Platelet rich plasma (PRP) therapy has been gaining traction over the years as an alternative treatment for soft tissue injuries. Clinicians have also employed it to treat alopecia. Even aesthetic medicine utilizes PRP injections for certain types of applications. But what about combining PRP therapy with physical therapy?
When PRP injections are chosen as a treatment for soft tissue injuries, physical therapy can be a fantastic companion. The combination of injections and exercise can help promote healing, increase strength, and return full function to affected limbs. But it is not a matter of doing a few exercises here and there. There is actually a 4-phase protocol for combining PRP and physical therapy.
The Basics of PRP
Before discussing the 4-phase protocol, let us first talk about the basics of PRP therapy. It is an injection therapy rooted in the understanding that blood platelets come with a number of growth factors that medical science already knows are important to healing.
According to Lone Star Pain Medicine in Weatherford, TX, a PRP procedure is simple enough. The patient’s blood is drawn and then processed in a centrifuge to isolate platelets and growth factors. The resulting material is highly concentrated. It is injected into the injury site where it promotes natural healing.
The 4-Phase Protocol
Physical therapists in favor of PRP therapy generally follow a standard protocol for rehabilitation. This protocol applies to a variety of soft tissue injuries treated with PRP injections. The protocol is divided into four phases as follows:
Phase #1 – 0-3 days post-injection
Rehabilitation begins with complete rest on the day of the actual procedure. Over the course of the next several days, a physical therapist will recommend limited use of the treated area. Immobilization may be recommended, but not necessarily required. A therapist might also recommend gentle, passive range of motion exercises.
Phase #2 – 3-14 days post-injection
The second phase is designed to gradually increase patient activity and load bearing. If the affected area has been immobilized, it is expected that the patient will be gradually weaned from it. Patients are encouraged to participate in light activity while gradually engaging with more active range of motion exercises up to three times daily.
Phase #3 – 2-8 weeks post-injection
By the second or third week, a patient is typically ready to start the third phase: physical therapy. Therapy sessions might be 2-3 times per week with a focus on restoring function. Exercises are designed to strengthen affected tissues. As needed, cardiovascular exercises and core strengthening and balance training are added during this phase.
Phase #4 – 6-8+ weeks post-injection
The fourth and final phase progresses the patient to more intense exercises and targeted activities. Exercises will emphasize resistance, repetition, and frequency. Outside of therapy sessions, patients are encouraged to return to normal activities, but gradually.
Avoiding Too Much, Too Soon
One of the reasons pain medicine doctors encourage patients to follow PRP injections with physical therapy is avoiding the ‘too much, too soon’ syndrome. In other words, they want patients to gradually increase the stress they put on recovering tissues. If the tissues experience too much stress too quickly, any resulting damage could be worse than the original injury.
Physical therapy isn’t always recommended alongside PRP injections. But when it is, therapists prefer to follow the standard protocol. The protocol offers them a way to help patients regain strength and function without risking further injury.
When physical therapy is not necessary, PRP injections can still be helpful. They rely on encouraging the body’s natural healing function to do what it is already designed to do, but better.