Scott Webb: If you've ever had tennis elbow, you
probably wondered if you could speed up the recovery time. Well, you can using
platelet-rich plasma and this treatment option even has uses beyond sports
injuries. And here today to help us understand PRP and its various uses and
benefits is Dr. Catherine Reese. She's a primary care sports medicine physician
with Franciscan Health Sports Medicine.

This is the Franciscan Health Doc Pod. I'm Scott Webb.
Doctor, thanks so much for your time. We're talking about platelet-rich plasma
for athletes. But before we get started here, let's just set the scene for
listeners. What exactly is platelet-rich plasma?

Dr. Catherine Reese: So platelet-rich plasma comes
from your own blood. So basically, what we do in the office to get platelet-rich
plasma is we draw the patient's blood, take it out, spin it down in a
centrifuge and then take out the part that is really rich in platelets. It's a
concentrated platelet product and that is rich in growth factors, proteins,
cytokines, and other molecules, which are really important in tissue healing.

Scott Webb: Which seems like it would be particularly
relevant and important to athletes. So when and why, like how is it used
specifically in practice on athletes?

Dr. Catherine Reese: We'll often use it in an
overused tendon injury, is one of the main considerations for it. And an
overused or diseased tendon is one that gradually over time starts to thicken
and starts to get a little bit disorganized. So one way I used to explain it is
that when we're born, our tendons are all like a brand new box of spaghetti. So
everything's nice and aligned and straight. And then kind of gradually over
time as we age, as we continue using those tendons, as we overuse those
tendons, our spaghetti gets cooked a little bit. It starts to get a little bit
disorganized. It starts to get a little bit thicker. That's not necessarily an
inflammatory process.

So it doesn't necessarily always trigger our brain and our
body to go into that tendon and heal that up. And then over time, that can
cause pain. What the PRP does is you go in and you actually kind of rough that
area up with a needle a little bit. You poke that tendon with a needle to
recreate an injury of a diseased tendon, and then you inject that PRP, which
supports the healing process.

Scott Webb: That is undeniably cool. I am just
listening to you taking this in, and that is really cool. And I can sort of
picture what you're saying that, you know, as we get older the spaghetti gets a
little twisted and turned, but the body doesn't say, "Hey, there's
something wrong. I should go fix that." So you have to sort of create
that, recreate that and say, "No, there's something wrong here. And now,
here's the PRP. Go fix it," right?

Dr. Catherine Reese: Exactly. You can do it without
the PRP. But with the PRP studies, it has shown to have a little bit extra
benefit to healing that tendon.

Scott Webb: That is really fascinating. And I'm
wondering are there uses for the general public that aren't athletes, haven't
suffered, you know, some catastrophic injury? Are there other ways in which you
use PRP?

Dr. Catherine Reese: Actually, PRP is used in a lot
of different fields now. It's used sometimes with surgery. It'll be given at
the same time as surgery, maxillofacial surgery. It's commonly used in
dermatology at this point, in terms of skin rejuvenation procedures.

Scott Webb: And who benefits the most when we talk
about PRP? We've talked a little bit about, you know, athletes and other
general uses, but really who benefits the most from the use of PRP?

Dr. Catherine Reese: I would say it's that person who
has been trying all of the rest of the things. It's someone who has done
physical therapy and tried the anti-inflammatories and tried resting, and
really isn't able to get their musculoskeletal injury to be back where they'd
like to get in terms of fitness. So that's the person that we typically start
having conversations about PRP or other options with.

Scott Webb: And is this a widely accepted enough
that, as you say, people who haven't suffered some sort of major injury, but
want to explore this possibility, possibly use PRP? I guess I'm asking are
there some insurance complications?

Dr. Catherine Reese: There are insurance
complications. So in studies on PRP, it's been kind of mixed in terms of
whether PRP is helpful or not. And a big part of that is actually the numbers
in the studies on PRP. It's a lot of smaller studies and there's a lot of
different ways to prepare PRP and different protocols to do afterwards. So it's
kind of like trying to compare apples to oranges in a way. It's all PRP, but
it's done very differently. So it's hard to come up with like a big study that
actually explains how PRP works.

Insurance companies, every person would have to check with
their insurance company individually. There are some randomly that will cover
it, but I would say most of the time it is a cash fee.

Scott Webb: So we frame this today as a discussion
about athletes, so let's talk about the process for them in terms of diagnosis,
treatment, what can they expect, how soon after the PRP treatment can they get
back on the court, back on the field, that sort of thing.

Dr. Catherine Reese: Well, let's give an example of
tennis elbow and I'll kind of walk you through that example because that's one
that is a little bit more accepted in terms of the studies as well as being
helpful. So if someone comes in with tennis elbow and we look at them and
they've already done occupational therapy, which is elbow therapy, and they've
already tried resting and working back into their activity, and they're not
able to do that. Typically, what I would do is I would set up an appointment
with them explaining the whole PRP process. If they've been on
anti-inflammatories, we actually have to have them stop taking anti-inflammatories
for about 10 days before and then four weeks after the procedure, because you
want that inflammation. You actually want that process to occur.

Scott Webb: Yeah, one of the few times you would want
inflammation, right?

Dr. Catherine Reese: Exactly. And then things like
blood thinners and aspirin. Aspirin is okay if someone has a heart condition or
something like that. But blood thinners, we'd typically ideally have someone
stop as well. Then the day of the procedure, they come in it's about an hour
long, so we draw the blood, spin it down in the centrifuge. While it's spinning
down, we go in in the area that we're going to be injecting the PRP, do a
little bit of that needling into that tendon to create that reinjury, it'll
already be numb though. And then inject that PRP into the area right away after
it's ready to go.

Usually, someone's pretty uncomfortable for about two to
three days. You think about it, you've just recreated an injury in their elbow.
So typically, we would use a sling for the first couple of days. And then the
next two weeks is just kind of doing some range of motion stuff and trying to
get back into regular activity. I would say most of my patients after the first
week, they said they felt a little bit more back to normal and then, gradually
from there, started to improve.

Scott Webb: Yeah, it's good to know that they're not
down and out for too long. And, as you say, right, you you've recreated an
injury, so there's going to be some healing and then some discomfort and maybe
some pain, but they'll get over it and they'll get better. And I'm glad you use
the tennis elbow analogy because I think we can all identify that even if it
wasn't caused by tennis, we all sort of know what tennis elbow is. We know what
that feeling is. Doctor, as wrap up here today, anything else you want to tell
people about platelet-rich plasma for athletes or anybody else?

Dr. Catherine Reese: So PRP will often take up to
three months to even 12 months to get the full benefit from, I would say three
months is kind of that magic number in terms of looking at the literature,
looking at the studies to get that full benefit from it. So it's not like an
immediate magical cure. The goal of PRP is going to create longterm healing. So
it's not a quick fix, like a cortisone injection. It can take that three months
to really notice the improvements.

Scott Webb: Doctor, this has been educational and fun
and really interesting. So thanks so much for your time and you stay well.

Dr. Catherine Reese: Thank you. You too.

Scott Webb: For more information, visit YouTube and
search platelet-rich plasma therapy, Franciscan Health. And if you found this
podcast helpful, please share it on your social channels and be sure to check
out the full podcast library for additional topics of interest. This is the
Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next
time.