Public Perception of Platelet-Rich Plasma

Does the use of platelet-rich plasma by professional athletes, change public perception about effectiveness and application? While hundreds of sources (including this blog) have differentiated platelet-rich plasma therapy from steroid use and blood-doping, many remain unaware of the differences. Other posts on this blog explain the different aims and means of PRP compared to illegal substances used in sport. Thus, this post contends that in the current age of professional athletics, where fans' heroes may have cheated their games, the use of PRP by athletes may create public skepticism. While this may be considered a negative result, it also serves to build awareness about PRP and encourage further public investigation. Because the true beneficiaries of platelet-rich plasma will be the working and active public, it the duty of doctors and writers to properly fill the informational gaps that exist as a result of mass-appeal reporting on this therapy.

The public knows pro athletes rely heavily on their bodies ability to perform at intensely high levels. This has conflicting implications: fans know athletes need to be healthy to perform and they know some are willing to test ethical boundaries to gain a physical advantage. For the kind of money pro athletes compete for, few are surprised that these boundaries are crossed and many people are quick to jump to uneducated conclusions about PRP.

An example of these overly quick judgments occurred in December when Tiger Woods was implicated by many bloggers and writers, to having used steroids when he received PRP injections in his surgically repaired knee. CNN's Anderson Cooper accurately distinguished between the two soon after.

It could also be argued that the public perceives treatment effectiveness favorably when athletes credit PRP for their hastened return following injury. This also has negative implications because in such cases, PRP is used simultaneously with other accepted and experimental therapies. To what degree PRP was used in relation to other therapies and recovery procedures, is not reported. There is no way of discerning to what extent PRP actually influenced the recovery in these instances.

In the last four months alone, it has been revealed John Daly, Joakim Noah, Brandon Roy, Blake Griffin and Chris Canty all received PRP for various soft-tissue injuries. In this same time period, at least five legitimate, clinical studies have been published on platelet-rich plasma, with four indicating PRP is or may be effective.

The majority of media attention surrounding PRP however, does not focus on the clinical studies. The construction worker with chronic tennis elbow is then unaware that he may be back to work sooner because he does not require surgery. The mother of four living each day in pain due to Plantars Fasciitis, is unaware she may be able to soon get on the field and play with her children. Therefore, the medical community along with writers, must continue to publish PRP clinical studies and expose them to the public, regardless of supporting or negative outcomes.

PRP has far more potential to one day save jobs and improve people's lives than it does in professional athletics. While platelet-rich plasma therapy remains in development and should currently be offered as a last resort to invasive surgery, improving the flow of accurate information will bring future accessibility and sound judgment to the use of PRP.

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."