Thinking Outside the Doctor's Office

Runners Find Relief from Alternative Treatments for Injuries

Shiple, the Division Chief of Sports Medicine and Director of the Sports Medicine Fellowship Training Program for the Crozer-Keystone Health System in Springfield, PA, says that he is gaining company in the medical community in looking outside medicine’s traditional black bag to treat injuries. "Now, we’re getting referrals for prolotherapy from surgeons.

Avoiding surgery was Kandi Blomquist’s primary goal. A triathlete from Novato, CA, Blomquist tore her left medial collateral ligament while lifting weights. She could hardly walk. Her MCL had been a trouble spot before, and she knew what her long-time orthopedist was going to recommend: no training for six weeks; or surgery, then no training during recovery from surgery. "I had worked so hard to get to this point," says Blomquist, who was six weeks away from her goal race. "The thought of losing those gains was really upsetting." Instead, she headed to the Berkeley, CA, office of Donna Alderman, D.O., for a thorough exam and her first treatment, which included 18 injections into her MCL.

Blomquist reports that she never felt any pain post-treatment, just some stiffness. She took one day of complete rest, then slowly eased back into her training. Two weeks post-treatment, she had her first really challenging workout scheduled. "After an hour at race pace on the bike, followed by an hour on the treadmill, the only place my knees didn’t ache was where the prolotherapy had been done," says Blomquist. She has completed two of her four scheduled treatments, and plans to make it to the start of her triathlon healthy and confident. "It has not been painless, but to be back running, biking and swimming this fast after a pretty major injury is almost miraculous."

Not all injuries or patients are candidates for prolotherapy. Ligament or tendon ruptures off the bone are not appropriate injuries to treat with prolotherapy. In addition, people who smoke, are allergic to procaine-type anesthetics, who have bleeding disorders that require anti-clotting medications, or who are severely immuno-compromised should avoid prolotherapy.

Some doctors try other treatments before prolotherapy, because it is a more invasive treatment. Elite runners also shy away from this therapy because it often requires the patient to take a day or two off from training. "Our usual treatment protocol is a trial of ART or physical therapy prior to performing prolotherapy," says Shiple, who has worked on runners and other athletes at the U.S. Olympic Training Center in Colorado. "Sometimes ART will take care of the problem and we can avoid the needles. Other times ART will decrease the number of injections per treatment."