PRP and Gel Shots for Your Knees?What does the Science Say and is There a Less Invasive Alternative?

If we can keep our Pickleball knees feeling loose and mobile we can play better and pay less of a price in the aftermath, right? Well, listen, painful and degenerative knee joints need optimal recovery after all that stop and go on the court. Your first priority is to remove the impact and torsion, yes, that means what you don’t want to hear....a day or two off!

But for some ongoing maintenance and assistance, what’s the deal with all these gel shots and PRP methods? And is there a secret, non-invasive alternative? Stay tuned....

First of all, what is PRP and what are gel shots?

PRP stands for Platelet Rich Plasma and Gel Shots are actually injections of Hyaluronic Acid! Ok, but that really doesn’t make it any clearer. What are these treatments all about?

For PRP, they draw your very own blood and then they “Spin” your blood to separate and segment “the good stuff” and then they inject these growth factors into your knee joint to promote tissue healing and reduce inflammation. 

For “Gel Shots,” they are basically injecting a naturally occurring substance (Hyaluronic Acid) that exists in synovial (joint) fluid meant to lubricate and provide “cushion” to the inside of your knee! What we know, is that this substance is diminished in arthritic joints and can lead to pain, stiffness, and discomfort. 

Ok, What’s the Science telling us about the effectiveness?

In a very recent, high-quality research study ² Xu H et al concluded that PRP is more effective than HA, but in another recent credible study, Du D and Liang Y¹ indicated that when combining PRP with HA (Gel Shots), the patients benefit from more pain relief AND achieve better function than with PRP treatment alone! Nothing else needs to be said! 

But....is there a less invasive alternative that produces great results? 

Enter Extracorporeal Shockwave Therapy (ESWT) ! 

From experience, I can attest to the application of hypersonic soundwave as an alternative that can make your knees feel better and function better and delay the need for PRP, HA, or surgical intervention. The Softwave brand of ESWT does a phenomenal job of reducing inflammation and pushing away inflammatory chemicals (cytokines) at the cellular level, recruiting stem cells from your own bone marrow, and producing angiogenesis (building new blood vessels) thereby delivering more oxygen. Basically, calming down angry joint surfaces!!! I see this success up close and personal in every day practice with painful and arthritic knees in Pickleball players! 

I personally haven’t seen evidence for combining PRP, HA injections, and ESWT for the hat trick, but the future may very well hold those cards!!!!

Final ThinkaDink

I know Pickleball players just like you who will go to any length to continue playing the fastest growing sport in the US and perhaps globally in some regions. It helps to know the scientific evidence and also the real time clinical results of pickleball injury providers. It looks like you can’t lose when combining PRP and Hyaluronic Acid (HA) “Gel Shots” if you’re looking for some extra mileage on those knees! But also, consider going to softwavetrt.com, punching in your zip code and finding a Softwave-Shockwave provider near you. Lastly, and as always, please try to maintain an anti-inflammatory diet and participate with exercises and activities that promote strength and mobility of your knees!

References:

1.) Du D, Liang Y. A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA). J Orthop Surg Res. 2025 Jan 17;20(1):57. doi: 10.1186/s13018-024-05429-w. PMID: 39819683; PMCID: PMC11740359.

2.) Xu H, Shi W, Liu H, Chai S, Xu J, Tu Q, Xu J, Zhuang W. Comparison of hyaluronic acid and platelet-rich plasma in knee osteoarthritis: a systematic review. BMC Musculoskelet Disord. 2025 Mar 11;26(1):236. doi: 10.1186/s12891-025-08474-6. PMID: 40069655; PMCID: PMC11895219.