Email
Print
Email
Print

What’s the secret to Rafael Nadal’s rapid recovery from his knee injury?

Decrease fontDecrease font
Enlarge fontEnlarge font
Rafael Nadal

Rafael Nadal has made 13 finals in 14 tournaments since returning at the VTR Open in Chile in February. (Martin Bernetti/AFP/Getty Images)

SHANGHAI — There’s no doubt that Rafael Nadal’s 2013 season has been incredible; he’s reached the final in 13 of 14 tournaments, and he reclaimed the No. 1 ranking this week for the first time since June 2011. However, everyone is searching for answers as to how the Spaniard has been able to play at such a high level so soon after returning from a seven-month injury layoff, which started after he lost in the second round at Wimbledon in 2012.

In a report in The Daily Mail, Nadal’s team opened up about his use of platelet-rich plasma therapy (PRP) during his knee rehabilitation. The treatment involves taking a small vial of a person’s blood, spinning it in a centrifuge to separate the platelet-rich cells, which carry growth factors that are believed to have a regenerative effect, and reinjecting those cells into the site of the injury to speed up recovery.

According to Scientific American, the procedure was first used for sports-related injuries in 2008. Bloomberg estimates that thousands of athletes have undergone the procedure, including Tiger Woods, Kobe Bryant and Troy Polamalu. The World Anti-Doping Agency banned the procedure in 2010 because of concerns over its performance-enhancing effects, but legalized it a year later after a review of literature found there was no evidence that it was in fact performance-enhancing.

Here’s a snippet from The Daily Mail story about what it describes as PRP’s possible “interesting future”:

According to papers published in the American Journal of Sports Medicine this summer it [PRP] may have much wider benefits to performance. Doctors Amy Wasterlain and Jason Dragoo found that Human Growth Hormone ‘increases dramatically within the first 24 hours after PRP infiltration’. They said that their trials had shown its effects can include ‘rocketing both anabolic and catabolic growth factor release’.

They concluded that ‘our observation of statistically significant increases in multiple growth factors over multiple days after local PRP treatment points to a real systemic effect that cannot simply be ignored.’

The topic is sure to be among those discussed at WADA’s World Conference in Johannesburg next month.

How much of a benefit this might be to Nadal or any other athlete cannot be fully known, the same as with what part, if any, it might play in the ability of some to recover incredibly quickly from gruelling matches and bounce back for the next one.

Speaking to reporters at the Shanghai Masters, Nadal addressed the report and clarified that the procedure actually wasn’t as effective during his most recent injury.

“PRP worked unbelievable on my knee before, in 2010, 2009,” he said. “[In] 2009 I had to pull out of Wimbledon, then I came back, but I still I have pain. Just after Monte Carlo, I did for the first time the PRP treatment for my knee, but it was on the top of the knee, not down [below]. Worked unbelievable. I recovered 100 percent in a very short period of time during the PRP treatment.

“With the injury I have now, I did it. I tried it a lot of times, and it really didn’t help me a lot.”

The Daily Mail report also mentions Nadal’s use of an anti-gravity treadmill machine, which allowed him to stay fit during his injury layoff without putting too much strain on his knee.

Despite the seven months of rest and aggressive treatment and therapy, Nadal told reporters that he and his team didn’t find any magical recovery method. He still experiences pain in his knee, but he’s now learned how to manage it.

“The feeling on the knee is not 100 percent perfect,” he said. “But the feeling on the knee is very good for me because even if I have pain a lot of days, the pain is not limiting my movements. That’s the most important thing. I am playing with no limitations. I am free when I am playing. Even if I have pain, I am able to control that pain — something in the past I was not able to control that pain, so I couldn’t play.”

Nadal is seeking to win his record sixth ATP Masters 1000 tournament of the season this week. He’s never won this tournament since it moved from Madrid in 2009. Whether he wins it this year or not, he’s hopeful, if not confident, that he’ll have many more chances.

“[F]or the last five years, seems like a lot of people are talking like I will not be able to play long the way that I play,” he said. “But I am here again at 27 years old, and I really hope to have the chance to be here for a lot of more years.”

  • Published On Oct 08, 2013
  • 19 comments
    longy39
    longy39

    PRP stands for (plasma rich platelets), and its a process of taking your own blood then inserting this blood into a centrifuge that spins the blood for approx 10 mins. This separates the red blood cells from the plasma. the red blood cells are what remains at the bottom of the tube and the top lawyer is the plasma rich platelets.The PRP is then drawn out into a syringe and the rest is thrown out. 

    The skin around the injury is washed and then this PRP is injected into the injured area using 'Ultra sound' guidance. These 'platelets' in the plasma helps forms clots which stops bleeding (inflammation), and also have healing benefits that are due to chemicals called 'growth factors'. These growth factors have been shown to cause cells to multiply and form new tissue accelerating the healing time.However this procedure has been shown not to work on everyone but it wont do you any harm trying it either. If your lucky and it does work then you are still looking at many months down the track before the injury has healed enough to  resume any strenuous exercise. 

    PRP therapy is not in any way a performance enhancing procedure its purpose is designed for injury recovery and due to  its long healing process its not a quick fix!  the results so far show that the greater long term improvements outway other short term pain management therapies and also less injury recurrence. 

    The amount of time that Rafael took off tennis does coincide with the length of time that PRP therapy would take to get results. So i believe him 100%. Its his amazing tennis skills, speed and power that has got him to where he is today not any performance enhancing drugs. Its simply all the hard work and constant hours of training he puts into tennis that makes him so good! 

    Crisstti
    Crisstti

    SUCH a poor written article.  Quoting the Daily Mail?.

    "In a report in The Daily Mail, Nadal’s team opened up about his use of platelet-rich plasma therapy (PRP) during his knee rehabilitation."

    The Daily Mail didn't interview anyone from Rafa's team.

    Nadal's team has not "opened up" about the PRP treatment because it's NEVER been hidden, it's always been known he's used and it's in fact widely used by athletes.

    Plus, you yourselves quote him saying it didn't help him this time, so why the headline?.

    Pathetic.

    rafannie
    rafannie

    I would think PRP would be embraced by the sporting community as an excellent treatment to aid injured athletes. Just like any new surgical technique would be accepted. It's a faster way to heal without using any added PEDs. 

    George51
    George51

    Isn't this blood thing what Dr Fuentes is doing time for? I think they mentioned couple of top Spanish players who were Dr Fuentes patients. Is Verdasco saying it was him and Nadal ?

    Tofurkey
    Tofurkey

    He was never injured, he was serving a silent ban for doping

    Kathy27
    Kathy27

    Quote The World Anti-Doping Agency banned the procedure in 2010,

     That statement is not actually correct. PRP was prohibited in 2010, but only when it was administered by intra-muscular route. It was never prohibited when administered directly into tendons or ligaments.

    Quote from  WADA 2011 Prohibited List Now Published
    September 30, 2010

    Following its approval by WADA's Executive Committee on September 18, the 2011 List of Prohibited Substances and Methods is now available.

    This List will take effect on January 1, 2011.

    Noteworthy changes compared to the 2010 List include:


    Platelet-Derived Preparations

    Platelet-derived preparations (commonly referred as PRP or blood spinning), prohibited in 2010 when administered by intra-muscular route, have been removed from the List for 2011 after consideration of the lack of current evidence concerning the use of these methods for purposes of performance enhancement. Current studies on platelet-derived preparations do not demonstrate a potential for performance enhancement beyond a potential therapeutic effect.

    Cris
    Cris

    @George51  No, I think  the method Doctor Fuentes used  which was Illegal was blood transfusions  which used large quantities of blood  that boosted performance of athletes.This method uses very little blood directly into the tendons and does not affect overall performance like the transfusions do. 

    shelley
    shelley

    @George51 NO! Stop it. Nadal was NEVER a patient of Dr Fuentes, has NEVER had anything to do with him. Fuentes was before Rafa's time on the tennis circuit. 

    I'm so sick of all the nasty lies about Nadal circulated by the anti-Nadal brigade just because he beats your favourite player all the time.

    rafannie
    rafannie

    @Tofurkey  Writing something like that is libelous. Rafa has never failed a drug test. 

    dj13e29
    dj13e29

    The only way that would be conceivable is if Rafa was put on a provisional ban, then exonerated after his hearing. Players can be provisionally banned. Making it public is entirely up to the the player during the time before their hearing if the suspension is contested. However, if the suspension is upheld, it is made public. This is the stated policy of the ITF.

    gasa.dudu
    gasa.dudu

    @Tofurkey You need to not peddle lies. It's okay to dislike somebody, even hate them if you want but you will not make your dislike seem more legitimate by mud slinging. You don't like the guy; no need to tell lies about him.

    George51
    George51

    @Kathy27I think you misread it. It says it was removed because of lack of evidence it can be used for performance enhancement. The quote above is "have been removed from the List for 2011 after consideration of the lack of current evidence concerning the use of these methods for purposes of performance enhancement."

    shelley
    shelley

    @tennis.fan Yes. And it's a popular treatment in virtually every other sport too.

    arturohbelano
    arturohbelano

    @shelley @George51 

    Nadal is a dopepheine.  I am sick and tired of seeing how he takes 4-7 month breaks because his knees are bad only to come back like new and beat everyone. He has earned the suspicions...and the fact that the ATP protects dopers (through silent bans, accepting ridiculous explanations from players like Gascquet and Cilic) doesn't help him either 

    JacynKoski
    JacynKoski

    @gasa.dudu @Tofurkey 


    Exactly, that is nonsense. You could see in the tournaments leading up to his break that he was clearly injured.

    I have no idea why people are on the love Fed/Hate Rafa or vice versa. We should love them both because they are two of the all time best ever. We should be so lucky to have witnessed them back-to-back like this (for those of you who like hockey I would compare this to having Gretzky in his prime followed immediately after by Lemieux, amazing stuff).

    Enjoy the ride people, it is great.

    Kathy27
    Kathy27

    @George51 @Kathy27

    I didn't misread it.. PRP for injection into tendons and ligaments has, according to WADA always been allowed. It was never on the banned list when used for this purpose. However  they did not allow its use for injection into muscles, because they felt it  may increase muscle and therefore give some performance enhancement, consequently PRP via the intra-muscular route was banned. Now they have removed the use via the intra-muscular from the banned list , because there is very little evidence to show that it gives any performance enhancement. So just to summarize,

    1. PRP when used for the repair of tendons and ligaments i.e when injected directly into tendons and ligaments, was always allowed and still is. It was never prohibited.

    2. PRP when injected into muscles was on the WADA banned list, but is no longer on that list.