These Mistakes Will Ruin Your Platelet Rich Plasma Treatment!

Platelet rich plasma or PRP is such an incredible treatment technique. It uses your own cells, your own platelets, your own growth factors to treat your body. But did you know that there are a lot of variables that could significantly affect the outcomes of your PRP treatment? And many of these variables are things that you can actually control. So in this video, we are going to look at which variables can affect the potential efficacy of PRP in order to optimize for the best outcomes.
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► ABOUT ME
Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He created a KZbin channel and blog to translate cutting edge medical knowledge and clinical research to benefit all those looking to live an active and healthy lifestyle. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.
Dr. Peng is board certified in sports medicine and family medicine. He completed residency with the Stanford family medicine residency program and completed his sports medicine training with the Stanford primary care sports medicine fellowship in San Jose. He is an active faculty member for both programs and is excited about training the next generation of physicians.
Dr. Peng’s sports medicine clinic is located in Campbell, California.
Twitter: @JeffreyPengMD; / jeffreypengmd
Website: www.jeffreypen...
► Disclaimer
My content reflects my own opinion and does not represent the views or opinions of my employers or hospital systems I am affiliated with. They are meant for educational purposes only. They do not substitute for the medical advice of a physician. Always seek the advice of your physician with any questions you may have regarding your health.

[@028fn48dne]

I did PRP for my elbow, and the doc said I gave them some of the richest plasma they'd ever seen. Here's why: they asked me to do moderate exercise for 20 minutes prior to drawing by blood. I overdid it. I ran around the block for 15 minutes and then ran up the stairs to the clinic... in a 12 story building. Later I looked it up and apparently moderate exercise increases platelet count but intense exercise increases platelet count even more.

[@JeffreyPengMD]

👍

[@shamailarizwan4083]

Is it scientifically proven?

[@028fn48dne]

Is it proven that rigorous exercise increases platelet count? I believe so. Is it proven that doing rigorous exercise before a PRP extraction/injection increases treatment effectiveness? I doubt anyone has done a controlled study on something that specific yet. For what it's worth I got my heartrate up to very close to maximum for at least four minutes shortly before my extraction/injection. @@shamailarizwan4083

[@VTVT1306]

Good info! Next I will do that too

[@atourversace4032]

Damn, my problem is in the knee, I won't be able to do that for extra workout

[@TheJuanisha22]

I had this done yesterday and had sever muscle spasms from my legs to my feet for 3 hours because I didn’t drink plenty of water. Please listen to the doctor 😢

[@th30ldman]

The severe pain I was in before was excruciating and debilitating if I can’t find a doctor to do it I will try doing it myself before I go back to opioids. I’m a disabled army combat veteran. It may not be a miracle fix it but I for one have had PRP on both knees by one dr and I went from a 8/10 to 10/10 pain and I went to 2/10 pain within 3 weeks then 0/10 pain at 6 weeks. The pain returned at about 18 months and the va had fired the doctor who administered the PRP it as almost 2 years before I found out I could go to a va facility that still offered the PRP’s he did them different he did a dose in both knees about 10ml in each knee and repeated for 1 each month for 3 months then start over at a year. My knee X-ray showed I was no longer bone on bone but rather I had normal space at about 6 months. I’m dreadfully awaiting the return of that pain

[@WrldExplorer]

It’s 5 months later, and any better?

[@DGNG-dd3to]

So insurance is covering part of hip replacement but not this? Doesn't surprise me. The USA medical system is BROKEN!

[@devinthomas4866]

10000% correct

[@WrldExplorer]

I moved to Colombia back in May. Continued my shoulder therapy here was $5 a visit. $50 total for 10 visits. I do have to pay out-of-pocket for that injection here because even my private insurance doesn’t cover the actual injection. I actually have an appointment tomorrow and the price is $350. I don’t know how much it cost in the states. The doctor here recommended that. I didn’t get a chance to go to the orthopedic surgeon in the US before I came here to see if they would’ve recommended the same thing.

[@SteveBarrons]

Enjoy your videos and appreciate the info. On this specific video I need to comment on the opinion on Saturated Fat effecting platelets. The is 100% false. I eat a mostly Carnivore diet and eat a lot of saturated fat. I eat zero vegetables and very little fruit. My diet is essentially red meat and eggs with unpasteurized whole dairy. I injured my knee and decided to get PRP, after watching some of your videos. The Doctor commented on how good my blood was because they basically got double the platelets than what is normal. So you might want to rethink the idea that eating saturated fat is bad for your blood.

[@mr400meter]

I'm pretty much doing the same thing too. Mine looked excellent also! I thought the same thing also when I watched this video.

[@avgonyma1]

Just a few thoughts: 1. yes, but as he mentioned: there are several factors influencing the platelet quality and number. --> perhaps you are doing all the other factors right? 2. there's a hack on how to get cholesterol/triglicerides in place: just take a good Omega 3 supplement. I can testify it works, in my case it worked on 2 weeks, i wasnt aiming for that, but just had bloodwork at a distance of 2 weeks, and the only difference inbetween was i started taking Omegas. I was stunned , as my cholesterol was 60% off for a few years straight. 3. did you have your cholesterol measured or are you just assuming it is high due to the diet?

[@SteveBarrons]

@@avgonyma1 My cholesterol is high because I am healthy. Low cholesterol is a sign of poor health.

[@jwmcneelyIII]

I'm currently undergoing PRP therapy for my knees. I've been on a whole foods plant based diet for about 4 years. My plasma was super clear, and it has been a real boon in many areas of my health. If I had gotten onto this a decade ago I might not have bad knees.

[@JeffreyPengMD]

Wow that's great! Thanks for sharing your experiences.

[@rurouni168]

Hi what was the diagnosis of your knees and how are they so far, how many treatments have you had?

[@MrPAULONEAL]

Or the therapy might not have been as advanced then.

[@alessandrococcia9509]

Very usefull video, like all from you doc ! Thank you for sharing. I just started my prp treatment

[@JeffreyPengMD]

Good luck!

[@kanakasurfer5407]

Just completed my PRP treatment yesterday for bilateral knee issues (.partial meniscus tear of posterior horn )This is my second PRP treatment, the prior being 2.5 years ago. I'm following the usual protocols no alcohol, caffeine, and lots of hydration particularly important here in Hawai'i. I'm also thinking about using low level red laser therapy from Kineon Move Pro on both knees in addition to those injections. Anyone know of any contraindications regarding supplemental red laser on knees post PRP injection?

[@donaldwest9103]

I'm about to start the QC Kinetix five-part protocol in five days for osteoarthritis of the knee. Do you know anything about this procedure? It's very expensive and I feel quite a gamble, but I'd rather not have surgery. Thank you for your videos. Very helpful and informative.

[@donbloomdahl5970]

I have one hip with decreasing range of motion and sometimes pain or limp and gave up basketball. I lift weights and wonder if lifting is too much physical stress on hip for PRP to work. Routine includes up to 30 reps of: Leg press (540 lbs), hip adductors & abductors (240 lbs), knee extension (240), knee curl (150), back extension (240), and abs (240). How much stress is safe for joints? (I have appointment with Doc in 2 weeks to discuss PRP.)

[@alessandrococcia9509]

Im undergoing prp right now, my doc told me not to do heavy lifting for a while, but more moderate cardio on a stationary bike, ill wait two or three months ti gi back to weights lifting, hope this help

[@darian5428]

How about bracing the treated joint for a period of time? Say your ankle has a torn ATFL, should you immobilize it and not bear any weight on it for how long?

[@JeffreyPengMD]

Very case dependent. Instability can benefit from a brief period of immobilization, but eventually you'll want to rehabilitate the muscles to provide that stability. You'll want to discuss this with your health care provider / physical therapist. Thanks for your comment

[@pierrevillemaire-brooks4247]

Thanks for sharing this info ! You didn't mention anything about the potential interaction that caffeine might have with this PRP injection treatment. Is it negligible or is there a potential risk ? I know that most people see coffee as a normal food , but to my eyes it is a extremely popular and trivialized stimulant that should be set along side alcohol and tobacco.

[@Thelimborg]

I'm also interested in an answer or a comment here.

[@devinthomas4866]

Most important thing is be well hydrated. Coffee will have zero negative effect.

[@ronenzexer.1774]

Hello - I was diagnosed 20 years ago with Lymphoma Follicular. 11 years ago, I had chemo treatment (RCHOP). Since then the disease has been in remission. My PLT ( blood test Aug 2023) is 158. Is this a limitation for getting PRP injection (hip pain in the last 4 years). Thank you.

[@mischiefgaming]

Just had prp in my shoulder for a slap tear in my labrum. Cracking is better but pain is still there :/ They saw some inflamtion in the rotator cuff as well not just the labrum tear. Might be hiding a small tear in the rotator. It has been 2 months since my injection but i think i till get one in the rotator cuff for good measure in a few months

[@MrFalcon58199]

Do you think that supplementation with alpha lipoic acid should be avoided prior to PRP treatment? I've seen on PubMed that this antioxidant can have anti-platelet and anti-inflammatory effect but so far haven't seen it mentioned anywhere as a thing to be avoided.

[@JeffreyPengMD]

A lot of things can have antiplatelet effects, whether that truly impacts outcomes, we're not sure. I think supplements are *probably* okay to continue

[@violet-green-eyes9574]

Thank you for sharing your knowledge! I wonder about something… How does the age affect the quality of your plasma? The young people (let say 20-30) recover faster than older people (let’s compare with 80 years old). Does it mean the plasma of the older people is not as powerful as by the young ones? Will the PRP or PRF treatment on the older person be less effective, as the harvested PRP gets less potent with age? Would love to know this! Thank you

[@JeffreyPengMD]

In theory, yes probably.

[@violet-green-eyes9574]

@@JeffreyPengMD- Thank you for replying, I appreciate it. If this theory would be right - do you think the older patients would benefit more from the skin boosters than from PRF for the skin rejuvenation?

[@devinthomas4866]

When we look at the "spin" in the buoy we can see healthy and unhealthy specimens, so yes

[@DEVanderbiltCecil]

Thank you SO much, Dr. Peng.

[@krefcenz]

Do you need to discontinue all anti-inflammatory substances such as fish, oil and turmeric before and after the procedure?

[@JeffreyPengMD]

Not typically. NSAIDs need to be stopped because their mechanism of action is to inhibit platelets.

[@Clarkson350]

So much awesome information!!! You rock!!

[@robertfoedisch]

I take low dose aspirin for a past heart attack last April should I stop taking it for prep injections

[@jeffmadrigal3593]

I am about to get my first PRP treatment. I have had 2 acl reconstructions in my life on the same knee over the last 25 years. I am now getting my first bouts of arthritis in that knee cap. I am 53 and want to keep active. I currently exercise 5 times per week. The knee is starting to hurt more under the knee cap. After the first injection what should be my protocols in regards to rest and then getting back to exercise slowly. Thx 🙏

[@JeffreyPengMD]

Thanks for your comment. Every treatment and post injection protocol should be individualized. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!

[@tampahomeinvestorsllc7559]

If I have rheumatoid arthritis, would there be any issues with using PRP for my Facet and SI pain?

[@kevinpark5462]

Dr. Peng? I have been taking Boswellia as a supplement for my arthritis and was wondering whether I should temporarily desist from taking it when I get PRP injections in my knees? Are the Boswellia supplements detrimental to the efficacy of the PRP Injections like NSAIDs are?

[@JeffreyPengMD]

Nope, should be fine

[@GermanFrisbeeDog]

I really appreciate these videos. Should I play in a hockey game the evening before my PRP injection?

[@mirasingh7428]

Respected sir For how many hours we can keep the prp after extracting from blood I had a procedure yesterday, but as soon as the dermatologist started injecting into my face he got some emergency call So he did my procedure after coming back around 2 and half later Does the prp gets damaged in 2-3 hours Please reply 🙏

[@drakhyarazhar]

Whats your thoughts regarding using activated vs not activating PRP? is it individualised or depending on the problem?

[@JeffreyPengMD]

Lot's of debate on this topic, we're still not sure which is better. Pros and cons for both. Will make a video on this in the future.

[@FrancesKrygier]

Can you get a PRP injection if you have idiopathic thrombocytopenia?

[@afff69696969]

I accidentally took medication called colchicine for a gout flareup. 2 doses of .6 mg 20 hours and 26 hours after my 2nd prp knee injection. Any problems associated with platelets because of this?

[@Aldertkingofflanders]

Hi Jeffrey, I would like to know what PRP kit (brand) has to be used to harvest the maximum of platelets.

[@marinasmith4772]

Is PRP for shoulder impingement more painful than a cortisone shot? I have bursitis in my shoulders and am considering PRP. I'm afraid of the pain after too.

[@JeffreyPengMD]

Nope, it shouldn't be! The approach to inject the subacromial subdeltoid bursa is the same regardless of what is in the syringe / what is being injected. Usually if shoulder injections are done ultrasound guided, there is minimal pain and discomfort.

[@batman-sr2px]

@@JeffreyPengMD subsacromial subdeltoid bursa is the same location as subacromial bursa(on top and front of shoulder)? I am also curious if prp/stem cell has found beneficial for treatment of capsular ligament laxity in shoulder?

[@linarocco7979]

My surgeon wants to remove part of the meniscus. Please let me know what your thoughts are.

[@sandragutierrez4861]

I'm pretty strong but the pain on my 😢shoulder was severe i cried screamed so loud but now 3 day out my hand feels better waiting on the shoulder to feel better.

[@heretolearnCA]

It’s painful at the time of injection but not as bad as people make it seem!! Breathe through it, take Tylenol if you can; use a squeeze stress ball in the other arm’s hand to distract from the injection. One moment of discomfort for exponential pain relief in the weeks that follow (I had it done on shoulder bursitis and super changed my life for the better!!) wish you the best xx

[@ebutuoy4315]

What effect does weed have on platelets?

[@tywoodard709]

Tryna figure this out Fr

[@devinthomas4866]

makes em slow...

[@MommaBearsCorner]

tks. did not realize this about hbp with such.

[@ajacastillo1614]

Hi great video, and quick question about PRP injection, would the size of the needle used to inject PRP potentially negatively affect the therapy? For instance is there a needle gauge that is too small for optimal PRP injections?

[@olitonottero7620]

Thanks for sharing this

[@JeffreyPengMD]

You're welcome! Thanks for your comment

[@cathaldowdall7467]

Can you take blended blueberries 🫐 every day during treatment

[@venktennis]

Does Acetaminophen negatively affect PRP treatment?

[@hannibaladventures8169]

Are there any studies showing whether being on a blood thinner, such as Eliquis, will impact PRP quality? How long should you suspend taking a blood thinner for a PRP treatment? Thank you for all the information!

[@JeffreyPengMD]

Most blood thinners that are not NSAIDs should not affect PRP as those medications work through a different mechanism.

[@hannibaladventures1073]

@@JeffreyPengMD thank you!

[@nadiastanley7216]

​@@JeffreyPengMD This is exactly what I'm concerned about I am on eliquis I don't believe that I am a candidate PRP.

[@mohammadmaiwand5034]

hello sir how should i know about the quality of prp and what is different between german prp turkey every clinic says our prp good

[@avgonyma1]

@@mohammadmaiwand5034 the PRP is done from your body.

[@fayezthekinghanna9245]

Oméga 3 fish oil will it affect prp ?

[@annamay3707]

when you say the outcome would be negatively affected, does it mean the prp treatment would not have an effect or does that mean the arthritis would be worse after the injection than before? Thanks for your videos, they are very scientific and informative, very helpful.

[@avgonyma1]

im sure he means less effective. its all about the number of platelets and that they havents been activated yet, if i understand corretcly.

[@rolandgerges9246]

Agreed ​@@avgonyma1

[@thebrightpoint3964]

I have low bp and migraine problem , which precautions should i take for better results of prp

[@JeffreyPengMD]

Best to discuss with your health care provider, good luck

[@dornalasridhar4729]

I completed 3prp injection yesterday I had meniscus tear and cartilage is 0.88mm in my right knee, How many days I have rest to running practice because national celection are there ,plz reply this messages

[@JeffreyPengMD]

Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!

[@TechieGhost]

How are you now after 3 shots of injections? Did cartilage regeneration happened?

[@salaheddinerabhi8431]

Hello. I have the same conditions. I strated the treatment yesterday and I'm really worried about the outcome after the 3rd injection. Would you please tell me about your experience and how do you feel right now?

[@devinthomas4866]

PRP will not regenerate or regrow your cartilage. Will help inflammation and lessen wear in some cases.

[@cpurna999]

What amount of blood recommended to be extracted (60 ml or more) to generate PRP and also what is the recommended billion count to get the best results? Thank you!

[@devinthomas4866]

60cc, correct for large joints. The X factor of cells they recover is based on the health of the patient.

[@tejalbhadra7765]

Hi I had a PRP injection on both sides of my hips It was done on the 19th of February. I am not sure what kind of exercise I can do and what are the precautions I have to follow,I still feel sometimes pain.i am not taking any regular medication. What to do, please help me.🙏

[@SemperSalam]

Perhaps ask the person that injected the PRP into you?

[@silviaarenivar6197]

I do prp for my hidrinities in bikini area it's helps alot but is it safe if a bit of my blood gets mixed in I did treatment today when they tried to get rich plasma today but this is my own blood is it safe ?

[@billsav6158]

Can you take creatine before prp?

[@avgonyma1]

there is evedience that a certain Trauma protocol (see: Huberman) can elevate the amount of Growth Hormone about 16x inn just one day. --> could it be that it could do the same to the growth factors in the platelets or rather the opposite? (very important questions in trying to prepare for a PRP procedure)

[@lucillelargey4674]

How much does it cost ??? Thank you 😊 🙏😌

[@JeffreyPengMD]

It depends on where you live! Prices vary WIDELY.

[@user-ck6dt1iz4z]

Can I use PRP with my torn acl?

[@johndougan6129]

How do I find a doctor in my area who does PRP injections?

[@SemperSalam]

Have you heard of the “internet” or “google?” try that.

[@UncleMac51]

How would biologic drugs like humira and methotrexate effect prp efficacy?

[@JeffreyPengMD]

Unfortunately we don't know.

[@franceslktm]

Can the use of a TENS after PRP knee injections help to improve the results?

[@sidmichael1158]

Should I stop taking colchicine for my. Gout?

[@JeffreyPengMD]

Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!

[@wildlifeparaguay2206]

Hi Doc, how frequent can I get an PRP injection?

[@JeffreyPengMD]

As often as you need them, it’s your own cells! That’s the beauty of prp

[@AlexanderThaGreat]

What about prf ? Same frequency?

[@sehamali3134]

Will taking single dose of nsaid destroy prp results?

[@debrahenno189]

Does bio identical HRT affect PRP?

[@devinthomas4866]

could cause elevated H&H numbers. Ask Dr first.

[@victoriawheeler5445]

Good video

[@JeffreyPengMD]

Thanks!

[@VTVT1306]

Is it safe to go to the sauna after PRP? Thnx for your great informative videos!

[@cocolee8396]

No u cant

[@VTVT1306]

@@cocolee8396 for how long you can’t go? They didn’t tell me. Also sports after PRP seems to be hurting the effect. I didn’t play sports for two weeks.

[@cocolee8396]

@@VTVT1306 16 hours

[@lindakootz4488]

I’ve been on a ketogenic diet for over a year. Will this create a problem for PRP injection?

[@QrtuiPkhfdyo-i2v]

Jones Sarah Hernandez Shirley Allen Laura

[@kaminisakore2545]

Thank s

[@JeffreyPengMD]

No problem!

[@th30ldman]

I wish I could find someone to do PRP on me. I know it works for a fact

[@kathleen1685]

Lemonade reduces fat in blood. Peanut butter increases protein.

[@brookedodson2888]

Anderson Barbara Jones Matthew Clark Thomas

[@PNW_Sportbike_Life]

Some of this advice is good and important, some is not. First, nobody should be eating a plant based diet; it's highly inflammatory, and DASH diet? Really? Second, High cholesterol is vastly different than high triglycerides. For example I have high cholesterol due to eating an animal based diet (mostly meat), but my triglycerides are nice and low (because I don't consume many carbs). I like your videos but this one is a bit of a miss.

[@VTVT1306]

If you’re not a doctor of nutritionist shut up

[@AncestralFuel]

I had the exact same response - this doctor has been a great source of information regarding his field of specialty; however, I agree that he is way off on diet and has conflated high trigs (which create cloudy blood) with saturated fat, which does not. It will be many years before the science of low-carb hits mainstream medicine.

[@teresitaabella3795]

👏👍💗

[@JeffreyPengMD]

Thanks for your comment!