A recent Runner’s World article cited the seven most common running injuries – how they are caused, how to rehab them and how to prevent them from coming back again. Not surprisingly these common running injuries have many of the same causes ranging from increasing mileage too soon, running in old shoes, weak muscle strength or structural weaknesses in the hips, knees and ankles.
No matter the cause, the solution is usually the same:
Rest, ice, compression and elevation (RICE) coupled with anti-inflammatory medication and a possible brace or splint.
A cutback in mileage or discontinuation of running for a few weeks up to a year.
Cross train on the elliptical, bike or in the pool.
Strengthening various muscle weaknesses associated with the specific injury .
While some of the above help (you can read further on our views of RICE, anti-inflammatories, steroid shots and braces) they may not always heal completely. These traditional treatments for running injuries often miss the foot problem, causing the runner to cease training and risk dropping out of the race. Thankfully, Prolotherapy offers a successful alternative to the common treatments for running injuries.
Let’s take a look at the most common running injuries & what Prolotherapy can do to heal them.
Definition: Runner’s knee is often diagnosed as chondromalacia patella or patallefemoral syndrome. The patella, or kneecap, is covered on its backside with the thickest layer of articular cartilage of all the joints in the body. Runner’s knee or Chondromalacia patella occurs when this cartilage deteriorates or erodes. Wearing away and cracking of the cartilage under the kneecap results in pain and degeneration which subsequently causes the cartilage to become rough and causes the kneecap not to glide smoothly over the knee. Many runners report that the pain feels worse while going down the stairs.
Prolotherapy to the knee induces inflammation to stimulate the immune system and bring in healing factors to the knee cartilage and surrounding knee ligaments. Therefore the cartilage behind the knee is built up again and strengthened. As the cartilage regenerates the cracking and pain diminishes and the kneecap is able to glide normally over the knee. Runners are encouraged to cycle and cross train throughout the course of treatment. Dr. Hauser gives specific guidance on resuming running, and many athletes are able to get back to training and run the race they have their hopes set on.
Definition: The Achilles tendon attaches the two major calf muscles to the back of the heel. It is the largest tendon of the human body and is one of the most commonly injured tendons in sports. Achilles tendon injuries occur when stress, such as overtraining, causes the tendon to tighten and eventually become irritated, resulting in pain.We have also seen this occur when runners switch too quickly to the popular “barefoot running” type shoes which can stretch the Achilles more than the body is used to.
The condition begins as a tendonitis because the Achilles tendon is trying to strengthen. Remember, the body is trying to heal itself through this inflammation. But often, because of NSAIDs and cortisone shots, the inflammatory process is halted. The tendon then begins to show signs of cellular damage and collagen degeneration. This is called tendinosis. Tendon pathology such as this can be encouraged to repair itself with Prolotherapy. Prolotherapy to the tendon can stimulate the growth of the tissue to make it stronger.
Definition: The hamstrings are the muscles running down the back of the thighs. They are responsible for bending the knee and extending the hip, and are used most when running, especially at speed. Pain occurs when there is tightness or weakness of the hamstrings or when the quadriceps (muscles on the front of the leg) are stronger than the hamstrings. One cause of hamstring pain is called tight hamstring muscle syndrome. It is most likely due to the pinching of the nerve that extends to the hamstring muscle because of the dislocation of a vertebra. Another theory is that it is a postural compensation for the displacement of the disc. And finally, it can involve ligament weakness that puts excessive stress on the hamstring muscle. On top of this, many of our jobs involve daily sitting, which also shortens the hamstrings.
Healing: In the case of tight hamstring muscle syndrome, Prolotherapy can help by strengthening the fibro-osseous junction of the ischial tuberosity, a point of attachment for the hamstring muscles. If the problem resides within the hamstring muscle itself, massage and myofascial release therapy will also be done. Neural therapy to the muscle belly and surrounding structures can also be given to relax the muscle and improve healing.
Definition: Plantar fasciitis involves painful inflammation on the bottom of the foot, along the thin layer of tough tissue known as the plantar fascia. The plantar fascia is made of collagen that is more rigid and non-stretchy. Repeated microscopic tears of the plantar fascia cause pain that is most notable in the morning after getting out of bed. Many of our patients with plantar fasciitis report that they feel like they will never walk again, let alone run.
Prolotherapy injections to the bottom of the foot strengthen the fascia and relieve pain. Dr. Hauser often recommends other ways to strengthen the fascia such as walking barefoot, wearing sandals, or using toe stretchers. He also provides specific guidance for cross training and running, allowing the body to fully heal before resuming full-on running, but allowing the athlete to continue to maintain his/her fitness levels, so as not to lose any ground.
Definition: Shin splints are known as medial tibial stress syndrome and can plague runners in their dominant leg. As with other injuries, shin splints can result from specific ligament weaknesses and cartilage degeneration in the shin. Tender areas are often felt in the form of one or more small bumps along either side of the shinbone. Boy, is this a painful injury, and one that lingers!
Healing: The only way to strengthen these ligaments and generate cartilage growth is through Prolotherapy that will stimulate plantar calcaneonavicular and posterior talofibular ligament repair. Orthotics are may also be a good addition to the healing program if the problem relates to gait. Dr. Hauser may also use neural therapy injections to assist with healing shin splints.
Iliotibial Band Syndrome (ITBS)
Definition: The iliotibial (IT) band runs along the outside of the thigh from the hip to the outside of the knee. The IT band stabilizes the knee during running. If there is any overpronation or weakness in the hip adductors or gluteal muscles the IT band will rub the side of the femur resulting in inflammation and irritation of the knee.
In the case of ITBS, Prolotherapy can help by stimulating ligament repair in the hip or knee joints allowing the IT band to loosen in its stabilization of a loose joint. The pain of ITBS is most commonly due to tendon and ligament weakness or cartilage deterioration. The safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage is Prolotherapy. After the healing is achieved, maintaining proper gait/form is essential to prevention. Dr. Hauser can assess your gait while in the office.
Definition: Stress fractures arise from overtraining as fatigues muscles are no longer able to absorb the shock of training. Therefore the bone takes over in shock absorption and tiny cracks, or stress fractures, occur in the bone. This injury occurs most commonly in the weight-bearing bones of the lower leg and foot. This is a serious and long lasting injury because not only do the muscles need to rest but the bone needs repair as well.
Prolotherapy heals stress fractures by strengthening the fibro-osseous (ligament-bone) junction in the area of the stress fracture. The inflammation induced by Prolotherapy strengthens the bone covering, or the periosteum, as well as the ligamentous and tendon/muscular attachments to the area. Neural therapy injections may also be given around the site of the stress fracture in order to increase the circulation in the area.Sometimes athletes’ hormone levels may also need to be checked to ensure that they are producing adequate levels to ensure healing. Adequate intake of Vitamin D, calcium, and protein are also essential to healing stress fractures. Sometimes athletes may feel that they are eating healthy, but in reality, they are not eating according to their physiology and may need to change their diets.
Runners’ injuries respond well to Prolotherapy because Prolotherapy addresses the root cause of the pain, which usually stems from structural weaknesses or cartilage degeneration from overuse. In simple terms, Prolotherapy stimulates the body to repair painful areas. It does so by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. Since the body heals by inflammation, Prolotherapy stimulates healing.
At Caring Medical, runners receive a physical examination by Dr. Ross Hauser that identifies the root cause of the pain. Prolotherapy addresses the root problem, leading to safe and effective healing, allowing runners to get back to what they love. If you are plagued by injury or you are starting to feel an injury coming on, don’t rest until you give us a call. Prolotherapy can get you back in the race.
Ross A. Hauser, M.D
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois running related injuries. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.
An alternative treatment for shin splints
Shin splints or medial tibial stress syndrome (MTSS) is caused by injury to muscle attachments onto the medial tibia which can include the soleus, posterior tibialis, among others. While traditional medicine treats shin splints with rest, ice, compression and elevation (RICE) and NSAIDs, these can often make the structures weaker and is one of the reasons shin splints often come back. Many athletes look to alternative treatments like Prolotherapy as a long-term solution to dealing with shin splint pain. In our practice in Oak Park Illinois, we use Prolotherapy to stimulate the body to repair the painful injured area(s) when the body’s natural healing process is not able to do the job on its own. As an avid runner myself, I know how it feels to be sidelined with a running injury!
In a study published in the February 2011 issue by the British Journal of Sports Medicine, the effectiveness of Prolotherapy was documented. Prolotherapy has long proven to be a great option for treating shin splints compared to traditional remedies because Prolotherapy strengthens the weakened areas, which is good news for runners who can’t seem to get over the pain. In our experience, typically 3-6 visits of Prolotherapy are needed to resolve chronic shin splints. This study proves what we have known for years! Prolotherapy gets runners back on the road much more quickly than the traditional treatments of icing, wrapping, and rest – which may linger on for months and months.
Do I Need to Modify My Training?
We recommends that you continue your training and activities while receiving Prolotherapy. Runners however may want to decrease mileage and avoid doing too much too soon. Using the ellipitcal or power walking on the treadmill set at an incline to keep the heart rate up can help you continue to exercise during treatments. Stretching the Achilles and calf muscles is very important as is strengthening the lower leg muscles. Listen to your body. While some muscle aches or discomforts are to be expected when you push yourself, pain is not. Pain is your body’s way of telling you that something is wrong. If you continue exercising through pain, you risk injury. And if you have an injury, seek help. You risk more damage and your recovery will take longer if you don’t!
In other words, traditional treatments for running injuries often miss the root problem, causing the runner to cease training and risk dropping out of the race completely. Prolotherapy addresses the real problem, leading to safe and effective healing, allowing runners to get back to what they love. Many of our runner patients’ races have been saved using Prolotherapy to get them safely back to running. If you are plagued by injury or you are starting to feel an injury coming on, don’t rest until you give us a call. Prolotherapy can get you back in the race.
Dr. Hauser received his M.D. from the University of Illinois, Chicago; completed his residency at Loyola-Hines VA-Marianjoy Hospitals in Physical Medicine and Rehabilitation; and received his Bachelor of Science degree from the University of Illinois, Urbana-Champaign. Dr. Hauser is the Medical Director and co-founder of the physician-run, comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy. He, along with his wife Marion, have written seven books on the topic of Prolotherapy, a comprehensive book on the natural medicine approach to cancer, as well as a myriad of articles and newsletters for the general public.