Platelet-Rich Plasma Therapy

Using the body’s own healing properties

Platelet-rich plasma (PRP) has been a hot topic in the athletic world over the past several years. High-profile athletes have been making headlines by seeking out this cutting-edge treatment from local and international sports medicine physicians. PRP is not a new treatment. It has been used for years in maxillofacial, plastic and orthopedic surgery as an intra-operative measure to promote healing as well as bone and cartilage growth.

PRP is a treatment commonly used for treating arthritis, tendon injuries, tendinopathy, as well as muscle and other soft tissue injuries. It is also part of an emerging set of treatments that use the body’s own healing properties to promote health in the right patients. These treatments are often categorized as “orthobiologics” or “regenerative treatment/therapy.”

The importance of PRP comes in the form its healing and growth-promoting factors. Normal blood contains plasma and platelets that travel throughout the blood stream and spring into action when injury occurs. Platelets primarily promote blood clotting, tissue repair, healing and remodeling by triggering growth factors and cytokines from within their cells. PRP treatment utilizes a concentration of 3 to 5 times more platelets1 and 1 to 25 times growth factor concentrations2 than normal blood. This concentration is achieved by collecting the patient’s own blood and using varying filters and a centrifuge to generate the platelet rich solution. Based on the method of concentrating the PRP solution, there can be different concentrations of cells and growth factors. The “best” concentration is still under debate in the medical community as clinical studies are in the early stages of providing a definitive answer.

  1. Stafford H, Sandbulte Z. Platelet-Rich Plasma? Athletic Training & Sports Health Care. 2011; Vol. 3: No. 4: 164-167.
  2. Hall MP, Band PA, Meislin RJ, Jazrawi LM, Cadrone DA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009;17:602-608.

Platelet-Rich Plasma Therapy FAQ

First, blood is collected from the individual’s arm by using a syringe and needle—this can range from 10 to 60 mL based on the concentration of PRP desired. The blood is then put in a machine called a centrifuge, which spins the blood at high speeds to separate out the platelet-rich component. A numbing medication similar to Novocaine is often injected near the site being treated. After the area is numb, the PRP is injected into the injured tissue. An ultrasound machine is used throughout the procedure so that the physician can see the injured tendon and ensure the injection goes to the injured site. The whole process typically takes 45-60 minutes.

Most patients achieve successful outcomes after a single injection. In some cases, two to three injections may be necessary over time to facilitate healing.

While anytime a break in the skin occurs an infection can result, the likelihood with PRP injections is significantly less than 1%. As the PRP is derived from your own blood, there is no risk of blood-borne infections. PRP also has a strong antibacterial effect, so the risk of local infection is exceedingly low. It is normal to have pain after the procedure for an average of 3 days. Pain relieving medication like Tylenol is usually adequate to help with pain relief. Need for stronger pain medication is not expected.

PRP stimulates healing of the injured tendon. In several studies, patients report on average a 50% or greater improvement after 6-weeks, and up to 100% improvement in 12 weeks. While we cannot know how each individual will respond to the treatment, it may eliminate the need for more aggressive and expensive treatment options such as surgery or long-term medication use. Additionally, because PRP is minimally invasive, it can be done in the clinic and you can go home the same day.

Yes. You and your physical therapist will be provided with a post-PRP rehabilitation protocol, which will help ensure successful recovery. Early stages of the rehabilitation protocol will focus on protection for healing and gentle range of motion. The protocol will then progress through exercises, which will focus on strengthening and neuromuscular control. The final stages of rehabilitation will be focused on stability and progressively dynamic extremity control for sport/activity specific movements.

Most insurance companies do not currently cover PRP injections, nor is it typically considered a reimbursable expense, though you can submit it afterward to see if your insurer will reimburse you. The price you will be quoted includes the supplies, use of the ultrasound machine, and the procedure itself. There will be no separate charge for the office visit to your insurance or any copay to you. If a splint is indicated after the procedure (necessary for some cases), this will be at an additional fee or reimbursable through insurance.

  • Schedule initial PT visit for 10-14 days after procedure
  • Schedule physician follow-up visit for 3-4 weeks after procedure
  • Stop anti-inflammatory (NSAIDs) medications 5 days prior to procedure (e.g. ibuprofen, Aleve, Advil, Goody’s powder, etc.)
  • In some cases, you may need to stop blood thinners (e.g. Aspirin, Plavix, Coumadin, etc.) 7 days prior to procedure. You must discuss this with Sports Medicine physician, as well as your cardiologist or primary physician and obtain approval. Other daily medications may be taken normally as directed.
  • Arrange for a friend or family member to provide transportation for you on the day of the procedure. Post-procedure pain may interfere with your ability to drive.

Timelines are estimated based upon current literature and patient progress in formal physical therapy. Concomitant procedures may delay the timeframes listed below.

  • You will likely have pain after the procedure. Typically, pain lasts approximately 3-4 days, and gradually decreases thereafter. In some cases, the pain can last up to 2-weeks.
  • Do not expect immediate relief from the procedure. Tendons treated with PRP typically start feeling some relief between 4-6 weeks after the procedure. It typically takes several months, often 4 months or a little longer, to reach maximal improvement.
  • Ice is OK for the first 24-48 hours post-procedure. Use only if needed for pain control. Ice after this period is OK to use, but may slow the healing process.
  • Avoid heating the treated area for the first 3-4 days. Heat may increase inflammation, which will result in increased pain.
  • Avoid non-steroidal anti-inflammatories (NSAIDs) such as e.g. ibuprofen, Aleve, Advil, Goody’s powder, etc.. as well as Aspirin (unless you were taking a daily aspirin prior to the procedure, in which case, see below). These medications should be avoided for at least 2-weeks, preferably for 6-weeks if possible as taking these medications can interfere with the healing process.
  • For your pain control, you can take the prescription medication we provide, or Tylenol (Acetaminophen) if you prefer an over-the-counter option. Please only take these medications as directed on the label.
  • Avoid excess activity on the treated area for 2-weeks. Normal day-to-day activities as tolerated are ok. After the first 2-weeks, follow the rehab protocol provided along with any additional instructions provided by your physician.
  • If you are on blood thinners (Coumadin, Warfarin, Plavix, Pradaxa, Xarelto, aspirin), and your physician instructed you to hold these medications for your procedure, you may resume them 24 hours post-procedure.
  • If you develop fever, persistent redness and swelling at the site of the injection, please contact your physician as these may be signs of an infection.

Timelines are estimated based upon current literature and patient progress in formal physical therapy. Concomitant procedures may delay the timeframes listed below.