Platelet Rich Plasma


By David Hunnius DO and Matthew Vogt MD at The Sports Medicine and Regenerative Therapeutics Institute - Hinsdale

Congratulations to all who participated in the 2017 Chicago Marathon! Whether it was your first marathon or one of many, it’s a great accomplishment showing dedication to your health and well-being. As the race kicked off my ten-year old son and I set up our table at the CARA sponsored exhibit room at the Palmer House Hilton. We were looking out the window when the first groups of athletes went by five stories below. How impressive it was to see athletes racing in racer chairs and handcycles and then runners on prosthetic lower extremities. What an inspiration! Then came the professional runners in a diamond formation that from above appeared to move like a swift group of one as opposed to separate individuals. Next along came the masses. Some groups were separated by runners that were holding flags representing pace groups that were being led throughout the race. It made me think of the selfless dedication that a pace runner donates of his/her time and the ability to lead a pack of several hundred runners or more to reach a certain goal or PR. Thank you to CARA, the hundreds of volunteers, race organizers, Chicago PD, EMS and all who made the Chicago Marathon a success again in 2017!

In this medical minute we’ll talk about a common runner’s foot injury – plantar fasciitis. We’ll then go on to share a recent case of an ultra-endurance athlete.

The bottom of the foot is composed of a thick ligament called the plantar fascia, which provides support to the arch of the foot. On the bottom of the foot it extends from the heel to the base of the toes. This structure is commonly strained which may cause inflammation and pain. Less well recognized, the plantar fascia at times sustains micro tears that may be visualized by diagnostic ultrasound. Plantar fasciitis often becomes a source of chronic pain due to continued weight bearing with activities of daily living and due to little vascular supply to the ligament which prevents adequate inherent healing ability. Often one will have a sharp heel pain when taking a first step in the morning or after prolonged sitting. It may last for several minutes or even several hours.

When plantar fasciitis fails to respond to conservative treatment measures such as physical therapy, there are additional non-operative treatments available. PRP – platelet rich plasma – utilizes your body’s own healing capacity by initiating a cascade that involves growth factors which attract your own stem cells to migrate to the area for enhanced healing. These injections are done in-office under local anesthetic and with ultrasound guidance. It is well tolerated, and improvement can at times be noticed within a couple of weeks. In a 2015 study PRP was shown to be as effective as corticosteroid at 3 and 6 months but unlike steroid the effects did not wear off (1). At 12 months PRP was significantly more effective than steroid. Similar results were found in a meta-analysis of randomized controlled clinical trials just this past month (2).

While physical therapy is usually very effective, should recovery stall, we may recommend adjunctive treatment options. The Astro XO flexible device is one such option that has shown to improve pain control, improve foot biomechanics, and increase dorsiflexion as part of a home therapy program. For further treatment options, or if a plantar fascial tear is seen on ultrasound, we recommend an ultrasound guided biologic injection.

Often times, patients will come to us after suffering from symptoms for a year or more and have already had trials of conservative management. One such patient, an ultra-endurance athlete, started to have plantar fascial pain after running the 2016 marathon. During history taking it was found that the patient ran 17 miles from home to get to the start of the marathon! Over the past year he had a trial of conservative management but was still suffering from heel pain. On ultrasound he was found to have a small plantar fascial tear. He received a single injection of a biologic growth factor product and over a period of a few weeks his pain had significantly improved. By his six-week follow-up his pain had largely resolved.

If you find yourself suffering from plantar fasciitis, contact us for a complete evaluation and treatment options. Our goal is complete recovery and to get you back to your active lifestyle as quickly as possible. The Sports Medicine and Regenerative Therapeutics Institute focuses on pain relief and recovery without surgery. Please visit or call us at 630-922-5071.

  1. Jain K, Murphy PN, Clough TM: Platelet rich plasma versus corticosteroid injection for plantar fasciitis: A comparative study. Foot (Edinb). 2015 Dec;25(4):235-7.

  2. Yang WY, Han YH, Platelet-rich plasma as a treatment for plantar fasciitis: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2017 Nov;96(44)