As a sports medicine specialist, I see many athletes on the examination table with "hot" inflammation in a joint that is hindering their ability to play their game. In the past, this athlete would have gone to another specialist with the hope of receiving a cortisone injection. Cortisone, they believed, would have them flying off the off the table with an expectation to be back at the game or training immediately. The problem that the medical community and athletes soon found out was that too much of a good thing - cortisone - can lead to a quicker end of the athlete's ability to participate in sports. For sports medicine specialists, an alternative to cortisone is just as important as being able to administer a cortisone injection. For some specialists that alternative is Prolotherapy.
Cortisone Cortisone is a naturally occurring steroid in the human body. In the late 1940's and 1950's researchers developed ways to produce it synthetically and make it available on a grand scale. Hailed as a miracle drug, it was widely prescribed by physicians for a large array of inflammatory problems and for the athlete, it was considered the gold standard for chronic inflammation, and THE way to get them back on the field as fast as possible.
Too much of a good thing The rampant, nearly unchecked use of cortisone, started to show its consequences to patients. Physicians and researchers started to issue warnings on the overuse of cortisone injections. As far back as 1969 Researcher Rodney Sweetnam writing in the Journal of Bone and Joint Surgery reported that not only were surgeons noting that prolonged usage of corticosteroids lead to the development of severe vertebral osteoporosis but also ruptured tendons in athletes. Later research points to cortisone accelerating cartilage degeneration in joints.
Alternatives Athletes have learned through research and their own personal experience that repeated cortisone injections will lead to arthritis, joint degeneration, and other unwanted side-effects. Athletes also want to be healed and returned to to their game as strong as before if possible. This is where the use of Prolotherapy can help reduce inflammation, reduce pain, and as opposed to cortisone, rebuild damaged tissue and strengthen the athletic joint. And Prolotherapy has been proven in studies to do this without the negatives of cortisone.
Chronic injuries in athletes are mostly caused by wear and tear on the connective tissues of the joints. Mainly, the ligaments, which connects bones to bones, and tendons which hold muscles to bones. It is these soft tissues that are the main culprit in joint inflammation, and the ones that receive cortisone injections.
Prolotherapy is a series of injections of simple dextrose (sugar) that stimulates the body to send the cells necessary to repair and strengthen damaged ligaments and tendons. Prolotherapy introduces dextrose into the area so that a mild, controlled inflammation occurs through irritation of the soft tissue. The immune system recognizes this irritation as an injury and is jump started into sending a new wave of immune cell building blocks to heal the wound.
Studies have shown that Prolotherapy can stimulate a 50% increase in mass and a 200 - 400% increase in ligament strength.
At our clinic, Darrow Sports and Wellness Institute, we don't like to offer cortisone but sometimes, in extreme chronic injury, cortisone, used one time is a very good diagnostic test to see where the pain generator is, and at the same time quiet the pain. The next step is to use Prolotherapy to rejuvenate the tissue and end the pain. Prolotherapy treatments for the athlete are typically given once a week over a 4 - 6 week period.
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