Platelet-rich plasma for muscle injuries


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The current issue of the British Journal of Sports Medicine has a couple of articles on platelet-rich plasma therapy, the experimental treatment that made headlines thanks to the Anthony Galea scandal and its links to Tiger Woods and other famous athletes. It’s most commonly used (in sports circles) for tendon injuries, but Kimberley Harmon of the University of Washington takes a look at the evidence for its use in muscle injuries (the full article is available for free at the BJSM site). Her conclusions are pretty much what you’d expect:

There is theory and preliminary evidence regarding the effectiveness of PRP, but its use is still investigational. It is incumbent upon physicians using this treatment to disclose its experimental status and to follow outcomes in a structured way. Further studies are needed to establish the effectiveness, indications and protocols for using PRP in the treatment of acute muscle injuries.

In other words, nobody really knows yet — but if you’re a pro athlete whose livelihood depends on getting that muscle or tendon fixed, it’s probably worth a try.

What I actually found most useful in the article was that it starts with a clear, detailed description of our current understanding of how muscles heal on a cellular level — the carefully choreographed sequence of platelets, growth factors, cytokines, neutrophils, and so on. This is a topic I was looking into recently during the research for another article, and I would have loved to find such a clear explanation.

(As an aside, she discusses the role of prostaglandin E2, which is affected by non-steroidal anti-inflammatory drugs like ibuprofen: “Recent studies have shown that NSAIDs likely tip the delicate balance of regeneration versus fibrosis toward fibrosis (scar).”)

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