PRF and PRP for Sports Injuries With Chiropractic Care

Abstract

Sports injuries can damage tendons, ligaments, muscles, joints, and other soft tissues. When these tissues heal slowly, healthcare professionals may consider biologic treatments such as platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) as part of a larger recovery plan.

PRP and PRF are made from a patient’s own blood, but they are not exactly the same. PRP is generally prepared as a platelet-rich liquid that can be injected into an injured area. PRF uses the body’s natural clotting process to create a fibrin network that can hold platelets, white blood cells, and signaling proteins within a three-dimensional structure. Research suggests this fibrin structure may allow some growth factors to be released over a longer period. However, PRF research in orthopedic and sports medicine is still developing, and results can differ depending on the injury and preparation method (Grecu et al., 2019; Costa et al., 2025).

An integrative recovery plan may also include chiropractic care and rehabilitation to address movement, joint mechanics, muscle control, and other physical factors that may continue to stress an injured area. At Injury Medical Clinic PA in El Paso, Texas, this multidisciplinary approach combines chiropractic and rehabilitation services with medical oversight, functional medicine, and injury care.

PRP, PRF, and PFP: Understanding the Terminology

A quick terminology clarification is important.

PRP stands for platelet-rich plasma.

PRF stands for platelet-rich fibrin.

The term “platelet fibrin plasma,” or PFP, is sometimes used informally, but it is not the standard term used in medical research for these treatments. When discussing sports medicine and orthobiologic treatment, PRP and PRF are the clearer terms.

Both begin with a blood draw from the patient. The blood is placed in a centrifuge, which separates components according to their physical properties. The goal is to prepare a portion of the patient’s blood that contains useful platelets and biological signaling substances and then place that preparation near the injured tissue. Yale Medicine, Johns Hopkins Medicine, and Hospital for Special Surgery describe PRP as an autologous treatment, meaning it comes from the patient’s own blood (Yale Medicine, n.d.; Johns Hopkins Medicine, n.d.; Hospital for Special Surgery, 2024).

Platelets are best known for helping blood clot. They also contain proteins and growth factors involved in the body’s normal response to injury. When concentrated platelets are placed near damaged tissue, these substances may help support cellular signaling, inflammation control, blood-vessel activity, and tissue remodeling. PRP has been studied for several tendon, ligament, muscle, cartilage, and joint problems, although results vary by condition and treatment protocol (Milano et al., 2019; Patil et al., 2024).

How Is PRF Different From Traditional PRP?

PRF is often described as a second-generation platelet concentrate.

One important difference involves clotting.

Traditional PRP is usually prepared so that it remains liquid long enough to be injected into the target tissue. PRF can be prepared without adding an anticoagulant. Because the blood is allowed to begin its natural clotting process, fibrin fibers form a three-dimensional network (Grecu et al., 2019).

Depending on the preparation method, PRF may be produced as:

• A fibrin clot
• A fibrin membrane
• A gel-like product
• Injectable platelet-rich fibrin, or i-PRF

The fibrin network may trap platelets, leukocytes, proteins, and growth factors within the treatment area. Research has also found that some PRF preparations can provide a slower release of certain growth factors compared with more rapidly activated platelet products (Miron et al., 2020).

It is important, however, to avoid saying that conventional PRP simply “evaporates.” PRP is a liquid biologic preparation that interacts with the tissue after injection. PRF differs because it can develop a stronger fibrin structure that functions as a temporary biological scaffold.

However, it should also not be described as stem-cell therapy. PRF is mainly a platelet-, leukocyte-, and fibrin-based blood product. Some preparation techniques may capture different circulating cells, but that does not make a PRF injection the same as a dedicated stem-cell procedure.

Why Does the Fibrin Scaffold Matter?

Think about the PRF fibrin network like a temporary biological framework.

After an injury, the body needs cells and chemical signals to communicate with one another while damaged tissue is repaired and remodeled. Fibrin is naturally involved in this process.

The PRF matrix may help:

• Keep platelets near the treatment area
• Hold growth factors within a fibrin network
• Support cellular attachment and migration
• Provide a temporary framework during healing
• Release some biological signals gradually
• Support the body’s normal tissue-repair process

PRF does not literally replace a torn tendon, ligament, or muscle. A better description is that it may provide a biological environment and scaffold that supports the body’s repair response.

This difference matters because regenerative medicine should not be presented as creating new tissue instantly. Healing still requires time, proper loading, adequate circulation, appropriate nutrition, and progressive rehabilitation.

Which Sports Injuries May Be Considered for Platelet Therapy?

PRP has been studied more extensively than PRF in sports medicine. Research has examined platelet-based treatments for conditions involving tendons, ligaments, muscles, cartilage, and joints (Milano et al., 2019; Patil et al., 2024).

Depending on the diagnosis and severity, clinicians may consider platelet therapies for problems such as:

• Patellar tendinopathy
• Achilles tendinopathy
• Tennis elbow
• Golfer’s elbow
• Rotator cuff tendinopathy or selected partial tears
• Certain ligament injuries
• Muscle strains
• Knee joint problems
• Some cartilage injuries
• Chronic soft-tissue injuries that have not improved as expected

PRP evidence is not equally strong for every condition. Reviews of sports-related muscle, tendon, and ligament injuries have reported positive findings in some areas while showing limited or inconsistent benefits in others. Treatment protocols also differ greatly between studies (Cruciani et al., 2019).

Research on PRF in orthopedic care is newer. A 2019 review found possible benefits in several musculoskeletal applications but also emphasized conflicting results and differences in preparation methods. A 2025 review of injectable PRF similarly described the treatment as promising while calling for better clinical research and standardized protocols (Grecu et al., 2019; Costa et al., 2025).

This is why each athlete should be evaluated individually rather than assuming PRP or PRF is appropriate for every injury.

Combining PRF With Integrative Chiropractic Care

A sports injury is rarely only a cellular problem.

Consider an injured knee. The damaged structure may be the patellar tendon, ligament, meniscus, or cartilage. But the athlete may also have poor hip control, limited ankle motion, weak gluteal muscles, altered walking or running mechanics, or compensatory movement.

An injection alone cannot correct all of those mechanical factors.

This is where integrative chiropractic care and rehabilitation may fit into the recovery plan.

Chiropractic care can focus on musculoskeletal evaluation, mobility, joint function, and movement patterns. Rehabilitation can then progressively rebuild strength, balance, coordination, endurance, and sport-specific movement.

Possible goals include:

• Restoring comfortable joint motion
• Reducing unnecessary mechanical stress
• Improving movement patterns
• Correcting muscle imbalances
• Improving balance and coordination
• Gradually strengthening injured tissues
• Rebuilding sport-specific movement
• Reducing factors that may contribute to reinjury

Research supports being careful about exaggerated claims. Chiropractic care should not be promoted as automatically increasing athletic performance. Earlier reviews found insufficient evidence to claim that spinal manipulation by itself directly improves sports performance. Its more reasonable role is as one possible part of musculoskeletal care and rehabilitation when clinically appropriate (Miners, 2010).

Biological Healing and Mechanical Rehabilitation

A useful way to understand this combined approach is to think of recovery as having two connected sides.

The biological side addresses the injured tissue.

PRP or PRF may provide platelets, fibrin, and biological signals that support healing.

The mechanical side addresses how the body moves.

Chiropractic care, therapeutic exercise, mobility work, and rehabilitation can help control the forces being placed on the healing tissue.

The goal is not to claim that chiropractic treatment makes PRF work better at the cellular level. Direct clinical trials proving a special PRF-chiropractic biological synergy are not currently established.

Instead, the treatments can address different parts of the same recovery problem.

A biologic injection may support the injured tissue, while rehabilitation addresses strength and load tolerance. Chiropractic care may address selected joint and movement limitations. Functional medicine may evaluate broader health factors when appropriate.

Dr. Alex Jimenez’s Clinical Approach to Injury Recovery

Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, describes a clinical model that connects biological treatment with biomechanics and rehabilitation.

In his published clinical observations, Dr. Jimenez emphasizes evaluating the injured structure while also examining the mechanical environment around it. His approach may include imaging, movement testing, progressive exercises, neuromuscular retraining, chiropractic care, and attention to metabolic and lifestyle factors (Jimenez, 2026).

For example, an athlete recovering from a knee problem may need more than treatment directed at the knee. Hip strength, walking mechanics, ankle mobility, balance, and lower-body control may also need attention.

For a shoulder injury, treatment may include evaluation of the shoulder as well as the shoulder blade, upper back, neck, and muscle-control patterns.

These are clinical observations rather than proof that one combination is superior for every patient. They support the broader idea that successful sports rehabilitation often requires more than a single procedure.

Medical Oversight With Dr. Maria Guadalupe Cardenas, MD

At Injury Medical Clinic PA in El Paso, Texas, Dr. Jimenez works within a multidisciplinary setting that also includes Dr. Maria Guadalupe Cardenas, MD, a board-certified Internal Medicine physician with more than four decades of medical experience. Public professional listings identify her NPI as 1164426748 and her Texas medical license as J2933. Clinic information identifies Dr. Cardenas as Medical Director and Collaborative Physician.

Her internal medicine background adds another level of medical oversight when patients have health issues that may affect recovery.

These may include:

• Diabetes or poor blood-sugar control
• Cardiovascular conditions
• High blood pressure
• Medication concerns
• Bleeding risks
• Kidney or liver problems
• Inflammatory conditions
• Other medical conditions that may influence treatment decisions

This allows the Injury Medical Clinic PA team to combine chiropractic care and rehabilitation under Dr. Jimenez’s clinical direction with medical oversight involving Dr. Cardenas, while also providing functional medicine, personal injury care, diagnostic evaluation, and related multidisciplinary services. Clinic materials describe this broader approach as addressing sports injuries, personal injuries, work injuries, musculoskeletal problems, rehabilitation, wellness, and functional medicine concerns.

A Step-by-Step Sports Injury Recovery Plan

A multidisciplinary program may follow a path such as:

1. Identify the injury.
   The team performs an examination and reviews imaging when needed.
2. Determine the cause and severity.
   A tendon problem, ligament tear, joint injury, or muscle strain may require different treatment.
3. Decide whether platelet therapy is appropriate.
   PRP or PRF is not needed for every sports injury.
4. Protect the healing area.
   Adjust early activity to prevent unnecessary overload.
5. Restore movement.
   Chiropractic care, mobility treatment, or other conservative care may be used when appropriate.
6. Begin progressive rehabilitation.
   Strength and movement exercises are increased as the tissue tolerates more load.
7. Correct movement problems.
   The athlete works on balance, coordination, posture, joint control, and sport-specific mechanics.
8. Test readiness to return to activity.
   Pain alone should not be the only measurement. Strength, movement quality, confidence, and functional performance also matter.

This creates a more complete recovery plan than depending on an injection alone.

The Takeaway

PRP and PRF are related but different autologous platelet treatments.

PRP remains the more established platelet therapy in sports medicine research. PRF adds a natural fibrin network that may create a three-dimensional scaffold and provide a more gradual release of certain biological signals. However, PRF research for orthopedic and sports injuries is still developing, and neither treatment guarantees tissue regeneration or a faster return to sports.

When appropriate, platelet therapy can become one part of a wider recovery program.

At Injury Medical Clinic PA in El Paso, the multidisciplinary model combines Dr. Alex Jimenez’s chiropractic, functional medicine, injury care, and rehabilitation approach with medical oversight by Dr. Maria Guadalupe Cardenas, MD. The purpose is to look at both sides of recovery: the biology of the injured tissue and the mechanics of the person using it.

For an athlete, that can mean treating the injured structure while also rebuilding the strength, mobility, coordination, and movement needed to return safely to activity.

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References

Costa, F. R., de Souza, S. A. L., Martins, R. A., et al. (2025). The role of injectable platelet-rich fibrin in orthopedics: Where do we stand? Current Issues in Molecular Biology, 47(4), 239.

Cruciani, M., et al. (2019). Platelet-rich plasma for sports-related muscle, tendon and ligament injuries: An umbrella review. Blood Transfusion.

Grecu, A. F., Reclaru, L., Ardelean, L. C., Nica, O., Ciuc?, E. M., & Ciurea, M. E. (2019). Platelet-rich fibrin and its emerging therapeutic benefits for musculoskeletal injury treatment. Medicina, 55(5), 141. https://doi.org/10.3390/medicina55050141

Hospital for Special Surgery. (2024). Platelet-rich plasma (PRP) injection: How it works.

Jimenez, A. (2026). PRP and chiropractic for faster injury recovery explained. DrAlexJimenez.com.

Jimenez, A. (n.d.). About Dr. Alexander Jimenez and the multidisciplinary clinical team. DrAlexJimenez.com.

Johns Hopkins Medicine. (n.d.). Platelet-rich plasma (PRP) injections.

Lin, A. F. C., Piong, S. Z., Wan, W. M. H., Li, P., Chu, V. K., & Chu, E. C. P. (2023). Unlocking athletic potential: The integration of chiropractic care into the sports industry. Cureus, 15(4), e37157.

Milano, G., Sánchez, M., Jo, C. H., Saccomanno, M. F., Thampatty, B. P., & Wang, J. H. C. (2019). Platelet-rich plasma in orthopaedic sports medicine: State of the art. Journal of ISAKOS, 4(4), 188–195. https://doi.org/10.1136/jisakos-2019-000274

Miners, A. L. (2010). Chiropractic treatment and the enhancement of sport performance: A narrative literature review. Journal of the Canadian Chiropractic Association, 54(4), 210–221.

Patil, P., Jadhav, M., Suvvari, T. K., & Thomas, V. (2024). Therapeutic uses of platelet-rich plasma (PRP) in sport injuries—A narrative review. Journal of Orthopaedic Reports, 3(2), 100287. https://doi.org/10.1016/j.jorep.2023.100287

Yale Medicine. (n.d.). Platelet-rich plasma (PRP) injections in sports.