hand and I had trouble grasping things (so you know the amount of pain I described is standard following PRP and I’ve had 4 MD’s and a PA confirm this). Everything hurt, so, I became one with my ice pack. We were best friends.
After suffering through a miserable 2-3 weeks, I started to see some progress. I also realize if I hadn’t had to work so much, it probably would not have been as painful, but still. At about the 4 week mark, like clockwork, my shoulder started to feel better than it had in several years. I was able to raise my arm all the way up without pain, and able to return to my vigorous work and lifestyle. I was doing push-ups, side planks, and handstands and all without pain! It was a serious miracle. Truth be told I cried a little at my amazement with the results! I am now about 3 months out from the injection and so far, so wonderful! I could not be happier- seriously! There is only a little pain when I work out really hard with my arms, and obviously the torn ligament still clicks sometimes, but my shoulder feels awesome. I can do this now—————————*happy dance*
I’ve been asked many times since if I would do it again knowing what I would go through, and most patients end up getting 1-3. This is a tough question to answer- because it really was excruciating, but it was also incredibly helpful. I think I would need to be at a bad place again; where my shoulder hurt constantly and it prohibited me from being able to do my job, and yoga (which is also my job really). So, if you are considering it for a tendonitis, ligament or small muscle tear, or arthritis- I would make sure you have exhausted less painful alternatives without relief, and have a lot of pain in the area you’re considering. One patient I had complained of knee pain only when sprinting and asked me if I thought he should get one….umm, no dude! Now; if he had knee pain all the time and chronic patellar tendonitis and wasn’t able to do most of the things he wanted to do…well that’s up to him but I could see that scenario having a better end result.
Small disclaimer- the amount of pain depends on how strongly your body responds and how many platelets your blood produces. Which in my case was a strong response, and much more platelets than your average person- so of course, it’s possible for you to get one and have less pain than I experienced.
So, let me know if you have had one, are thinking about it, or have any other questions for me!
contributed by Dr. Katie Addis, DPT
www.howardluksmd.com › Sports Medicine