With the sun coming out and Spring in bloom, training season is already in full force as runners gear up for this summer’s races. Sports injuries can get in the way of training and set back an athlete’s progress.
Typical treatments for running injuries involve rest, ice, compression and elevation. The RICE protocol is effective for alleviating acute inflammation, but it does not correct chronic joint dysfunction nor does it repair damaged connective tissue and cartilage.
Many athletes are choosing prolotherapy as a treatment for their sports-related injuries. Prolotherapy is a non-surgical treatment that repairs weakened, stretched and torn ligaments and tendons, and rebuilds cartilage within a joint. Prolotherapy involves injections of dextrose, saline solution and anesthetic into joints and into attachment points of ligaments and tendons.
The weakest point of a ligament or tendon is at the weld point, where it attaches to the bone. This is commonly where a connective tissue tear will occur.
Dextrose (concentrated sugar solution) stimulates a localized inflammatory response at the site of injury, which calls to action the immune system and brings healing cells to the area to repair the damage, lay down organized fibers of connective tissue, and build new cartilage. Because there is limited blood flow to connective tissue, ligament and tendon injuries often do not heal effectively without the help of surgery or dextrose prolotherapy.
Below are some examples of very common running injuries that can be treated using prolotherapy:
Tight Hamstrings/ Hamstring Pain
Tension in the hamstrings can be due to an imbalance or subluxation in the low back or pelvis, weakness of the hamstring tendons which attach to the ischial tuberosity (sit bones) and backs of the knees, or quadriceps muscles that are stronger than the opposing hamstrings.
Treatment involves assessing the joints and muscles of the low back, pelvis, hip and knee for subluxation or imbalance. Prolotherapy can be used to repair ligament weakness, pain, or tearing within the connective tissue of the hamstrings. Strengthening exercises for the hamstrings and injections into trigger points within the muscle belly may also be indicated.
Runner’s Knee (Chondromalacia Patella)
Runner’s knee is an overuse injury that results in degradation, cracking and wearing away of the cartilage under the kneecap. As a result, the kneecap no longer glides smoothly over the surface of the joint when flexing and extending the knee. This can result in significant pain, especially when descending stairs.
Treatment for chondromalacia patella with prolotherapy involves injections into the joint space under the kneecap which stimulate cartilage repair via new cartilage growth. During this time, cross-training such as swimming, elliptical, or cycling are most beneficial, and running can resume shortly after as the cartilage surface regenerates.
Plantar fasciitis is a painful inflammation of the connective tissue on the sole of the foot. Tears in this connective tissue from overuse, tightness of the calf, weakness of the arch or improper footwear can be extremely painful, especially upon rising in the morning, and can put an athlete out of running commission for a long time.
The plantar fascia runs along the sole of the foot, from the calcaneus (heel bone) to the ball of the foot. With tearing and constant trauma to the plantar fascia at the calcaneus, heel spurs may also develop, increasing the discomfort associated with this condition.
Prolotherapy can strengthen and repair the plantar fascia and the medial and longitudinal arches of the foot via injections into the sole and the heel. Exercises to strengthen the foot and stretch the muscles of the calf are also prescribed.
The Achilles tendon can become tightened and irritated from overuse or barefoot running. The body tries to repair the tendon through inflammation, but this condition often becomes chronic when inflammatory healing is suppressed through the use of NSAIDs and cortisone injections.
Chronic Achilles tendinosis is characterized by deterioration of the tendon, scarring and fibrosis. Prolotherapy injections into the tendon and at its attachment to the heel can promote proper collagen formation and organized connective tissue deposition to help re-strengthen the integrity of the tendon.