The Sports Docs Podcast
Sports medicine is a constantly evolving field, with hundreds of new articles published each month on the topic. This ever-growing wealth of information can make it challenging to stay updated on the newest approaches and techniques, and to know which data should actually change your practice. Join orthopedic surgeons, Dr. Catherine Logan and Dr. Ashley Bassett, as they chat about the most recent developments in sports medicine and dissect through all the noise.
On each episode of The Sports Docs podcast, the hosts will tackle a specific injury – from ACL tears to shoulder instability – and review the top research from various high-impact journals that month, including The American Journal of Sports Medicine, Arthroscopy: The Journal of Arthroscopic and Related Surgery, Sports Health, Journal of Shoulder and Elbow Surgeons, and more. The Sports Docs will also be joined by experts in the field of sports medicine – orthopedic surgeons, nonoperative sports medicine specialists, athletes, physical therapists, athletic trainers and others – to provide a fresh and well-rounded perspective based on their unique experiences.
The Sports Docs – Dr. Logan & Dr. Bassett – are friends & former co-residents from the Harvard Combined Orthopaedic Residency Program, who went onto esteemed sports medicine fellowships at The Steadman Clinic and The Rothman Institute, respectively. Dr. Logan practices in Denver, CO, and serves as Team Physician for Men's USA Lacrosse & as a Team Physician for U.S. Ski & Snowboard. Dr. Bassett is the director of the Women’s Sports Medicine Center at the Orthopedic Institute of New Jersey and practices across northern NJ, primarily in Morris and Sussex Counties.
Together, they will bring monthly conversations on how to care for athletes of all ages and levels of play, with a healthy mix of cutting-edge science and real-world application.
The Sports Docs Podcast
182: Overtime – Can Exercise Improve PRP? Exploring Exercise-Mobilized Platelet-Rich Plasma
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Could something as simple as a 20-minute bike ride improve the quality of platelet-rich plasma?
In this episode of Overtime with The Sports Docs, Drs. Ashley Bassett and Catherine Logan explore an intriguing laboratory study examining whether exercise performed immediately before a PRP blood draw can enhance the cellular composition of platelet-rich plasma.
As biologic therapies continue to expand throughout sports medicine, optimizing PRP has become increasingly important. While most discussions focus on centrifuge systems, platelet concentrations, leukocyte content, and injection techniques, this study introduces another potential variable: the patient.
The authors found that a brief bout of vigorous exercise significantly increased platelet concentrations and mobilized hematopoietic progenitor cells, raising the possibility that exercise could serve as a simple, low-cost strategy to optimize biologic treatments.
In This Episode, We Discuss:
- The fundamentals of PRP and how it works
- Why PRP variability remains one of the biggest challenges in interpreting the literature
- Conditions with the strongest evidence supporting PRP:
- Knee osteoarthritis
- Lateral epicondylitis
- Patellar tendinopathy
- Plantar fasciitis
- The concept of exercise-mobilized PRP
- Differences between plasma-based and buffy coat PRP systems
- Whether higher platelet concentrations actually translate into improved clinical outcomes
- How this research may influence real-world PRP protocols
Study Breakdown
Study Design: Prospective laboratory study
Participants:
20 healthy volunteers (ages 21–45 years)
Exercise Protocol:
- 5-minute warm-up
- 20 minutes of cycling
- Target heart rate: 70–85% of predicted maximum
Blood samples were obtained before and immediately after exercise and processed using two PRP systems:
- ACP System (plasma-based PRP)
- Angel System (buffy coat PRP)
Key Findings
Whole Blood Changes After Exercise
- Platelet count increased approximately 22%
- White blood cell count increased approximately 50%
ACP System
- Platelet concentration increased from approximately:
- 457,000/µL → 562,000/µL
Angel System
- Platelet concentration increased from approximately:
- 2.95 million/µL → 3.77 million/µL
- PRP volume increased
- Hematopoietic progenitor cell concentrations increased significantly
Why This Matters
The study suggests that patient physiology before blood collection may significantly influence the final biologic product.
A brief exercise session may:
- Increase platelet yield
- Mobilize progenitor cells
- Potentially enhance biologic activity
- Provide a low-cost method to optimize PRP preparation
For clinicians performing biologic injections, exercise may become another controllable variable alongside:
- PRP preparation system
- Centrifuge settings
- Leukocyte concentration
- Injection technique
Clinical Pearls
✔ PRP is not a single product. Composition varies substantially between systems.
✔ Patient factors may influence PRP quality just as much as centrifuge settings.
✔ Twenty minutes of exercise increased platelet concentrations in both PRP systems.
✔ Buffy coat systems demonstrated increased progenitor cell concentrations.
✔ The clinical significance of these changes remains unknown.
The Big Question
Does exercise-enhanced PRP actually improve patient outcomes?
This study demonstrates changes in laboratory measurements, but it does not tell us whether patients:
- Heal faster
- Experience less pain
- Return to sport sooner
- Demonstrate better tendon or cartilage healing
Future studies are needed to determine:
- Optimal exercise type
- Ideal exercise intensity
- Timing before blood draw
- Which conditions benefit most
Dr. Logan's Clinical Perspective
At the Joint Preservation Center, this study has prompted discussions about incorporating pre-injection exercise into PRP protocols. A simple 20-minute cycling session before blood collection may represent a practical strategy to optimize a patient's own biology before treatment.
While additional evidence is needed, this concept aligns with the broader goal of maximizing the effectiveness of biologic therapies through thoughtful patient preparation.
Take-Home Points
- Exercise before PRP collection significantly increases platelet concentrations.
- Short bouts of exercise may mobilize progenitor cells.
- Patient physiology may influence PRP composition.
- Exercise represents a low-cost, non-pharmacologic optimization strategy.
- More research is needed to determine whether these laboratory changes improve clinical outcomes.
Resources Mentioned
- Episode #161: Platelet concentration and outcomes following PRP for lateral epicondylitis
- Recent Sports Docs episode with Dr. Arianna Gianakos discussing PRP for plantar fasciitis
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Our Hosts:
Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com