Ep. 114: Does PRP Work? & Other Sports Rehab Questions Answered
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More people than ever before are exercising to stay fit and active well into their senior years. The field of sports rehabilitation and therapy is flourishing as a result, with lots of therapies generating buzz. But which ones work for aging athletes, and which ones are a waste of money? Here, Medcan’s Chief Medical Officer, Dr. Peter Nord (pictured below) and the Director of Orthopaedic Surgery, Dr. Sebastian Rodriguez-Elizalde (pictured above), explore platelet-rich plasma (PRP) injections, prehabilitation, cortisone, hyaluronic acid and many more sports rehab treatments designed to boost your athletic performance, whether you’re 25 or 95.
LINKS
Arrange a consultation to see one of Medcan’s diverse range of sports rehab clinicians, including Dr. Peter Nord or Dr. Sebastian Rodriguez-Elizalde, at the Medcan website’s sports therapy web page.
On the Medcan Insight’s blog: Is Platelet-Rich Plasma Treatment Right For You?
Previous Eat Move Think episodes with master’s athletes:
Charlie Evans, who did a muscle up at 70, is in episode 100.
Keijo Taivassalo, 82, won his age group category at the Boston Marathon by 30 minutes. He’s in episode 93.
Management of osteoarthritis of the knee in younger patients. CMAJ
See some scientific research on PRP and prehab:
Effect of Prehabilitation Before Total Knee Replacement for Knee Osteoarthritis on Functional Outcomes: A Randomized Clinical Trial in JAMA 2022
Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review. Arthroscopy
INSIGHTS
Dr. Nord brings up PRP therapies: The PRP injection process begins with the collection of a small amount of blood from a patient. That sample is spun in a centrifuge to separate the liquid into its various components. Platelets are the growth factor-containing blood cells that promote clotting and healing. The platelets are then injected back into the patient at the site of the injured joint, to reduce the pain of an arthritic joint, or promote healing of chronic tendon injuries. “You get a return to a more natural milieu and a less inflamed and angry state of that knee,” says Dr. Rodriguez Elizalde. “A series of one to three injections could last several months, and for some people can be a year or two.” [08:57]
How does PRP compare to other injection therapies? Cortisone shots are a temporary way to manage pain and inflammation, particularly for those who come in “with a very hot, suddenly painful knee that needs to be treated immediately,” says Dr. Rodgriguez-Elizalde. “To really reduce that inflammation, there’s nothing better than a cortisone shot in the short term for that pain.” Hyaluronic acid is a more long term solution which “has a more rapid onset of action than PRP,” but “studies show that PRP can actually outlast hyaluronic acid when used and compared to head to head,” says Dr. Rodriguez-Elizalde. “If you've had an injection that didn't work, often trying a different type of injection could offer you relief. So it doesn't mean all injections are off the table.” [15:19]
Dr, Nord brings up stem cells, which have been generating increasing buzz over the last few years. “In Canada there’s been a moratorium on the delivery of stem cells,” says Dr. Rodriguez-Elizalde, describing the buzz that exists around the therapy as similar to what existed around PRP 15 years ago. “A lot of clinics were selling stem cells as a cure for everything,” Dr. Rodriguez-Elizalde says. “But there’s not a good definition of what is a stem cell… so people have to understand where these cells are coming from, and what they’re capable of.” Finally, Dr. Rodriguez-Elizalde says, “You can put stem cells literally anywhere via injection or infusion, but it doesn't mean it's actually going to treat that problem. So I think it's with guarded anticipation that we can look forward to medical advances in stem cells, and their applications towards either chronic disease, or in acute injuries. I don't think we're quite there yet.” [20:10]
Let’s talk a little bit about how to get the best benefit from rehab surgery, says Dr. Peter Nord. Starting rehabilitative treatment before surgery, or “prehab,” which sees you increasing strength, aerobic fitness and overall flexibility, can make a huge difference in your surgery’s success. “Eighty percent of your recovery is going to be dictated by your pre-habilitated state,” says Dr. Rodriguez-Elizalde, meaning, the state of your fitness, flexibility and strength before your surgical procedure. Even before surgery, “your knee will feel better if you bike a few times a week, if you do these stretches, if you build muscle mass, that chronic knee pain that you're complaining to me about.” [32:49]
Dr. Nord and Dr. Rodriguez-Elizalde provide a series of tips at the episode’s end to help aging people avoid injury. The big one, they say, is to stay active by taking part in numerous different types of exercise. Aim for seven times a week, says Dr. Nord, so that if you miss a couple fitness sessions a week you’re still getting four or five. Both docs advocate for strength training on top of aerobic fitness. “Previously… lifting weights was something considered for 20 or 30 year old males in a gym,” says Dr. Rodriguez-Elizalde. But weight training gets more important as you age to preserve muscle mass. “It's imperative, especially [for] women, to do it on a semi-regular basis.” He suggests weight training two or three times a week. “It can be light, but it has to be more than just your body weight.” [40:00]
Medcan chief medical officer Dr. Peter Nord (below).
*LEGAL
This podcast episode is intended to provide general information about health and wellness only and is not designed, or intended to constitute, or be used as a substitute for, medical advice, treatment or diagnosis. You should always talk to your Medcan health care provider for individual medical advice, diagnosis and treatment, including your specific health and wellness needs.
The podcast is based on the information available at the time of preparation and is only accurate and current as of that date. Source information and recommendations are subject to change based on scientific evidence as it evolves over time. Medcan is not responsible for future changes or updates to the information and recommendations, and assumes no obligation to update based on future developments.
Reference to, or mention of, specific treatments or therapies, does not constitute or imply a recommendation or endorsement. The links provided within the associated document are to assist the reader with the specific information highlighted. Any third-party links are not endorsed by Medcan.