Does Platelet Rich Plasma injection for a HIGH ANKLE SPRAIN in elite athletes improve return to play?

By Phillip Steele, MD RMSK, CAQ Sports Medicine
Performance Injury Care & Sports Medicine
Helena Montana

A recent study of elite athletes with the worst type of ankle sprain were divided into a traditional recovery program with a rehabilitation program versus a platelet rich plasma (PRP) injection plus an identical rehabilitation program found that there was a significant difference in return to play.

The anteroinferior-tibiofibular ligament (AITFL) is the injured ligament with a high ankle sprain. An athlete can take 2-4 weeks for return to sport with a strain of the ligament without a tear. With a partial tear, an athlete can take 4-8 weeks for return with rehabilitation and with a complete tear usually 8-16 weeks to return to running and cutting for sport.

Although the elite population of athletes has all the bells and whistles of a full time athletic trainer with daily treatments and all the tools of the trade, including therapeutic ultrasound, low light laser, iontophoresis treatments and constant daily attention, we still struggle to return elite athletes to play with out pain.

This is one of the first randomized control trials that divided 16 elite athletes that were diagnosed with a syndesmosis instability (AITFL) tear into two groups and compared recover time. All athletes had dynamic instability of the ankle. Dynamic ultrasound diagnostics were done to confirm a AITFL tear. Again, both groups did the same identical recovery program.

The PRP group recovered and returned to play (RTP) with less pain. The PRP group returned to play on average 19 days sooner than the control group. The more important factor however was only one person in the PRP group had discomfort with RTP, while 5 athletes in the control group were returned to play with mild persistent pain. Although only 19 days earlier, an elite athlete return to play for a championship game, Olympic trials or world cup play makes a difference at the professional sports level. For the high dollar athletes of the NFL, 19 days might be 2-3 more games played in a season.
Here is another study showing the utility of platelet rich plasma treatment for sports.

Performance Injury Care & Sports Medicine is located in Helena Montana and is the leader of Regenerative Mmedicine in Montana and Diagnostic Ultrasound Imaging.