Adam’s Journal
Almost six months ago, I suffered a hamstring injury while running. It is no exaggeration to say that (caution, Dad joke ahead) it’s been hamstringing me ever since.
I’ve tried rest, cross-training, stretching and rehab exercises, but nothing has seemed to work. A friend recently suggested a platelet-rich plasma injection. What do you think?
Dr. Scofield Prescribes
Platelet-rich plasma (PRP) treatment involves taking blood from a patient and harvesting certain components of that blood – platelets – that are known to promote healing. Those platelets are then reinjected into the site of an injury, with the theory being that they’ll help promote healing.
Use of the treatment soared after a number of high-profile athletes, including Tiger Woods, reported that the treatment had repaired their injury. But anecdote is one thing, and careful clinical study is another. And when researchers have conducted randomized clinical trials to investigate PRP’s effectiveness, the results have generally not been promising.
For example, in a study of nearly 300 people suffering from knee osteoarthritis, participants were either injected with PRP or a placebo of saline solution. (Neither the participants nor their physicians knew which they were getting.) After a year, the two groups didn’t show a significant difference in symptoms or joint structure.
Scientists led a similar trial in people with injured Achilles tendons, which connect the calf to the heel bone. After six months, those injected with their own plasma showed no difference from those who’d been injected with a saline placebo.
Most relevant for you, scientists have also conducted a randomized trial in 90 professional athletes with hamstring injuries. Once again, they found no benefit to PRP injections.
Notwithstanding the lack of rigorous scientific evidence, the treatment remains widespread. This is true even though insurance companies will not pay for the procedure, which can cost more than $1,000 per injection.
There are some studies that have shown some positive results. And it is possible that PRP has different effects on different injuries or that certain techniques can make the procedure more effective. It is also possible that, while the therapy is not effective in general populations, it can work for certain individuals.
In other words, we don’t currently have scientific evidence that PRP works. But we can’t definitively say it can’t help some people under certain circumstances.
Against this backdrop, I can’t say I’d recommend PRP for your hamstring. However, the clinical trial that looked at hamstring injuries does contain what I’d call a silver lining: It noted that intensive rehabilitation remains the primary way to return to physical activity following a muscle injury.
In other words, time to head to physical therapy. It may not be a silver bullet, but it’s a tried and true path to healing sports injuries.
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Adam Cohen is OMRF’s senior vice president and general counsel. Dr. Hal Scofield is a physician-scientist at OMRF, and he also serves as Associate Chief of Staff for Research at the Oklahoma City VA Medical Center. Send your health questions to contact@omrf.org.
