Have you ever sprained your ankle or pulled your hamstring? Have you ever been injured during a car accident? Maybe you have slipped and fallen on your backside and tried to catch yourself and also sprained your wrist. All of these kinds of injuries are called acute injuries that are caused by trauma or occur in a short amount of time. Chronic injuries are different, they are due to overuse or a disease process that takes time to set in over a longer period. Acute injuries most often happen when people are out and about either playing sports, or participating in outdoor activities such as hiking or biking, or accidents that take place at home or in a vehicle.
Injuries due to trauma take time to heal. In most cases, the time frame for acute injuries to return to post-injury status is between 6 to 8 weeks. However, stiffness and pain can persist for 6 months and up to 1 year. This can be attributed to how the body remodels the damaged tissue. In order for the body to try and get back to full function it attempts to heal as quickly as possible. This quick healing can be good and bad at the same time. The good part of healing quickly is that the damaged tissues have been repaired and “sewn” back together. The bad part is that because the healing is done quickly the body repairs the tissue by connecting it in any manner it can, so it looks like a cross-stitch instead of lining up the fibers to the original orientation. This is what leads to scar tissue which then leads to the feeling of stiffness and pain because the repaired tissue is unable to stretch and move like the tissue used to. The overall feeling that an injury feels like it is taking 6 months to a year to heal is because the rehabilitation
of the damaged tissue is being done over a long period of time. This is why sometimes people do physical therapy to rehab an injury more quickly. However, there are other options to aid in the healing process.
Traumatic injuries don’t make up a lot of visits to the hospital, but there are still a large number of people who are admitted to the hospital because of acute trauma. Most of the time those who do not seek care at a hospital are because the injuries are self-limiting, meaning that there is no need for immediate medical intervention. The types of injuries that have been mentioned above, sprains and strains, are the most common injuries in athletics and outdoor recreation. There are other injuries too such as tendonitis, fractures, dislocations, and concussions. We will focus more on the sprains, strains, tendonitis, and dislocations for the applications of PRP and ozone.
Each of these examples of traumatic injuries has similar traits. Sprains, strains, tendonitis, and dislocations all have an aspect of tissue tearing. Strains and tendonitis are the tearing of muscle or tendon tissues. Strains are acute injuries, more commonly known as muscle pulls. Tendonitis is more commonly a chronic overuse injury but it can increase and become acute with the onset of inflammation and pain due to the constant micro-tearing of the tendon. Tendons attach muscle to bone. Sprains are tears within ligaments. Ligaments attach bone to bone and surround joints. In almost all dislocations there will be some tearing of the ligaments around the joint. The tearing of tissue jumpstarts the inflammatory response in the area of damage to begin the process of healing the tissue. The first step in this process is the leaking of blood from the torn tissue into the surrounding area. This is usually why sometimes there will be bruising after a significant tear. Blood not within blood vessels is irritating tissue and more inflammation occurs. During this acute stage macrophages, which are specific white blood cells, start the cleanup of the damaged tissue and send signals to the body for other immune cells to come and do their part.
As the body continues into the subacute stage after most of the inflammation has subsided it begins to repair what has been torn or damaged. Cells receive signals through other cells in the blood responsible for specific tasks to repair. These signals are sent out by cells called platelets. This stage of healing and the platelets that are responsible for most of the repair can be introduced in more abundance with the use of PRP and ozone.
PRP is platelet-rich plasma and it is a therapy to help heal damaged tissue. Platelets are produced in the human body and possess healing properties to help the body repair itself. Platelets carry growth factors in great varieties to repair and regenerate tissue. Platelets also carry proteins and peptides as well as cytokines. A whole bunch of big medical words describes how platelets help repair and regenerate damaged tissues. Growth factors are signaling proteins that stimulate cell growth, tissue repair, and inflammation. Acute inflammation is therapeutic and protects against chronic pain. As platelets are activated they divide, multiply and differentiate to become healing cells for injured tissue, as they change they release growth factors. Another great benefit of PRP is that there is stem cell attraction and binding. Stem cells are like blank canvases, they can become anything that the body needs to help repair damage. Stem cells have also been seen to lay dormant within tendons and ligaments, the same tissues with little blood supply and the potential to have chronic issues and pain. PRP can activate those stem cells within those troublesome areas to achieve long-lasting pain relief and recovery. PRP also helps create and release exosomes. Exosomes are molecules within cells that act as communication for the rest of the cells of the body. These exosomes relay information to recruit other cells for the repair and recovery of damaged tissues. Exosomes also help to decrease pain. There is a portion of the separated blood called a buffy coat. This thin layer between the plasma and the red blood cells is highly valuable for PRP because it holds a lot of these exosomes as well as some white blood cells that help to remove the debris from the damaged cells.
PRP is natural. It comes from the same person that the PRP is being injected into. There are no chemicals, no compounds, or other products in PRP besides what is already naturally occurring within the blood. Second, PRP encourages the healing and recovery of damaged tissues instead of masking the problem. We have already established that PRP boosts the body’s ability to heal, therefore, we don’t need to worry about the destructive tendencies that cortisone or other steroid injections have.
Lastly, PRP is long-lasting. PRP continues to work and be productive weeks and even months after the injection or series of injections. PRP has other benefits besides direct recovery and healing of tissue. Neurotransmitters are specialized molecules within the body to turn up or down certain functions within our body systems, mainly the nervous system. PRP specifically increases serotonin. Serotonin is vital as it affects our mood, emotions, appetite, digestion, and restful sleep. Serotonin is considered the happy neurotransmitter. A boost of serotonin helps us to feel happy, content and level-headed instead of drastic mood swings. And let’s be honest, having a more restful sleep is just great for anyone. All of these changes also occur with PRP. More than likely it isn’t a huge drastic change but a little bit can go a long way.
PRP is very effective in treating these acute traumatic injuries. The biggest caveat to this therapy is its efficiency and efficacy in obtaining the PRP product. First and foremost, is the quality of the PRP. Poor PRP can be beneficial but it will not be as effective if the collection of the PRP is not done well and if the plasma does not have a high concentration of platelets. Next is the physiologic state of the person that is needing PRP. If someone has a poor diet, does not exercise, and is unhealthy overall then the effectiveness of PRP goes down. In order to get good results from a therapy like PRP is it important to have a healthy lifestyle or at least start a more healthy lifestyle. Someone who does not eat well does not exercise or has a sedentary lifestyle will not get as good results as someone who is active, has a well-rounded diet and takes care of their body. PRP is only as good as the physiologic state of the person that PRP is taken from. In essence, the better the overall health of a person the more effective PRP will be.
PRP is a great option to be able to help heal and recover from new injuries or conditions. However, it may not be an option for everyone. It is all about how well the PRP can be obtained and the overall health of the patient which will impact the quality of the PRP. Low PRP quality will result in a low probability of results. 99 times out of 100 PRP can be acquired with minimal problems or imperfections. Results can vary however and PRP is not going to be 100 percent effective for everyone. Everyone will respond differently to PRP just like with almost any other procedure. Be mindful that PRP has good success when done properly by well-trained professionals but the success varies from person to person.
Let’s talk about ozone and its role in the recovery of injuries. Ozone has many benefits and each of those benefits helps with the healing and regeneration of the tissues that are injected with ozone. Ozone helps with the activation of the immune system, improving circulation, increasing metabolism, increasing tissue oxygenation, increasing cellular rejuvenation, and ozone is anti-inflammatory and antimicrobial. Without question, these biological processes are vital for tissue healing and recovery. Ozone helps to facilitate these processes at an increased level working directly with the injured cells. It all really boils down to the body and the cells utilizing oxygen more efficiently and thereby increasing the body’s natural ability to heal.
When ozone is injected into the body it creates a small oxidative stress in the tissues. Oxidative stress is not as bad as it sounds. This small stress response helps to increase the amount of antioxidant enzymes that help to eliminate free radicals. Free radicals are the major cause of cell decay and death as well as degenerative diseases such as arthritis.
Ozone when injected will automatically be broken down and forms O2 and hydrogen peroxide or H2O2. Your body then converts the H2O2 into water and even more oxygen. All of this oxygen is then used by the mitochondria to produce ATP which is the energy source of all of our cells.
The combination of PRP and ozone is potent and when applied properly it can dramatically help in the healing process of injuries from sports or weekend activities. Our office utilizes these therapies for that exact reason and to give our patients the best healthcare available. We want to see our patients not only recover and heal but lead fulfilling active lives.