As if there weren't enough questions swirling around Tiger Woods, the golfer preparing to make his return to the game this week at the Masters revealed that he received an experimental medical treatment from a Canadian doctor under investigation for alleged links to human growth hormones.
During a long and open press appearance while practicing Monday at the Augusta National Golf Club, Woods said he had Dr. Anthony Galea administer PRP or platelet rich plasma treatments.
Woods had been linked to Galea in media reports since the doctor came under investigation after U.S. customs caught his assistant allegedly transporting HGH across the border.
Woods denied that he received human growth hormone treatments, or "any illegal drug ever for that matter," instead saying that he had received PRP treatments from the Canadian physician.
Neither the PGA Tour, nor Woods' representatives returned messages seeking comment.
Platelet-rich plasma injections, or PRP treatments, have spread across the sports medicine community in recent years, and are even reaching lay people. A few doctors in select academic research hospitals are investigating the idea, but most agree the technique is far from standardized, never mind proven.
During a PRP the procedure, doctors draw blood, put it in a centrifuge to separate the blood's plasma (which contains platelets) from the red blood cells and then inject the solution back into the patient's injury.
Supposedly this concentrated injection would mimic the healing process when blood swells around an injury site. The idea is to maximize, or accelerate the signals a swollen injury site sends to the body to continue the healing process.
But not all doctors are convinced the procedure really works.
"It's kind of expensive to pull it out plasma," said Dr. William O. Roberts, past president of the American College of Sports Medicine. "The temptation of it is that you're using your own tissue, your own blood to heal your injury. But the process? I'm just not sure it's ready to go yet."
"Some people have had good luck with it, and I don't know if it's real or not," Roberts said.
Plasma-Rich Platelet Treatments Are Mostly Experimental
Roberts said he does not endorse PRP and hasn't tried it in patients yet. A randomized control trial of PRP published in the Journal of American Medical Association didn't bode well for the treatment.
"It didn't have much better effect than the placebo," he said.
Effective or not, PRP is currently only restricted by sports organizations such as the World Anti-Doping Agency. According to ESPN, PRP is allowed by the PGA.
Why Human Growth Hormone Is Banned, But PRP Is Not
"Whether it [PRP] actually works or not, I think the jury is out," said Dr. Gary I. Wadler, chairman of WADA's prohibitive list committee.
WADA allows athletes to get platelet rich plasma treatments to heal torn ligaments, tendons and joint injuries if the athlete submits a declaration of use.
But Wadler said WADA bans PRP injections in muscles because "it's believed that it stimulates stem cells, which make the muscles get bigger" and that is perceived as enhancement rather than treatment.
Human growth hormone or HGH, on the other hand, is completely banned by many sports organizations.
Wadler said some lay people illegally try human growth hormone for its so-called "anti-aging" effects and some athletes may illegally try human growth hormone for enhancement purposes.
But, he said, "it's not for longevity, it's not for healing or for anti-aging."
"HGH is responsible for the growth of all tissues in the human body and if it's unregulated you can end up with serious problems, abnormal growth," Wadler said. "It can result in diabetes, carpal tunnel syndrome, hypertension and, some believe, certain malignancies."
Wadler said some patients are allowed HGH, such as children suffering from documented growth hormone deficiencies, people who cannot produce normal amounts of growth hormone because of damage to their pituitary gland or patients who are suffering in the "wasting stages" of AIDS.
Legal or illegal, doctors say the sports medicine world is full of new ideas to keep up with the competition to heal athletes. Some turn out to be fruitful, but Roberts said most turn out to be useless.
"If you counted supplements and things like that, new ideas come up very frequently but very few of them come out to make a lot of a difference. But sometimes people make a lot of money in the interim."
"I think it's better to have these tested before it's popularized," said Roberts.