LOUISVILLE When Katherine Pohlgeers, MD, started medical school at the University of Louisville, she didn’t even know there was a specialty in primary care sports medicine. But once she shadowed those doctors, she realized it was the perfect fit for her.
After completing her residency and fellowship at U of L, Pohlgeers has been in family practice for the last six years, toggling between multiple roles: a team physician for U of L sports; seeing patients at University Hospital and Jewish Hospital in downtown Louisville; acting as medical director for a primary care office; seeing sports medicine patients at a location near the football stadium; and working with medical residents there. Pohlgeers works with Jessica R. Stumbo, MD, U of L primary care sports medicine fellowship director and clinic’s medical director, Jennifer Daily, MD, U of L primary care sports medicine associate fellowship director, and Brittney Richardson, MD.
Pohlgeers says she enjoys the diversity in her patient population. In the primary care sports medicine arena, the doctor says her goal is to keep her patients out of surgery as long as possible. She sees cases across the board: from U of L athletes to weekend warriors to 70-year old patients trying to get active.
“We see a lot of osteoarthritis, but because we see kids, we also see a lot of overuse or growth plate injuries. With all the new modalities, particularly in sports medicine, it’s always evolving. I find it exciting to keep up with all the new techniques and procedures out there,” says Pohlgeers.
PRP Promotes More Natural Healing
One newer treatment that has been added to the sports clinic’s repertoire this summer is platelet rich plasma (PRP) injections, which Pohlgeers used numerous times during her fellowship year. “I felt like the patients responded well enough to it that I wanted to incorporate it into our clinic. It’s been around a little while and is just now starting to get research data behind it,” she says.
The procedure involves using injections of the patient’s own blood to promote a more natural healing for chronic conditions as well as injuries. Pohlgeers explains that there are a variety of patients for whom this alternative treatment may be a good option. “You have some patients that can’t tolerate steroid shots, perhaps due to allergies or poorly controlled diabetes; or someone who has had steroid shots but they don’t work anymore due to advancement in their condition or disease.”
One advantage of PRP, according to Pohlgeers, is that PRP can be used in a wide spectrum of situations, from someone who just suffered an acute injury to a patient who has been dealing with the same injury for 20 years, such as a patient who is borderline for a knee replacement with bad osteoarthritis. They’ve had steroid shots but are now at the point where they have to decide if they want to have surgery or just learn to live with the pain and discomfort and alter their lifestyle. This is a perfect candidate to try PRP, says Pohlgeers.
“PRP is also excellent for treating some arthritic and degenerative type conditions.”—Katherine Pohlgeers, MD
PRP is also excellent for treating some arthritic and degenerative type conditions. “I love it for tennis elbow because that condition is one that’s frustrating to treat,” says Pohlgeers. “Before PRP, we’d tell patients they have the options of steroid injections, physical therapy, oral medication, or even nothing at all. Typically, the recovery time is all about the same. PRP offers another option.”
On the other end of the scale, PRP can be administered in acute presentations for athletes for certain body parts that might not be good candidates for steroid injections such as Achilles and patellar tendons, hamstrings, etc. “We can do PRP immediately, and I have definitely seen athletes returning to play quicker,” says Pohlgeers.
Other benefits to PRP are that, because it is using the patient’s own blood, there are no risk factors beyond the fact that there is a needle inserted, and also no limitations. “With steroids, you don’t want to do it too frequently, or be on it too long-term, especially if you start younger because you risk caustic effects to the joint spaces,” says Pohlgeers. In fact, she says, with PRP, patients seem to respond with not just short-term relief, but sometimes it fixes the problem completely. But if it does have to be repeated annually or alternated with steroid injections, there are no additional risks to the patient.
PRP Promising Treatment for Variety of Patients
Pohlgeers is encouraged by what she has seen so far and sees potential for using PRP injections to treat additional conditions or injuries in the future. “Plantar fasciitis is one example,” she says. “It’s a miserable condition for a patient, but steroids can cause fat pad atrophy, and when you lose the heel’s natural cushion, it’s not a good thing. PRP can be a great alternative.”
Pohlgeers doesn’t consider PRP to be experimental, especially if you can use it to avoid invasive surgery. Insurance companies, however, don’t yet pay for the procedures. That represents a challenge for patients who may not be able to afford the $450 out of pocket expense.
Pohlgeers says she believes it is just a matter of time before insurance companies get on board with covering PRP. “Once the data rolls in showing we’re either preventing or delaying surgery, it only makes sense.” She hopes that providers who have patients with chronic injuries remember to keep PRP in their “back pocket,” especially when talk turns to surgery. “It’s just another tool they can use,” she says.
Pohlgeers, a native of Fort Mitchell, Kentucky and former Bellarmine and Hillsdale College basketball player, has been in Louisville ten years and finds getting sidelined athletes back in action one of the most gratifying parts of her job. “When you do something like a PRP injection or another procedure, you see the immediate relief. They’re so grateful, and you did something that to you is pretty simple, but for them is a gamechanger.”
Pohlgeers says being a team physician for U of L sports is a dream come true. “I’m a huge U of L fan, and it’s pretty great getting to be a part of my favorite team.”