From the Sports Protoscience Files: PRP Therapy
PRP user Tiger Woods (public domain photo)
Want to get rich quick? Come up with a plausible-sounding medical therapy, get a few high-profile professional athletes to try it out for you, charge cash only (since insurance companies don’t pay for it), and become wealthy.
And that’s just what a lot of sports doctors, chiropractors, and other real and quasi medical professionals are doing. Their therapy of choice? PRP, platelet-rich plasma. You take your own blood, centrifuge out the red blood cells, and inject the resulting platelet-rich plasma into an injury. The idea is that the heavy concentration of platelets should accelerate healing.
Superficially, it sounds a lot like blood doping. In blood doping, an athlete takes his own red blood cells, stores them while regenerating, and then re-introduces them into the bloodstream before a sporting event. The resulting high concentration of red blood cells temporarily boosts the blood’s ability to carry oxygen, and enhances muscle endurance. Because it actually works, blood doping is prohibited by WADA (the World Anti-Doping Agency).
On the same theory, WADA banned PRP in 2010, just as it was beginning to get some traction among athletes and a few small trials found that it successfully improved healing. Some experimented with its use as a performance enhancer. But then science caught up. Outside magazine reported that two large trials found PRP worked no better than placebo injections for injury recovery; and WADA duly removed PRP from their banned substance list for 2011, basically acknowledging that there are no performance enhancing benefits:
Platelet-derived preparations (commonly referred as PRP or blood spinning), prohibited in 2010 when used by intra-muscular route, have been removed from the List for 2011 after consideration of the lack of current evidence concerning the use of these methods for purposes of performance enhancement. Current studies on platelet-derived preparations do not demonstrate potential for performance enhancement beyond a potential therapeutic effect.
As far as its use for injury recovery, the theory of PRP is generally sound, and the research does show a certain amount of promise. But if your sports medicine guy offers to lighten your wallet for a PRP-based performance enhancer, walk out the door — it’s pretty clear that it’s bogus. If he offers it for injury recovery, I’d probably still walk out the door. For now, PRP should be limited to experimental trials. The evidence is just not there yet.
It’s that simple? Damn I need to quit my job and work full time on a scams like this.
No you need to be a doctor to administer this.
Right, scammers without a medical degree should stick to sugar pills and water, which anyone can sell. In the US you have to be careful to market them as supplements, and make no claims of efficacy for any purpose whatsoever, but it’s remarkable what you can get away with not-quite-saying.
Supplement labels can make vague claims, and homeopathy labels HAVE to list indications. That’s why Oscillo is sold as “homeopathic medicine for headache, body aches, chills, and fever.”
And manufacturers of FDA approved pharmaceuticals often hide the reports which show adverse effects of their drugs. I’m sure a lot are like Merck who pays “unbiased doctors” to send letters to editors telling them that the HPV vaccine is totally safe.
Max, just when you think it’s safe to believe Dunning, he’s reporting … well, industry talking points on fracking over at Skeptoid. File this URL away in your anti-Dunning talking points.
Brian, how can you even discuss fracking without mentioning the 1987 EPA study that saw the light of day this summer?
http://skeptoid.com/episodes/4275
And, my take on that 1987 EPA study:
http://socraticgadfly.blogspot.com/2011/08/water-fracking-is-happening.html
Folks, if you want the truth on fracking, or at least more of it than Dunning will give you, read Chris Mooney. Go to western magazine High Country News at http://www.hcn.org.
Outside magazine reported that two large trials found PRP worked no better than placebo injections for injury recovery
Should that be “for performance enhancement”? The next paragraph certainly sounds like it.
No, it’s correct, sorry if I wasn’t clear. It was late. :)
Actually, it sounds more like Prolotherapy with the “blood doping” part added.
In fact, I asked a friend who is one of the top Prolotherapy practitioners in the world about PRP. He said, “The plasma thing is just a bunch of hand waving… but it’s amazing that they got the insurance companies to cover it, when they won’t cover Prolo.”
A therapy like PRP provides a nice cover for dispensing illegal performance enhancing drugs which actually work. See Anthony Galea, for the leading example.
Tiger Woods is frantically paging Galea as we speak.
If anything I would expect more scarring rather than “increased healing”. I can’t imagine how the formation of more fibers or the quicker formation of fibers would promote quicker healing.
There are many things you don’t know.
But the list of things I don’t know simply do not compare with your grand ignorance of reality.
You’re just mad that you’ve never heard about prolotherapy before therefore you have no clue whether it works or not. You’re mad because you had to read so much about it to get yourself up to snuff. You’re mad because you know of no one who has ever had prolotherapy. So who is the ignorant one?
You’re the ignorant one Sheila because you have no evidence in your favor – only empty claims, and claims which even a biology freshman should see as nonsense. Prove you’re not an ignoramus: SHOW US THE EVIDENCE.
Actually you are because you have no clue whether prolotherapy works or not, but you seem to have an opinion.
Oh, poor poor Sheila – you obviously think you’re the clever one (though you give the opposite impression). I’m still waiting for your evidence for this therapy of yours. You see, I’ve dealt with hundreds of people like you in over 3 decades. Others will typically point out crackpot publications or (far more rarely) really bad papers which somehow made it to print in a more reputable journal (for example, Wakefield’s nonsense in The Lancet). However, you seem to be the type who doesn’t even bother to point to a crackpot article. How is anyone to take you seriously when you only whine about how something works and cannot provide credible evidence?
Oh you’re that weirdo that sits in his basement all the time and never talks to anyone, aren’t you?
Still waiting for that ‘evidence’ of yours Sheila.
Since I already posted it I guess you can continue sitting in your stench in your basement.
I know of many people who have paid for prolotherapy. Do you know why that is? Because it works. And that’s why it’s used on athletes and paid for by the companies that own them. But you people keep on hoping that through your medical insurance you’re going to get better, LOL.
And quasi is my damn work (as in quasi scientist) get your own.
You’re selling hokum. Where is the evidence for your claim that “it works”? Having numerous wealthy clients and their testimonials is no proof of efficacy. Even now the “Power Bands” are incredibly popular despite the fact that they’re pure nonsense.
Look it up in your peer reviewed medical magazines, moron. I can’t do your homework for you.
Plus dingdong, I’m not selling anything.
You could replace “prolotherapy” with the name of any other nostrum and find someone on the internet saying the exact same thing. And it’s not any more persuasive when anyone else says it.
Brian’s review of the literature seems to indicate there is very little evidence to support prolotherapy, either as a performance enhancer or to help repair injury. If you know of any strong evidence, why not post a link for us?
That’s what google is for. But since you asked I’ll come back and tell you later.
Case # 237416
32 year old male struck by arc of lightning while chaining up truck during a storm. He awoke with blood coming from ears and arc seems to have gone through his shoulder and out his foot. Radio was fried in truck. He went to the hospital and after numerous tests was told that he has lost 50% and 90% hearing. He also suffered from migraine headaches daily. It was intolerable for him to be around people because the noise bothered him. No help from the regular medical community, they could do nothing for him. He tried prolotherapy and regained most of his hearing after just one session and only suffers from regular headaches on occasion.
His quality of life has improved tremendously.
That’s a nice fantasy, but:
1. what is your source for that story
2. where is the evidence that your pet therapy works
As I noted in other posts, the odd testimonial (even if a genuine testimonial, which you have not established here) is no proof of efficacy.
My source is personal and I will not reveal it. I guess I’ll ask him if it works considering he went from migraine headaches everyday to only having occasional regular ones. Yes I’m sure he wished he could go back to the days of not being able to hear – since he did suffer for 2 years before receiving prolotherapy. The proof is in the pudding. And I really don’t give a crap what you think.
Interesting. (1) Platelets are not specifically designed to heal; rather, in layman’s terms, they form a plug to stop bleeding. (In pathological states, they form a plug that causes a heart attack or stroke.) The platelet doesn’t do any actual healing. (2) As a component of blood, plasma carries a number of proteins, free cytokines, and whatnot throughout the body. It is not directly involved in healing as such. The healing of an injury is a complex process involving a number of types of inflammatory cells as well as the cells of the injured tissue itself and stromal supporting cells. I don’t see how the plasma (with or without platelets) would do much of anything.
Now here’s a real scam promoted with golfer endorsements in Golf Magazine…
http://www.golf.com/golf/equipment/article/0,28136,1917529,00.html
Hmmm … I’ll have to work with some retired ex-top-level golfer and introduce the Quantum Ionomagnetic Shirt to improve those swings… It’ll crap all over anything The Shark has to offer.
I will be of no help to you, but I’d like a 5% finderd fee.
I understand how doping would work in a bike race or a marathon, but would it help with golf?
Absolutely. Among the many drugs banned for example, are various painkillers. If a golfer is suffering from a sprain or other painful inflammation which would interfere with the game, doping helps.
“Doping helps” those are pretty powerful words from the unwise. Do you realize that people can get addicted to painkillers? Oh I forgot, you never thought that far ahead.
Shooting under par and being addicted to painkillers are not mutually exclusive.
Sheila, you’re an ignoramus and an idiot to boot. Not every painkiller is addictive, so your claims are on par with your others: devoid of sense or fact.
Which painkiller is not addictive?
Advil is not addictive.
Ibuprofen is only one example of a long list of painkillers which are not addictive but which is banned from many sports events or at least requires approval of dosages etc by the regulators.
Advil is addictive and so is ibuprofen. Nice try. Did you get that information from the manufacturer of those drugs?
Gee Shelia, where do you get your ‘facts’ about drugs? Do you look at what ‘Big Pharma’ and the Guvmint says and assume the opposite must be true? You’re obviously one of those kooks who believes the ‘Big Pharma’ conspiracies. Although Big Pharma can indeed be evil (hell, they’re the biggest pushers of ‘supplements’) they don’t lie about absolutely everything.
The information came from doctors, dumb dumb. You know, those people that have to treat painkiller addicts.
Prescribed painkillers are banned? I just saw Novak Djokovic take painkillers for his back during the final match against Nadal.
Numerous over-the-counter painkillers are banned from the Olympics, not only prescription ones. Different sports have different rules; the Olympics is one of the most rigid. I don’t know the rules for tennis.
Could psychiatric drugs like Xanax and Ritalin enhance performance in golf?
No, but it reduces the pain of the spectators.
Maybe you can steal some ritalin off of your daughter.
Do you have any links/evidence to support your side of the PRP topic Sheila? Seems like all you are doing is trolling – calling people ‘ignorant’, ‘moron’, ‘dingdong’ and just generally insulting peoples intelligence. Maybe it’s time to put up or shut up?
Yes I do a personal case who is dear to my heart.
And we’re still waiting for that evidence.
Sheila, that’s called an anecdote. One case, without controls, for which you refuse to provide any details. And you expect anyone to be convinced?
Would you like to buy some bear repellent?
Nah, bears don’t scare me. I don’t care if you’re not convinced. That’s really not my concern. I’ve only posted it for open minded people. So I guess that excludes you.
Your personal experiences do not equal truth, so when others ask for evidence, they expect more then snide comments and rhetoric.
Looks like there might be a troll lurking about.
That’s not very nice talking about yourself that way.
Intentionally injecting excess platelets into your blood stream? So um, why to we as a society spend so much money trying to decrease platelet functionality?
Yes I know I am glossing over lots of details but this just seems like injecting an embolism. Hooray for blood clots.