Sixers point guard Jerryd Bayless missed the first 13 games of the NBA season while working back from an injury to his left wrist. After just three games in the lineup, Bayless has been out of commission again, with his timetable for return uncertain. Bayless was not suited up for Wednesday’s postponed game, but did talk to CSN Philly’s Jessica Camerato about his rehabilitation.
Bayless described the discomfort as “a general kind of dull soreness.” On Monday, he received platelet rich plasma (PRP) treatment to help his wrist.
“They take your own blood and they spin it,” Bayless explained. “They take all the good cells and they shoot it back into your wrist.”
Platelet rich plasma treatment has become a more commonly used method of rehabilitation in sports medicine, but not long ago, the science behind PRP made it seem more like science fiction.
WADA, you say?
As recently as 2010, the World Anti-Doping Agency had banned PRP, claiming the regenerative effects of “blood spinning” created an unfair advantage in athletic competitions. In 2011, WADA reversed its decision on PRP, recognizing the method as “a legitimate treatment in the recovery of injury.” The official WADA banned list had a section dedicated to PRP as recently as 2013 which stated that, “[d]espite the presence of some growth factors, platelet-derived preparations were removed from the List as current studies on PRP do not demonstrate any potential for performance enhancement beyond a potential therapeutic effect.”
A 2010 article posted by the Brisbane Courier Mail,written by Peter Badel of The Sunday Telegraph, attributed the genesis of PRP use to European athletes in the early aughts.
PRP therapy, first used around 10 years ago by athletes in Europe, including cyclists, has sparked major debate in recent times – prompting the World Anti-Doping Agency to amend its prohibited list this year.
Under section S2-6 of the 2010 WADA code, PRP can be used by athletes, but only if injections involve joints or areas surrounding muscles. Direct injections into muscles are banned and can invoke a two-year ban from competitions.
WADA does not have legal oversight of the NBA and, in the past, has had something of an up-and-down relationship with the Association, at times calling the league out for ‘gaps’ in anti-doping enforcement. More recently, thoug, the group lauded the NBA for its stance on hGH testing. (For context, Bayless’s injury is to a joint area.)
USADA, the United States Anti-Doping Agency, backs WADA’s determination that PRP is an acceptable use of therapeutic treatment, though warns potential offenders that, “individual growth factors are still prohibited when given separately as purified substances.”
A Magic Cure-All
This is where PRP becomes rather interesting. Today, PRP is used as something of a cure-all. A search on YouTube pulls back dozens of videos showing treatments to help regenerate hair growth in men and as a substitute for collagen injections in women’s faces.
The science seems pretty simple. Your blood is extracted, spun around for a few minutes and the good parts are shot back into your body to help you heal. Here, let’s allow this hilarious 1980s film strip-style video of a knee treatment to provide the visuals.
Is this blood doping?
PRP is not blood doping, but for years PRP treatments have been linked to the seedy underbelly of the performance-enhancing drug world.
Less than a decade ago, Dr. Anthony Galea was one of the top doctors in the world for injured athletes seeking advanced rehabilitation treatment methods. In December, 2011, Galea was sentenced to one year of supervised release after pleading guilty to bringing unapproved drugs from Canada, including both human growth hormone and the performance enhancer Actovegin, which is made from calf blood and is still in use today.
Prior to his arrest, Galea’s clients included Alex Rodriguez and Tiger Woods.
While Galea and his high-profile customers long denied any drugs being exchanged or administered, a 2014 book about the steroid era in American sports reported that Galea had treated Woods 14 times in 2009, while an associate of Galea made 49 visits, totaling more than $200,000, in an effort to help Woods recovery from knee surgery. Hank Haney, Woods’ swing coach at the time, told Golf.com he watched the whole thing go down.
“There was never anything that went into Tiger Woods’ body that didn’t come out of his body,” Haney explained. “They take blood out, they spin it, they inject the plasma back in. I totally believe that Tiger Woods has never taken any performance-enhancing drugs.”
From Tiger to Kobe
While Woods may be the most famous athlete in the world to use PRP, Kobe Bryant was certainly the most notable NBA player.
A few years ago, Bryant was hampered by a degenerative knee issue that threatened to end his career. Instead of retiring, Bryant went to Germany to receive a PRP-like treatment called Regenokine.
While WADA and USADA may not have had issues with PRP at the time, the FDA had not approved Regenokine treatment, forcing athletes to Germany to get the career-extending procedure.
Per an article by sports injury expert Will Carroll in 2013, Regenokine differed from PRP because “the blood is removed from a patient up to three weeks beforehand, mixed with other substances and then re-injected. It is believed that many US patients have their blood drawn, frozen and shipped to Germany ahead of their treatment by an American affiliate, Dr. Christian Renna.”
Carroll pointed out in his story that Renna was a doctor previously linked to the BALCO laboratory. Yeah, the Barry Bonds people.
This is totally blood doping, right?
There’s a fine line between blood spinning, or PRP, and blood doping.
Lance Armstrong has become a pariah in sports because of his blood doping — and incessant lying about being a cheater — stripped in 2012 of his seven Tour de France titles and other trophies and accolades. In early 2013, Armstrong admitted to cheating by taking EPO (a common practice in the cycling world), a hormone naturally produced by our kidneys that sparks the production of red blood cells. EPO has been banned in cycling for decades.
Other charges levied at Armstrong included the use of blood transfusions during long races. CNN.com explained the benefits of transfusions as performance enhancers.
Blood transfusions have a similar effect on the body’s red blood cell count [to EPO]. Usually an athlete will store some of his blood when his hemoglobin levels are high, then reinfuse it right before an event. This type of transfusion cannot be detected by current tests, according to the USADA.
Cyclists out on the long road with days and days of consecutive riding would (read: do) ostensibly replace their used, tired blood with fresher, more oxygenated plasma, thus helping the rider recover quicker, and pedal faster.
Isn’t that what PRP does? Simply put, yes.
But in a more scientific way…not exactly.
A 2013 study published in the American Journal of Sports Medicine found that in PRP treatments, “[p]latelet-rich plasma appears to trigger an increase in circulating growth factors through activating biological pathways rather than by serving as a vehicle for the direct delivery of presynthesized growth factors,” concluding that the study shows evidence “that PRP contains and may trigger systemic increases in substances currently banned in competitive athletes.”
In other words, PRP isn’t putting magic growth juice into your body, but it may help your body create its own magic growth juice, a process that is legal everywhere, including professional and amateur sports in the United States.
Athletes who used the Regenokine procedure had to be careful of what was put into their spun blood, so as not to trigger a failed drug test, but for players like Bryant, hGH testing didn’t come to the NBA until this year. Who knows what they were putting into his blood.
With PRP, the theory is the spinning is all that’s needed to fix a player’s ills.
Back to Bayless
Bayless is not doping or cheating or doing anything against medical advice. In fact, in less than a decade, treatment methods like PRP have gone from being used by shady doctors who peddle illegal drugs across international borders to common medical practice in the United States.
Athletes like Armstrong and Rodriguez are pilloried in the sports community for and cheating to achieve their success. But as modern science continues to evolve, one generation’s cheating might become the next’s great cure.