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Tottenham could turn to the treatment, which has a chequered history in sport, to hurry Gareth Bale back into action but what are the benefits and is there even evidence it works?

By Husmukh Kerai

When Gareth Bale's right ankle buckled under an innocuous-looking challenge from David Degen during Tottenham's Europa League clash with Basel last week, White Hart Lane collectively held its breath hoping the Welshman's injury was not as serious as it looked.

In a desperate attempt to rush the talismanic 23-year-old back into action, Spurs have reportedly once again turned to the controversial procedure of blood spinning.

Andre Villas-Boas revealed that the club have been using the treatment since the start of the season.

He told reporters earlier this year: "We believe a lot in [non-isolated] growth factor treatment and plasma platelet treatments. It is not common but does happen from club to club."

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The practice, which the club also used on Jermain Defoe's pelvic injury this campaign, reportedly helped the striker recover five-times quicker.

Platelet-Rich Plasma Therapy (PRP), or "blood spinning" as it is more commonly known, has a checkered history in sport. For years the use of the procedure has been considered controversial and even deemed illegal within particular sporting bodies.

In 2005 Chelsea, while under the management of Jose Mourinho, were referred to the World Anti-Doping Agency (Wada) over their use of the method to speed up the recovery of their injured players.

UK Anti-Doping (UKAD), the body responsible for drug testing in Britain, had also advised footballers to stay away from the treatment at the time.

However, the stigma surrounding the procedure is now slowly beginning to fade after Wada lifted the ban on PRP a year after it was originally imposed in 2010, with UKAD also revising their position.

A Wada spokeswoman said the anti-doping agency eased restrictions on PRP because, after careful consideration of the latest research, there was no evidence that the procedure actually enhances performance.

"Despite the presence of some growth factors, platelet-derived preparations were removed from the list as current studies on PRP do not demonstrate any potential for performance enhancement beyond a potential therapeutic effect," Julie Mass, director of communications of of the world's anti-doping agency, explained to Goal.com.

"Wada will continue to monitor all substances and methods that have the potential for abuse, based on the latest research and studies. We are connected closely to research and clinical teams working with PRP in order to regularly monitor the effect of this method."

The treatment has been considered common practice in the United States for a few years now, with American sports stars such as Tiger Woods, Kobe Bryant and Alex Rodriguez all admitting to having undergone the procedure to aid their recovery from injury.

Professor Chris Cooper, Director of the Centre for Sports and Exercise Science at the University of Essex told Goal.com: "Basically you take a sample of the athlete's blood, spin it down so that you get a solution rich in cells called platelets and some associated growth factors. Then you inject these at the site of the injury."

The effectiveness of the procedure is still a subject of debate, though, with further research required for a definitive answer. Any endorsement of the treatment from medical experts has so far only been anecdotal.

The treatment is no longer banned because it does not enhance performance, but there is still no definitive proof it actually boosts healing.

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"The technique has been around for about 20 years to aid recovery in dentistry and facial surgery. The evidence that it is helpful in sports injury is weaker. Though there is a lot of suggestive data that it can improve healing after sports injury, there is as yet no definitive clinical trial saying it works," Professor Cooper continued.

Blood spinning is not to be confused with blood doping, which is still illegal. The practice when 'administered by the intramuscular route', the technique used by Lance Armstrong in the Tour de France, is used to enhance endurance.

Platelet-rich injections administered to tendons rather than muscles, as in blood spinning, are intended to boost healing and not performance and therefore remain permissible in sport.

Simply stated, blood spinning is legal because it aims to repair soft-tissue tears naturally, blood doping is illegal because it attempts to enhance red blood cell counts artificially.

Professor Cooper continued: "The practice was briefly banned by anti-doping agencies as it was a form of blood manipulation, but it is no longer on the banned list. You are basically just transferring a component of your own blood to the site of the injury. So it is very different to the sort of blood doping that Lance Armstrong got up to."

While it may no longer be against the law, the uncertainty over its effectiveness means blood spinning still has an element of desperation about it.

But it is a desperate situation that Spurs now find themselves in, and they will seemingly do anything within the rules to get their star man back on the pitch as soon as possible.

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