I just read an interesting article published in the New York Times on September 4 2011 about whether there is enough “good” evidence to support common procedures currently being used by sports medicine doctors. These include steroid injections, platelet rich plasma (PRP) injections, taping, and surgery. It’s an interesting article and it mirrors what I hear people tell me after undergoing these procedures – sure, it works for some, but for others it doesn’t help at all, and for some it has made their injuries worse. One woman I treated for tennis elbow had a PRP injection and said not only did it not help her, it was so painful she would never recommend it to anyone.

The article cites several examples, such as the woman who tore her hamstring, then spent A YEAR AND A HALF and thousand of dollars on MRI, ultrasound, laser therapy, cortisone, a PRP injection (that cost $1,500), then more cortisone. At the end of 18 months, in her own words, “the stupid hamstring is really no better”. Normal healing time without any intervention, just rest, should be 3 months at most.

The application of these techniques may improve over time, but at the moment there are no clear guidelines on how and when they should be used. Studies have contradictory results, and it has been discovered that there are 4 different ways they can prepare the injection – and no-one knows which one works best. Another study found that the treatment was no better than saline injections (salty water, that is, a placebo) for people with Achilles tendinopathy.

All I’m saying is you need to give these procedures due consideration before embracing them. Over time they may be improved upon and turn out to be fantastic, but at the moment there is inconsistency in their application and so be wary of having to high an expectation on what your results might be.