Tuesday, December 29, 2009

Differentiating "Blood Doping" and "Blood Spinning"

Platelet-Rich Plasma Therapy (PRP) has begun to adopt the appropriate title of "blood spinning." This post aims to differentiate that label from "blood doping," a separate treatment performed for a completely different purpose. While a blood transufussion means of doping relies on an athlete's blood being spun in a centrifuge similar to PRP, the materials being extracted from the centrifuge are different in both procedures, with seperate uses and intentions. Simply stated, PRP aims to repair soft-tissue tears naturally, blood doping attempts to enhance red blood cell counts artificially.

PRP is the removal of a small amount of blood from a patient with a soft tissue injury (tendon, ligament, muscle, etc.). The blood contains healing components called platelets that release growth factors used by the body to grow and create cells. These platelets are not normally used by the body in large enough concentrations in such injuries. Patients' blood is thus spun in a centrifuge, which extracts these natural platelets. The platelets are then concentrated in a specific dose and injected directly into the injury, catalyzing the body's natural healing abilities. This entire process takes roughly an hour.

If you were trying to fuse a split 2 x 4 with a small drop of wood glue, it may stick momentarily, but when used, it would be unstable and likely break again. PRP gives the woodworker the entire bottle of wood glue to fuse the split wood. The process is very safe with almost no risk of side effects because the platelets are natural and come from the patient. The World Anti-Doping Agency (WADA) has approved the use of PRP in all soft tissue excluding intramuscular injection. When injected directly into muscle, it is possible PRP can enhance growth, thus creating a similar outcome to steroid use.

PRP has been widely used in professional athletics and deemed a legal form of therapy for soft tissue tears and tendinitis but the therapies true potential lies in healing injuries for the weekend warrior and the construction worker with a torn elbow tendon.

"Blood Doping" of the other hand has various means and a multitude of procedures, all with the same intention: to increase red blood cells in the blood stream. It has been deemed illegal by WADA, the International Olympic Committee and International Cyclist Union and can have life threatening side effects. Red blood cells carry oxygen to muscles and increases red blood cell count resulting in oxygen being taken to muscles more efficiently. This gives aerobic athletes a significant advantage over competition as they battle less fatigue.

While red cell counts can be increased naturally by training at high altitudes where less oxygen is present, blood doping gives athletes an increased and illegal boost. To gain the higher count through doping, athletes inject themselves with erythropoietin (EPO), a hormone that stimulates red blood cell production. EPO has been pervasive in the top levels of cycling for the past two decades. Because it thickens the blood, it has dangerous side effects such as blood clotting that can cause heart attacks and strokes. An abnormally high red blood cell count can also result in impaired blood flow and death.

Athletes can also have four units of blood removed a month prior to competition and spun through a centrifuge to remove the red cells. Three weeks later, the concentrated red blood cells are transfused back into the athlete. Thus, the blood spinning is inherent to this process but the material being collected is unique and for a different purpose.

If PRP is the wood glue that reconnects the severed 2 x 4 making it once again useful, blood doping is taking a pristine 2 x 4 and infusing it with graphite for artificial strengthening.

Where PRP is described as "blood spinning" it should not be confused with or categorized as "blood doping."


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