Randi Druzin is an author and journalist based in Toronto. She has worked at the CBC and several other major media outlets, and has written for publications such as The New York Times and The Globe and Mail. She has also written three books. Randi first learned about regenerative medicine while researching a story on multiple sclerosis last year and has been fascinated with it ever since. Her web site is: www.rdcommunications.ca
When reports surfaced that NFL star quarterback Peyton Manning had turned to stem cell therapy to treat a neck injury (herniated disc) that had rendered him unable to throw, other athletes took notice.
In the five years since, hundreds of professional football players have used the therapy, as have professional basketball and baseball players. Soccer players have reportedly banked stem cells harvested from their bone marrow.
Tennis superstar Rafael Nadal underwent stem cell therapy to repair cartilage in his back in November 2014, a year after he turned to the therapy to treat a knee injury.
Not surprisingly, there has been a trickle-down effect and a growing number of recreational athletes are now turning to stem cell therapy in their haste to return to action.
Specialists are isolating mesenchymal stem cells (MSCs), which can grow into new bone, cartilage, muscle or connective tissue, from the athlete’s own blood, bone marrow or fat cells then injecting them into damaged tissue with the aim of boosting the healing process.
The torn meniscus, one of the most common sports injuries, is viewed as an ideal candidate for stem cell therapy because this cartilage is composed of one cell type (chondrocytes) and heals slowly due to a relatively low blood supply. Some research suggests that when MSCs are injected into the knee they transform into chondrocytes and promote healing.
From ruptured Achilles tendons to tennis elbow, tendon injuries are also prevalent in sports. The tendon heals by producing new fibers that fuse with healthy tissue. But the process is slow and, because it creates scar tissue, the tendon is left weakened and less pliable. MSCs may generate cells that lead to increased collagen production in the damaged tendon, which enhances the healing process.
MSCs play a pivotal role in the healing of damaged bone. A fracture causes inflammation, which draws these stem cells. They transform into chondrocytes and the rebuilding process begins. Studies suggest that direct injection boosts the healing process.
The use of stem cell therapy to treat sports injuries has expanded and become a multi-billion dollar industry with clinics popping up around the world. (The cost of one stem-cell treatment can range from a few thousand dollars to seven times that amount, depending on the extent of the treatment and the country.)
In response, many physicians and researchers are waving the red flag, emphasizing that these therapies have not been clinically proven to be effective.
Researchers at Rice University in Houston, Tex., looked at the growing use of stem cell therapies for orthopedic treatment in the U.S., particularly among NFL players, and said the league must take steps to better understand and regulate this treatment to protect the health of their players.
Closer to home, Timothy Caulfield, the Canada Research Chair in Health Law and Policy at the University of Alberta, describes stem cell research as incredibly promising, but notes that very few stem cell therapies are ready for the clinic. The treatment athletes are receiving, he says, has not been established to be effective in well-run clinical trials.
“Stem cell research is an exciting area of research. I believe that a host of beneficial therapies for a range of diseases are on the horizon,” he says. “But we aren’t there yet, no matter what you hear about Manning and Nadal.”
He’s howling into the wind.
In their quest to be faster, higher and stronger, elite athletes have been pulling out all the stops as far back as Ancient Greece, when competitors experimented with herbal medications, used hallucinogens and even ate animal testicles to give them a competitive advantage.
In Ancient Rome, not even animals were immune from the effects of man’s competitive zeal. Chariot racers fed their horses an alcoholic beverage made from honey hoping it would make them run faster. (It’s still unclear how the inebriated animals were able to negotiate the tracks’ hard turns.)
If an elite athlete would consume the naughty bits of an animal to attain peak performance, why wouldn’t he allow bone marrow blood to be extracted from his pelvis to speed up his recovery from an injury?
It’s a rhetorical question, of course.
High performance athletes will continue to go to great lengths to be fighting fit — and the recreational athletes who travel in their wake will follow suit. As H.R. Haldeman, Richard Nixon’s chief of staff, once said, “You can’t put that toothpaste back in the tube.”
All physicians can do now is continue to sound the alarm bells and hope that regulators make it hard for non proven therapies to be offered, and wait for the day science delivers on the incredible promise of stem cell therapy.