PRP = PED?

Listening to the radio the other day (on Mike and Mike ESPN 1050), Tiger Woods was being interviewed about his connection to Dr. Galea. As some of you may know, Dr. Galea was purported to have given performance enhancing drugs (PEDs) to professional athletes a few months ago. Tiger Woods denied any use of performance enhancing drugs but stated that he saw Dr. Galea for PRP or Platelet Rich Plasma therapy.

What is Platelet Rich Plasma?

To answer this question we must first understand platelets. Platelets exist in all human blood and are used to “clot” blood. Without platelets in your blood, a little cut would end in extensive blood loss and possibly death. People with impaired platelet aggregation have a condition called hemophilia. The important part of platelets, in regards to PRP, is that platelets also cause cell growth. This cell growth is necessary for healing a wound and to eventually close the wound. Platelet Rich Plasma is relatively new and innovative technique used by physicians to treat chronic and lingering injuries. The mechanism behind this technique is injection of platelets into the site of the injury which causes cell growth and repair. Recent research is mixed but some show significant improvements in the rate of healing.

This technique is usually used on people with long standing chronic issues that were not successfully treated with conservative therapy. Conditions such as tennis elbow, plantar fasciitis and Achilles tendonitis can be treated with PRP. PRP, however, is not a full proof procedure that is somewhat invasive. Minor conditions, such as these, can also be treated with simple physical therapy. PRP is performed by physicians usually in an outpatient setting mostly when physical therapy has was not successful.

So if PRP a Performance enhancing drug?

No, PRP is used just to increase the rate of healing without any systemic effect. Improvements in performance would be related to a decrease in pain and increase in functional strength. Maybe if PRP enhanced performance Tiger Woods would have won a major this year? 

OW My Tendon Hurts!

Tendinitis

What Exactly is a Tendon?
 Tendons are the tissues which connect muscle to bone. All muscles are connected to bone by a tendon and are integral part of the musculo-skeletal system. Tendons are used by the body much like ropes are. Ropes bare the load of an object in order to move the object through space. If you imagine a man pulling a rope in order to pull a bucket of water out of a well, you can imagine that the “man” as the muscle, the bucket of water as the limb, and the rope as the tendon. The man would never be able to pull the bucket of water out of the well without the rope. Likewise, the body cannot move without its tendons.

What is Tendinitis?
Tendinitis is a fancy word for inflammation of the tendon. Because the tendon is required to take much of the load of the limb it often becomes inflamed. This inflammation can be caused by a wearing away of the tendon or just irritation to the tendon. When dissected from the human body, a healthy tendon should look like a white “shoe lace”. An unhealthy tendon will look like a yellow “frayed” shoe lace. This fraying works well with the rope analogy we used before. As you can imagine repetitive stress along with poor body mechanics, unhealthy lifestyle, and age can wear away at this tendon and cause to be “fray”.

What can be done about it?
As a Physical Therapist, I encounter tendinitis everyday! Tendinitis can be easily treated. However, if tendinitis is left untreated and is repeatedly reinjured, it can become Tendinosis. Tendinosis is not just a fraying of the tendon but a progressive death of the tendon. Think of it this way, imagine the rope the man was using to pull up his bucket is grating against a rock, at the edge of the well. The rope begins to fray and begins to weaken. What do you think will happen to the rope if nothing is done about the progressive weakening of the rope? You guessed it! Rupture isn’t the only risk with tendinosis. Calcification of the tendon is also a possibility. Both of these outcome require much more than just physical therapy.

I don’t mean to scare you out there. Tendinitis is not a serious condition, but if left untreated and ignored it can become a big problem. Especially for those of you that are active in sport or life, tendinitis can keep you on the sidelines. Who knows when you are going to need to pull a bucket of water out of a well anyway!