Platelet-Rich Fibrin (PRF) and Chiropractic Care for Sports Injury Recovery

Abstract

Sports injuries can damage tendons, ligaments, muscles, joints, and other soft tissues. When healing is slow, some patients may benefit from treatments designed to support the body’s natural repair process. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are treatments made from a patient’s own blood. Both concentrate platelets and healing signals, but PRF also creates a fibrin network that can hold platelets, white blood cells, and growth factors near an injured area.

PRF is being studied as a possible treatment for orthopedic and sports injuries because its fibrin structure may provide a longer-lasting biological environment for tissue repair. When appropriate, PRF or PRP may also be combined with integrative chiropractic care, corrective exercise, rehabilitation, and medical management. This multidisciplinary approach addresses both biological healing and the mechanical problems that may continue to place stress on injured tissue. However, PRF research in sports medicine is still developing, and results can vary depending on the injury, preparation method, and patient.

PRP, PRF, and “PFP”: Clearing Up the Terminology

The first important step is understanding the names.

PRP means platelet-rich plasma.

PRF means platelet-rich fibrin.

The term “platelet fibrin plasma” or “PFP” is sometimes used informally, but it is not the standard medical name for these therapies. PRP and PRF are related because they are both made from a patient’s own blood, but they are not exactly the same product.

PRP is produced by drawing blood and processing it in a centrifuge. This separates and concentrates platelets within plasma. The platelet-rich solution can then be injected into an injured tendon, ligament, muscle, or joint. Platelets contain growth factors and signaling proteins involved in normal tissue repair (Johns Hopkins Medicine, n.d.; Yale Medicine, n.d.).

PRF belongs to the same general family of autologous platelet concentrates, but it includes a stronger fibrin network. Researchers describe PRF as a platelet- and leukocyte-rich fibrin material that can hold platelets and growth factors within a biological scaffold (Grecu et al., 2019).

Therefore, PRF should not simply be called another name for PRP. The goal of both treatments is similar—supporting natural tissue repair—but the way the blood product is prepared and behaves after treatment can be different.

How Platelet-Rich Plasma Supports Sports Injury Healing

Platelets are best known for helping blood clot after an injury. They also release growth factors and chemical signals involved in healing.

PRP places a concentrated amount of these platelets near damaged tissue.

According to Yale Medicine, PRP has been used for problems involving:

• Tendons
• Ligaments
• Muscles
• Cartilage
• Chronic tendon injuries
• Rotator cuff injuries
• Tennis elbow
• Golfer’s elbow
• Certain arthritic joints

(Yale Medicine, n.d.).

Hospital for Special Surgery also describes PRP as an option used for selected tendon, ligament, and muscle injuries. However, results are not identical for every condition, and research remains mixed for some problems such as certain rotator cuff injuries (Hospital for Special Surgery, 2024).

PRP should therefore be viewed as a tool that may support healing, not as a guaranteed cure.

What Makes PRF Different From Traditional PRP?

PRF was developed as another generation of platelet concentrate.

One major difference is the role of fibrin.

Fibrin is a protein involved in normal clot formation. In PRF, fibrin forms a three-dimensional network that can act like a natural biological scaffold. Platelets, leukocytes, proteins, and growth factors can remain within this network (Grecu et al., 2019).

Many PRF protocols also avoid adding an anticoagulant. Injectable platelet-rich fibrin, often called i-PRF, may initially remain liquid long enough to be injected before gradually forming a fibrin network. This is different from saying that every PRF product begins as a thick solid gel.

A 2025 review of injectable PRF in orthopedics describes i-PRF as an anticoagulant-free platelet concentrate containing fibrin, leukocytes, platelets, and growth factors. Researchers believe these components may help support tissue regeneration and blood-vessel formation, although more research is needed to determine the best preparation and treatment methods (Costa et al., 2025).

Think of PRP and PRF this way:

• PRP: Primarily provides concentrated platelets in a plasma solution.
• PRF: Provides platelets and healing signals within a developing fibrin network.
• PRF’s fibrin scaffold: May help keep biological signals around the treatment area for a longer period.
• Both: Come from the patient’s own blood.

PRF should also not be described as a stem-cell treatment. PRF contains platelets, fibrin, leukocytes, and other blood-derived biological components. It is different from procedures designed specifically to harvest or deliver stem cells.

Why the Fibrin Scaffold May Matter

A sports injury creates a complicated healing environment.

For example, when an athlete partially injures a tendon, the body must control inflammation, remove damaged material, create new tissue, form blood vessels, and gradually strengthen the repaired area.

PRF may help by creating a temporary fibrin framework around the injury.

The scaffold can serve as a place where platelets and signaling molecules remain concentrated while the body performs its normal repair work. Reviews of PRF describe this fibrin structure as one reason researchers are interested in PRF for orthopedic and musculoskeletal medicine (Grecu et al., 2019; Costa et al., 2025).

However, the science is still developing.

Researchers have reported promising results in areas such as cartilage repair, rotator cuff surgery, ligament healing, and other orthopedic applications. At the same time, studies have produced conflicting results because PRF preparation methods, centrifuge settings, treatment doses, and injury types are not always the same (Grecu et al., 2019).

A 2025 laboratory study comparing PRP and PRF after medial collateral ligament injuries found stronger ligament tissue and better collagen organization in the PRF-treated animal group. The researchers clearly stated that human clinical trials are still needed before those results can be applied broadly to patients (Sakti et al., 2025).

Sports Injuries That May Be Evaluated for PRP or PRF

Depending on the diagnosis, injury severity, medical history, and previous treatment, platelet-based treatments may be considered for certain musculoskeletal problems.

Examples may include:

• Tennis elbow
• Golfer’s elbow
• Patellar tendinopathy, or jumper’s knee
• Achilles tendon problems
• Partial ligament injuries
• Rotator cuff tendinopathy
• Some partial tendon tears
• Chronic muscle injuries
• Certain knee injuries
• Early joint degeneration
• Slow-healing soft-tissue injuries

PRP already has a larger body of sports-medicine research than PRF. Reviews describe PRP as a commonly studied orthobiologic for tendon, ligament, muscle, and joint problems, although results depend heavily on the diagnosis and PRP formulation (Milano et al., 2019; Patil et al., 2024).

Why an Injection Alone May Not Fix the Entire Sports Injury

An important question remains:

What caused the tissue to become overloaded in the first place?

A biologic injection may support tissue healing, but it does not automatically correct every movement problem.

For example, a runner with patellar tendon pain may also have:

• Poor hip control
• Limited ankle movement
• Weak gluteal muscles
• Abnormal running mechanics
• Poor recovery between workouts
• Repeated excessive training loads

A shoulder injury may involve poor shoulder-blade control, limited thoracic movement, muscle imbalance, or repeated throwing stress.

This is where rehabilitation and integrative chiropractic care may fit into a broader plan.

How Integrative Chiropractic Care Fits With PRF

Integrative chiropractic care focuses on the mechanical side of recovery.

Depending on the patient and diagnosis, Dr. Alex Jimenez’s clinical approach may include assessment of joint movement, posture, strength, mobility, muscle balance, spinal and extremity mechanics, and movement patterns. Clinic materials also describe the use of rehabilitation, corrective exercise, mobility training, nutrition, and functional medicine as parts of multidisciplinary care.

The goal is not to claim that chiropractic adjustments make PRF work better at the cellular level. High-quality clinical trials specifically testing PRF plus chiropractic care are still lacking.

Instead, the treatments can be viewed as addressing different parts of the same injury:

• PRF or PRP: May support biological tissue repair.
• Chiropractic and manual care: May help improve selected joint and movement problems.
• Corrective exercise: Builds strength, control, and tissue tolerance.
• Rehabilitation: Gradually prepares the injured area for normal activity.
• Medical oversight: Helps identify medical risks and determine whether injections or other treatments are appropriate.

This approach is especially useful when a sports injury involves more than one problem.

The El Paso Multidisciplinary Model

At Injury Medical Clinic PA in El Paso, Texas, care is organized through a multidisciplinary model.

Clinic information identifies Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN, as Clinical Director and as a chiropractor and Family Nurse Practitioner involved in chiropractic care, functional medicine, injury management, and rehabilitation.

His published clinical observations emphasize looking beyond the painful tissue itself. His educational materials discuss combining regenerative approaches with movement assessment, rehabilitation, nutrition, and correction of mechanical stress rather than depending solely on an injection (Jimenez, 2026).

Medical oversight is provided through collaboration with Dr. Maria Guadalupe Cardenas, MD, whose clinic materials identify her as Board Certified in Internal Medicine and Medical Director and Collaborative Physician. The practice lists her as NPI #1164426749 and Texas MD License #J2933.

Dr. Cardenas brings decades of internal medicine experience to the multidisciplinary setting. Her role allows her to provide medical evaluation and oversight alongside the neuromusculoskeletal care provided by Dr. Jimenez.

Together, the clinical model integrates areas such as:

• Chiropractic care
• Medical evaluation and oversight
• Sports injury treatment
• Functional medicine
• Personal injury care
• Rehabilitation
• Corrective exercise
• Musculoskeletal assessment
• Nutrition and health evaluation

This type of coordinated care is useful because an injured athlete may have both damaged tissue and a movement problem that continues to stress that tissue.

A Step-by-Step Sports Injury Recovery Plan

A complete non-surgical rehabilitation plan may follow several stages.

1. Identify the injury

The first goal is to determine exactly what is injured. A clinical examination and, when needed, imaging can help determine whether the problem involves a muscle, tendon, ligament, joint, cartilage, or another structure.

2. Reduce damaging stress

Training may need to be temporarily changed so injured tissue is not repeatedly overloaded.

3. Consider regenerative treatment

If appropriate, a qualified clinician may consider PRP, PRF, or another medical treatment based on the diagnosis and available evidence.

4. Improve movement

Chiropractic care, manual therapy, mobility work, or other treatment may be used when joint or movement restrictions are part of the problem.

5. Rebuild strength

Progressive rehabilitation helps the healing tissue tolerate greater loads.

6. Restore sports-specific function

Running, jumping, throwing, lifting, cutting, and other sport-specific movements are gradually reintroduced.

7. Return to sport safely

Pain relief alone does not mean that an injury has completely healed. Strength, movement control, mobility, and tolerance to sports activity should also be considered before full return.

Yale Medicine notes that patients undergoing PRP should follow their clinician’s instructions about returning to sports and may receive PRP together with rehabilitation or other treatments (Yale Medicine, n.d.).

The Bottom Line

PRP and PRF are related but different blood-based treatments.

PRP concentrates platelets within plasma. PRF adds an important fibrin network that can hold platelets, leukocytes, growth factors, and signaling molecules within a three-dimensional biological scaffold.

This feature makes PRF an interesting next-generation orthobiologic for sports medicine. However, the clinical evidence for PRF remains less developed than the research on PRP. Preparation methods also vary, so PRF should not be presented as automatically superior to PRP for every sports injury.

For the right patient, the strongest strategy may be a complete rehabilitation plan rather than one isolated treatment.

PRF or PRP may address the biological side of tissue recovery, while integrative chiropractic care, corrective exercise, medical oversight, and progressive rehabilitation address movement, loading, strength, and function.

At Injury Medical Clinic PA in El Paso, the multidisciplinary model used by Dr. Alex Jimenez and Dr. Maria Guadalupe Cardenas reflects this broader approach: treat the injured tissue while also looking at the mechanical, functional, and medical factors that influence recovery.

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References

Costa, F. R., de Souza, S. A. L., Martins, R. A., Costa, B. R., Pires, L., Macedo, A. P., Santos, N., Huber, S. C., Santos, G. S., Kruel, 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. https://doi.org/10.3390/cimb47040239

Grecu, A. F., Reclaru, L., Ardelean, L. C., Nica, O., Ciucă, 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) injections.

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

Jimenez, A. (2026). Why choose our clinical team?.

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

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

Patil, P., et al. (2024). Therapeutic uses of platelet-rich plasma (PRP) in sport injuries—A narrative review. Journal of Orthopaedic Reports, 3(2), 100287.

Sakti, M., et al. (2025). Comparison of outcomes in application of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in medial collateral ligament recovery: An animal study. Orthopaedic Journal of Sports Medicine, 13(3). https://doi.org/10.1177/23259671251324472

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