Platelet-Rich Plasma Therapy: Much Ado about Nothing?

March 18th, 2011 | 6 Comments | Source: Commentary

Platelet-rich plasma (PRP) therapy became a hot topic among professional and recreational athletes after some studies suggested it could hasten wound healing and several high-profile athletes reported using it as they rehabbed from various injuries.  But recently, the news hasn’t been quite so good. For those not in the know, let’s do a quick review of the subject.

PRP therapy involves extracting and centrifuging a person’s blood to create a concentrated broth of growth factors and white cells, and then then injecting the stew directly into injured tissue. The growth factors supposedly promote healing.

PRP therapy has been used for numerous conditions including tennis elbow and pulls, sprains and strains of dozens of different muscles, tendons and whatnot.

The treatment became buzzworthy after animal studies showed that it fostered collagen and new blood vessel formation in the tendons of animals that had been surgically injured by scientists.

The buzz grew after reports surfaced that Tiger Woods used PRP therapy to treat a sore knee, NFL player Chris Canty used it for a hamstring injury, and itinerant MLB pitcher Cliff Lee used it for an abdominal strain. After these high-profile athletes claimed to be satisfied with the results, recreational athletes began demanding PRP therapy for themselves, even though it cost $1,000 per shot and isn’t covered by most insurance plans.

Alas, recent scientific studies of PRP therapy should dampen that enthusiasm, at least a bit. It just doesn’t seem to work in humans with overuse injuries and strains, according to these studies.

This month for example, S. de Jonge and colleagues at Erasmus University (Rotterdam) published one-year follow-up data on their placebo-controlled trial of PRP therapy for Achilles tendinopathy. Their original report showed no benefits at 6 months, and the extended follow-up showed the same thing (no benefit). de Jonge’s group concluded there is “no evidence for the use of platelet-rich plasma” therapy in this particular condition. (more…)



Long-Term Effects of Multiple Concussions

September 21st, 2010 | 9 Comments | Source: Wall Street Journal

A small study has linked multiple blows to the head, sustained during athletic competition, to a degenerative brain condition similar to Lou Gehrig’s disease.

In the study, Bob Cantu, a neurosurgeon at Boston University Medical Center and colleagues examined brain and spinal cord tissue from a dozen former athletes that had died. Three of them had been diagnosed with ALS before their deaths.

Each athlete had sustained multiple concussions. One of them had at least 10 concussions. The subjects were found to have protein deposits known as tau and TDP-43 in their brains and spinal cords. These proteins have previously been found in the brains, but not the spinal cords of patients with ALS.

The fact that similar proteins were found, but in a different distribution from “classic” ALS suggests that the neurodegenerative disorder associated with multiple head trauma is similar to, but distinct from the classic disease.

Repetitive head injuries include both full-blown concussions and less severe blows to the head, said Robert Stern, in an interview with the Wall Street Journal. The study co-author added that “concussions are really the tip of the iceberg.”

This doesn’t mean children shouldn’t participate in contact sports, cautioned Gerard Gioia, chief of pediatric neuropsychology at Children’s National Medical Center. “The benefits of kids’ activities in sports, in recreation, in physical exercise far outweigh the risks,” Gioia told the Journal. “But that doesn’t mean we ignore the risk.”

Previous studies have suggested that repetitive head trauma increases the risk of other degenerative brain disorders including Parkinson’s disease (think about Muhammad Ali) and Alzheimer’s disease.

The write-up appears in the Journal of Neuropathology and Experimental Neurology,


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The Banana Smacks Down McFondle

April 15th, 2009 | No Comments | Source: Wall Street Journal

Seattle Semi-Pro Wrestling has entertained bar patrons in the Pacific Northwest for 6 years with its lampoons of World Wrestling Entertainment.

ronaldmcfondleThe cast includes Ronald McFondle, a raunchy rendition of a the iconic hamburger peddler who finishes off opponents with a lewd gesture and a vainglorious fellow named Deevious Silvertongue who looks like a cross between David Bowie and Liberace.

The characters grapple on foam padded stages, or at least they did until the Washington State  Department of Licensing classified the show as “sports entertainment,” meaning the SSP had to post a $10,000 bond, hire medical personnel to monitor events, and buy a regulation wrestling ring.

The SSP, which has no money to speak of, plans to appeal the ruling but has halted matches in the meantime.

“It’s a bunch of grown men and women in costumes pretending to be professional wrestlers,” David Osgood, the league’s lawyer told the Wall Street Journal. “It is to wrestling as ‘West Side Story’ is to actual gang relations.”

To which department spokesperson Christine Anthony countered that pro wrestling “is just as much theater as these guys claim to be.” The department considers the WWE to be sports entertainment and requires it to have a license to perform in the state.

The smackdown was prompted by a fallout involving the league and The Banana, one of its characters. Apparently, Paul Richards, who played The Banana, left the league upon hearing of plans to sideline his character.

The league had named Lucas Keyes to be The Second Banana, a sidekick to The Banana, and planned to have The Second Banana betray and then defeat The Banana.

Richards stormed off rather than lose his status as the top banana, according to the Journal.

TheBananaThat might have been the end of it, but then Richards found out that SSP members were ridiculing him behind his back, so he notified the licensing department that he believed SSP was violating the law.

In his appeal, Osgood will argue the ruling threatens everything from jello wrestlers to actors engaging in a sword fight in “Hamlet.”

“We’re in ‘Looney Tunes’ territory here,” he told the Journal.


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A-Rod Definitely Juiced

February 24th, 2009 | No Comments | Source: NY Times

ARodHRputsYanksup17-0Young, stupid and naïve was the way Alex Rodriguez described his behavior during his tenure with the Texas Rangers between 2001 and 2003.

The latest A-Bomb from A-Rod was that he used performance enhancing drugs during that particularly prolific part of his career…after adamantly denying this for years.

So now Rodriguez becomes the poster-boy for Major League Baseball’s juicing era; he’s by far the most famous player to admit using performance enhancing substances.


Other players like Mark McGwire, Sammy “Captain Cork” Sosa, Barry Bonds and The Rocket are also widely believed to have juiced, and like A-Rod’s, their denials have become required viewing for YouTubers.

“When I arrived at Texas in 2001, I felt an enormous amount of pressure,” Rodriguez told ESPN reporter Peter Gammons. “I felt like I had all the weight of the world on top of me and I needed to perform, and perform at a high level every day.”

“Back then it was a different culture. I wanted to prove I was worth being one of the greatest players of all time. I did take a banned substance, and for that I am very sorry and deeply regretful.”

According to the New York Times, Rodriguez said he didn’t know what he took and emphasized he’s been clean since joining the Yankees before the 2004 season. His positive test dates to 2003, his last with the Rangers.

whichurineisarod's?In keeping with terms of the collective bargaining agreement between MLB and the player’s union, testing that year was carried out randomly, was associated with no penalties, and the results were to be kept secret.

All that changed in April, 2004 when the Feds, in hot pursuit of perjury charges against Barry Bonds in the BALCO case, seized the positive urine specimens from 2003. One of those cups contained A-Rods’ urine, which was reportedly glowing in the dark.


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Lookin’ Like Bonds Juiced

February 24th, 2009 | No Comments | Source: NY Times

this...Last week the Feds unsealed 200 pages of evidence against Barry Bonds.

They plan to use it in March when the former San Francisco Giants slugger stands trial on charges he perjured himself before a grand jury in the 2003 BALCO case by claiming he never knowingly used steroids.

The documents tie the all-time home run king to 4 positive tests. They also include doping calendars and transcripts of a secretly-taped conversation in which Greg Anderson, Bonds’ longtime trainer and confidant says he injected Bonds with the juice.

plusthis...Anderson has racked up more than a year behind bars for contempt by famously refusing to testify before that very same grand jury. His obstinance may yet invalidate some parts of the Fed’s case.

Three of the 4 positive tests date to 2000-2001 and were performed at the Bay Area Laboratory Co-operative. The fourth, a specimen collected by MLB in 2003 showed the designer steroid THG, a synthetic testosterone and clomid, a female fertility drug.

That specimen had come up clean using MLB-sanctioned tests, but it was seized by the Feds a year later and handed over to the UCLA Olympic Analytical Lab which found the goods. 

equalsthis!The tape-recorded conversation took place in 2003. It involved Steve Hoskins, a former Bonds business manager, and Anderson. Transcripts reveal Anderson saying he injected Bonds with designer steroids that weren’t detectable at the time.

Hoskins and Bonds had been childhood friends that reconnected when Bonds returned to the Bay area to play Left for the Giants in 1993. They had a spat in 2003 and next thing you know, Hoskins was wearing a wire for the Feds.

In sworn testimony before the BALCO grand jury, Bonds admitted using “the clear” and “the cream,” but claimed he did not know they were laced with performance enhancing substances.


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That Happiness Study? Oh Come On!

December 15th, 2008 | No Comments | Source: British Medical Journal

In the latest and by far the biggest buzz-producer on the subject, Christakis and Fowler concluded that happiness is contagious.  If your friends become happy, sooner or later you will too. 

Yea right.

Tell that to the 6 Yankee fans living in Boston in October, 2004 when their team experienced the greatest collapse in American sports history, at the hands of the dreaded Sawx no less.

Those few-and-far-between Yankee fans were immersed by a wave of collective happiness involving essentially everybody within a 200 mile radius. The celebration continued well after the Townies rolled to their first World Series victory in 86 years.

How happy were people in Boston? 60 year-old men wept openly and wished only that their fathers were still alive to share the joy. 40 year-olds wept too. They hoped their little ones would remember where they were when it happened.

Friends, family members, work associates, even the baristas and gas pumpers of those 6 Yankee fans got happy, but the emotion sure didn’t spread to those poor Yankee fans.

The Red Sox triumph was an epiphenomenon, a big, contextual event that out-explains the explanation given by Christakis and Fowler.

Subtle epiphenomena from upticks in the economy to a cool new teacher at middle school, to the release of a Harry Potter movie provide a more plausible explanation for Christakis and Fowler’s observations, even though the particular epiphenomena at work are unknown and unknowable.

Look, when the Sox won game 4 to cut the series deficit to 1-3, a handful of Sox fans became happy. At least we weren’t swept, those few fans reasoned.

A day later the Sox won game 5 and more people became happy.

When the Sox won their third in a row to tie the series, pandemonium reigned and that was dwarfed by the transcendent moment at the end of game 7.

The epiphenomenon of the Sox’ comeback explains how, over time more Bostonians got happy. Christakis and Fowler want you to believe instead that happiness is contagious. That’s buzz-worthy and actually plausible at first blush, but it is simply wrong and 6 Yankee fans living in Beantown will attest to that.


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Atlas Shrugged

December 9th, 2008 | No Comments | Source: NY Times

Atlas Sports Genetics claims to have a test that predicts which kinds of sports match your child’s innate abilities. You can buy it right now for $149.

The test determines ACTN3 gene expression. ACTN3 is one of 20,000 human genes.

The so-called R variant of ACTN3 instructs the body to produce alpha-actinin-3. This protein component of fast-twitch muscles provides forceful, quick contractions required to excel in power and speed sports like football and sprinting. The X variant suppresses the production of alpha-actinin-3.

Children inherit one copy of the ACTN3 gene from each parent, so they can be “RR,” “RX,” or “XX.”

Atlas Sports claims that power and speed sports are best suited to RR offspring, whereas endurance sports like marathons and distance swimming are best suited for XX offspring. Apparently RX offspring can do anything.

If this sounds dicey to you, you’re not alone.

Dr. Theodore Friedmann, the director of the gene therapy program at UCSD for example, told the New York Times the test amounted to “an opportunity to sell new versions of snake oil.” He elaborated, “I don’t deny that these genes have a role in athletic success, but it’s not that black and white.”

There is no doubt the science being commercialized here is compelling, if not ready for prime time.

In 2003, Australian scientists studied 429 world class athletes including 50 Olympians. They found that 50% of the 107 sprint athletes were RR. That’s twice the frequency of RR in the general population. And not one female sprinter was XX. What is more, every male Olympian involved in power sports had inherited an R variant from at least one parent.

So where does the XX Spanish long jumper fit in?

It’s hard to know but Carl Foster, a co-author of the study and director of the human performance laboratory at the University of Wisconsin-La Crosse has devised another way to see whether your 6th grader will excel at power and sprint sports:

“Just line them up with their classmates for a race and see which ones are the fastest,” he said.


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