Thinking Outside the Doctor's Office

Runners Find Relief from Alternative Treatments for Injuries

Alana Watkins of Denver was a skeptic. She was training for the New York City Marathon in 2002, running about 40 miles per week, when she developed plantar fasciitis. "I tried everything: stretching, cortisone shots, orthopedic inserts, chiropractors, physical therapy—the whole nine yards," she says. After two years of pain and frustration, she was on the brink of surgery when she decided to try acupuncture. Watkins’s course of treatment began with once-a-week visits to the acupuncturist for a month, then tapered off over the next few months. Watkins felt immediate pain relief after the first treatment, and the relief lasted longer after each subsequent treatment. "After about two months—maybe five or six treatments—I was pretty much completely pain free," says Watkins. "There were several contributing factors, both physical and psychological, but my acupuncturist was the catalyst for the healing process finally being set in motion."

Dr. Berger says that the recent popularity of this all-natural technique is due, in part, to a modern problem. The doping scandal in track and field and drug use in other sports has spurred interest in natural treatments such as acupuncture. "The athletes don’t want to take any chances," she says.

Body, Heal Thyself

As with ART, prolotherapy is a method of repairing damaged soft tissue. Instead of manually working to remove scar tissue, the osteopaths and M.D.s who practice prolotherapy use injections to stimulate the body to generate healthy, stronger tissue. Doctors began using prolotherapy in its current form in the 1950s, though the concept dates back to Hippocrates.

A solution, typically dextrose (sugar water), combined with an anesthetic to dull the pain of the injection, is injected into a weak or damaged ligament or tendon. Then, the body takes over. The injection causes inflammation, swelling, and pain—it’s a trick to make the body think that a fresh injury has occurred. The body reacts to the inflammation by increasing the blood supply to the damaged area, which results, naturally, in tissue repair. "In a sense, we are turning the body’s own natural healing system back on," says Brian J. Shiple, D.O., who performs thousands of prolotherapy injections per year, and says that 80 to 90 percent of patients who receive those injections have good to excellent results.

Prolotherapy injections do not contain the anti-inflammatory steroid cortisone; in fact, prolotherapy could be considered the anti-cortisone treatment because the key to the treatment is inflammation. Currently there is no protocol for treatment; it’s extremely important to find a doctor who has exceptional knowledge of anatomy and is trained and experienced in prolotherapy. The number of injections per treatment, the number and frequency of treatments, and the amount and concentration of the solution are the doctor’s call, and all depend on the location and severity of the injury.

"We treat patients anywhere from one to six times, three to six weeks apart for most conditions," says Shiple. "Some problems may need as many as 10 treatments." Post-treatment pain starts a few hours after the injection. It takes one to three days for any swelling and pain to diminish, but can last as long as five days, and in rare cases, 10 days.