“Preparing the Soil”: How to Get the Best Results from Your PRP Injection

Why Preparation Matters in Regenerative Medicine

When it comes to treatments like Platelet-Rich Plasma (PRP), most people focus on what is being injected. But in reality, where it’s going matters just as much, and we’re not just talking about anatomy. We're talking about the internal environment of the body, the metabolic soil in which PRP must grow.

Just like a seed won’t thrive in poor soil, PRP will struggle in a body overwhelmed by inflammation, insulin resistance, nutritional deficiencies, or sleep deprivation.

Recent research confirms that you can dramatically improve the outcome of PRP and other regenerative therapies by first optimising your internal biology.

What Does the Evidence Say?

Two groundbreaking studies from 2024 have shifted how we think about PRP preparation:

1. The SDIMMMER Model

Lana et al. proposed a framework called SDIMMMER, which stands for:

Sleep, Diet, (gut) Microbiome, Metabolism, Medications, Exams, and Rehabilitation.

By scoring patients in these seven areas, clinicians can identify hidden roadblocks, like poor sleep or low vitamin D, that may sabotage regenerative outcomes.

🔗 Lana JF et al. Life. 2024;14(6):1287

2. “Preparing the Soil” for Healing

Fonseca and colleagues reviewed how poor metabolic health, from low protein intake to gut dysbiosis, impairs tissue healing and reduces the impact of PRP.

They argue for a multi-week pre-treatment phase, aimed at correcting inflammation, blood sugar levels, micronutrient deficiencies, and microbiome imbalances.

🔗 Fonseca LF et al. Int Wound J. 2024;21:e70056

What This Means in Practice: The PRP Preparation Protocol

We’ve taken these insights and turned them into a clear, structured pre-PRP protocol that we now use in our clinic. It’s designed to give your body the best possible conditions for healing.

1. Start with a Soil Check (4 - 6 Weeks Before)

We test key markers of internal health, including:

• Blood sugar and insulin (HOMA-IR)

• Inflammation (hs-CRP)

• Vitamin D, zinc, and iron levels

• Hormones like testosterone or oestrogen

• Gut health and diet quality

We also apply the SDIMMMER scoring system to assess readiness across seven domains. The goal? A low-inflammation, well-nourished internal environment.

2. Stop Things That Block Healing (2 Weeks Before)

Some medications and supplements interfere with PRP’s regenerative effect:

• NSAIDs (like ibuprofen) and steroids, they blunt the very inflammation that PRP uses to stimulate healing

• High-dose omega-3s, turmeric, and curcumin, great for general health, but should be paused temporarily before your injection

• Alcohol and excessive caffeine, these can impair platelet function in the short term

3. Prime Your Body with Nutrition and Gut Support

Your cells need raw materials to rebuild tissue. So we ensure:

• Plenty of protein: aim for 1.6 g per kg of body weight per day

• Vitamin C, zinc, and copper: essential for collagen production

• Vitamin D: helps regulate inflammation and muscle health

• Prebiotics and probiotics: to nourish your microbiome and produce healing compounds like short-chain fatty acids (SCFAs)

  
  

4. Prioritise Sleep and Stress Management

Good sleep is a powerful biological modulator. Just a few nights of poor rest can reduce your platelets’ ability to function properly.

We recommend:

• Aiming for 7.5 - 9 hours of sleep

• Limiting screen time at night

• Using tools like magnesium or melatonin when needed

  
  

5. Move Your Body (But Don’t Overdo It)

Before your PRP injection:

• Stay active with light aerobic exercise (like walking or cycling)

• Avoid heavy strength training of the injured area

• Exercise helps sensitise your tissues to respond to PRP by boosting blood flow and growth factor receptors

6. On the Day of Your PRP Injection

• Stay hydrated (500 ml water beforehand)

• Avoid anti-inflammatory medications

• No fasting needed unless your procedure is under sedation

We perform the injection under ultrasound guidance, using a gentle draw technique to preserve platelet integrity.

7. What to Expect After PRP

• First 48 hours: mild inflammation is a good sign. Avoid ice and NSAIDs.

• Week 1 - 2: gentle rehab and movement encouraged

• Week 2 onwards: structured physiotherapy and activity plan

• Supplements like turmeric, collagen peptides, and omega-3s can resume after 3 days

What You Can Do to Boost Your PRP Outcome

Focus Area	What to Aim For
Nutrition	High-protein diet, daily vitamin C, D, zinc
Inflammation	hs-CRP < 1 mg/L, no NSAIDs before/after
Metabolism	HOMA-IR < 2, stable blood sugar
Sleep	7.5+ hours per night, consistent routine
Gut Health	Prebiotics + probiotics for 4 weeks prior
Hydration	35 ml water per kg body weight daily
Exercise	Light aerobic activity, no overload on affected limb

Final Thoughts

Regenerative treatments are only as good as the environment you place them into.

By preparing your body through nutrition, movement, sleep, and targeted bloodwork, you’re dramatically increasing your chances of recovery, and turning PRP into a true catalyst for repair.

Book a consultation to assess your readiness for PRP and optimise your healing: Pa@drbotchey.com

References

1. Lana JF, et al. SDIMMMER: A Proposed Clinical Approach to Optimize Cellular Physiology in Regenerative Medicine. Life. 2024;14(6):1287. Link

2. Fonseca LF, et al. Preparing the soil: Adjusting the metabolic health of patients with chronic wounds and musculoskeletal diseases. Int Wound J. 2024;21:e70056. Link

3. Everts PA, et al. Meta-inflammation impairs platelet bioactivity: Implications for orthobiologics. Stem Cell Res Ther. 2022.

4. Jo CH, et al. High-sensitivity CRP predicts PRP efficacy in knee osteoarthritis. Am J Sports Med. 2021.

5. Dohan Ehrenfest DM, et al. Classification of PRP and PRF: Platelet concentrations and biological rationale. Curr Pharm Biotechnol. 2012.