The Use of Biologics in NFL Athletes: An Expert Consensus of NFL Team Physicians
Murray IR, McAdams TR, Hammond KE, Haddad FS, Rodeo SA, Abrams GD; a Group of American Professional Football Physicians; Bankston L, Bedi A, Boublik M, Bowen M, Bradley JP, Cooper DE, Craythorne C, Curl LA, ElAttrache N, Gazzaniga DS, Kaplan K, Khalfayan EE, Larson C, Pepe M, Price MD, Schroeppel JP, Voos J, Waslewski G, West R. Orthop J Sports Med. 2023 Feb 10;11(2):23259671221143778. doi: 10.1177/23259671221143778. PMID: 36798799; PMCID: PMC9926009.
Physicians from National Football League (NFL) teams and NFL London developed a consensus on 47 statements related to the use of biologics (e.g., platelet-rich plasma, cell-based therapies) among NFL team physicians (see the list on the last page of the PDF). The document covers the challenges of treating NFL athletes, terminology, blood products (e.g., platelet-rich plasma), cell-based therapies, guidance for physicians, and future research.
I am a current MSAT student and hope to work in the NFL, so this very interesting to me. The ambiguity in the terminology of stem cells is a point of apprehension for physicans working in the NFL and have led to uncertainty in many biologic treatments as an intervention for rehabilitation back to RTP. Although the NFL and USA in general accepts the positive use of PRP injections for specific pathologies. There is also evidence that PRP can lead to degeneration or weakening of ligamentous tissues, so exploring other biologic options could be a new avenue with positive outcomes and less negative ones associated with it. With limited evidence it is understandable to restrict current NFL players from the use of biologic treatments, however, the research and use of biologics in general should continue as to validate its use. Furthermore, the pressures in the NFL as it is a very public and high level of play, leads to decisions like medical tourism and options that they think will shorten the length of them being out from injury, and will ignore the advise of the NFL Medical Professionals to see it out anyway. In such cases, the data should be collected to gather population specific data on the effectivity!
My question that requires more thought and research is regarding the mechanisms by which these biologics will follow. The terminology of stem cell and my background in undergrad as well as the mapping of biomarkers and tissue specific targeting is not clicking at the moment and will require more time on my part to fully comprehend the red tape from the NFL Physicians on the use of biologics as an intervention.