Platelet-Rich Plasma (PRP) Injections

Shock and awe is how I would describe my experience at Regenexx. Start to finish, I was out the door in three hours. When I entered the facility, the first thing I did was give blood through a butterfly needle.

If you have ever donated blood for Red Cross, it is the same experience but significantly shorter in duration.

Let us back it up, why do they need the blood in the first place? Platelets, also called thrombocytes, clot to repair the body after an injury. The platelets contain the proteins in the blood that help your injury heal. In this instance, platelets will serve as a rebuilding agent throughout the shoulder. The doctors needed my blood sample to inject back into my injury site. Instead of surgical intervention, platelets can support cell growth in my labrum and throughout my shoulder. Crazy, right?

What I found interesting is that they did with my blood… A blood transfusion into my shoulder would not help me. However, in Regenexx’s office they have a lab wherein they utilize proprietary processing techniques to create the right concentrations of blood. After I gave blood in the morning, a trained laboratory technician, custom-processed my platelets in their orthobiologics laboratory. Because the platelets secrete substances called growth factors, which can serve to stimulate tissue regeneration increasing the concentration has the potential to serve as a catalyst during the recovery process.

This concept was brand new to me but has long been present in the medical community. PRP was first used after an open-heart surgery in 1987 in the form of autologous blood transfusion. PRP can positively affect post-operative blood loss and infection.

Tyler, what is that? -- Autologous blood transfusion is the collection and re-infusion of the patient’s own blood. Homologous blood transfusion is the collection of a compatible donor’s blood and infusing that into the patient.

The onsite orthobiologics laboratory is a major differentiator. Other companies in this field will use a one-size-fits-all bedside centrifuge to process all samples. These centrifuges treat all samples the same and as a result can produce sub-optimal results.

The Platelet-Rich Plasma produced by centrifuges contain red blood cells, which have the potential to cause significant irritation and inflammation.

After an hour and a half, I was called back to the facility to begin my PRP injection. The doctor begins with a nerve block, to reduce any potential pain. It did not hurt at all! Your arm tires quickly, so the attending physician has to hold your arm throughout the process. This is a common occurrence.Get your popcorn ready because you will be on full display. My shoulder was shown on the ultrasound screen. You can watch the entire procedure or fall asleep, whichever you prefer. For me, I wanted to ask every question under the sun and know exactly where the platelets were injected and why.

Tendons naturally anchor to the bone, repetitive overuse, or in my case a sports injury can cause tears. The injured tendons heal by scarring but this is typically at a slower rate compared to connective tissues. The scarred tendons increase the risk of re-injury.

This is what my view was like during the entire process 

Fully stocked and scrubbed to prevent infection  

Letting the doctor weigh in:

Tyler, I did see some arthritis in your joint. Often the arthritis appears as bone spurs or osteophytes and calcium deposits within the tendons of the joint. This is a compensatory response of the body because of the instability of the joint. We inject platelets or stem cells into the supporting ligaments to strengthen the core of the joint as well as into the joint to help with inflammation of the cartilage. I also inject platelets into the tendons when I see evidence of tears or weakness of the tendons. The goal of the treatment is to strengthen and stabilize the joint by increasing the strength of the ligaments. Repair the tendon damage by injecting platelets into the tendons as well as remove calcium deposits and decrease inflammation of the cartilage by injecting platelets into the joint itself.  

Arthritis, this early. SHEESH.

What if I had chosen the surgical route?

I would have significantly higher out of pocket expenses. Further, my healing timeline would be significantly longer. For 10 days poster operative, I would be completely immobilized. I would have been in a sling for 6 months. It would have taken 8 months before returning to athletic activity.

Day 1:

My arm still felt the lingering effects of the nerve block. Contrary to after surgery, Regenexx recommends moving your arm around. It was stiff but I had no pain and made an effort throughout the day to be act. Honestly, I was very surprised. I expected a lot more pain following the injection.

Oh and guess what? NO PAINKILLERS. Zero, zilch, none. Talk about a change of pace. You are also advised against taking a Nonsteroidal Anti Inflammatory Drug (NSAID), for example, Ibuprofen. Thinning the blood is detrimental to the healing process. 

Day 2-7:

 Still stiff but no real pain. I spent a majority of the week figuring out my shoulder’s limit. To alleviate stiffness I found myself lifting my arm straight up and out to the side throughout the day. Motion created warmth in my arm and started to bring me back to normalcy. Usually I avoid sleeping on my injured side but I tested it out and felt no discomfort or pain. I felt that I was starting to feel the healing effects of the injection.

Day 7-21:

 Back to Physical Therapy, everyone’s favorite! Strength was my biggest issue, I still felt weak when moving things around the house or adjusting anything overhead. I spent a lot of my focus on working compact movement to put full weight on my shoulder. I was doing a lot of band work to make sure my back and core were supporting my shoulder. My goal was stabilize my shoulder and feel confident about using my right arm.

Day 21-30:

I used to have latent pain; it felt worse at night and made it hard for me to sleep. Frequently, it would hurt throughout the course of the day. My other muscles were overworking and it was causing my back to knot up. I feel good now; I can even sleep on my right side. I have not been able to do that since the injury occurred. I still have to continue with strengthening exercises but in my mind, I am through the woods.

The reason why I wanted to share my experience because I know I am not alone. Soft tissue injuries are prevalent throughout the United States. PRP and other offerings should be public knowledge. The surgical route is not the only option.

Questions or feedback? Feel free to message me.