Prolotherapy Instead of Platelet Rich Plasma? Who knew!

I have been trying to "fix" my leg and a few other parts for the better part of 2 years and I am sooo tired of it! And I can honestly say it is my fault as I didn't do the right things soon enough and I didn't stop training when I should have. So here I am, almost 2 years later, an entire race season washed under the bridge and I have finally found a treatment I hope will help me heal quickly and permanently.

18+ months ago I hurt my left hamstring on a very cold run. It didn’t get worse or better for many months and then when I tried to increase intensity summer 2010 race season (RED FLAG) it would not respond. I raced through my 2010 season at 75% knowing something wasn’t right but it was tolerable. I have enough tolerance for pain and good people like Dr. Ken who keep me moving...sadly to me detriment.

Last winter I trained for and raced a 55K in Moab. My left leg tolerated the training because it was all slow, on trail and linear. On the rare occasion that I would trip or fall sideways I knew there was a problem because my left leg would not respond. I literally would fall on my face. (RED FLAG!) It was getting worse but I really wanted to finish Moab! Idiot! After Moab the top of my hamstring got sorer, tighter and angrier but I started tri training anyway. I found if I stayed straight it would tolerate more abuse. Then in April I started to increase speed and intensity and I was shocked at how weak, sore and useless my leg became. I did a speed workout with Tyler and gang in Chatfield one evening and it would warm up but stopping and starting was terrible! The next week I was running with Barry and Julie on a soft surface and I was cruising in the middle of the 400 but when I had to restart I was completely ripped with pain. It hurt and would drag behind for the first 100 yards. HOW MANY MORE RED FLAGS DO I NEED? ASK MY 2 X HUSBANDS?

Thanks to Heidi I found Dr. Tim Mazzola at Cornerstone Ortho. He is a non-surgical Ortho and he did all his due diligence: x-ray, MRI, movement analysis. Great doctor with a great attitude. The diagnosis from the MRI was severe tendonosis. Apparently I had so much scar tissue at the top of my hamstring it was choking off the tendon making it useless and apparently I need that tendon to make my muscles run free and happy. After reviewing my pending race season we agreed I would not do Lubbock and Loveland, get PT 2-3 times a week and see if we could address my imbalance and stability issues. PT with Diana Gamache was incredible as I learned so much about my body, my weaknesses and my strengths. I quit doing anything but swimming for 2+ months with the thought that I would consider PRP after a real run at PT. Then at Lake2Lake (I became the perpetual cheer leader this summer!) I ran into an old friend and she knew a triathlete who had the same symptoms I had and he had PRP done and was running 10 days later! Yahoo! It turned out this guys was a Loveland, Kevin, and he emailed me all the info about his doc in Boulder who did his injections.

I packed up my lil medical records and went to see Dr. Roger Nichols, Radiologist at Boulder Community Hospital. A very confident guy who has done thousands of injections and knew what all my symptoms were without me saying a word. He knew his shit and I felt like I was now in good hands. This is not to say that Mazzola wasn't a great doctor however he had only done a couple PRP imjections on hamstrings and I was looking for much better odds than that.

Again we reviewed my history and devised a plan. Now I would not do Long Course Worlds in Las Vegas, a winter marathon or any racing except for Worlds in China. I was going to start and finish that race even if I had to walk my bike and crawl the run! Course correction...get a big fat dose of cortisone in July, let it soak in and then train for 3-4 weeks to the degree that I could, race in China and then, if necessary, do PRP when I returned from China. I hated backing off more big races but I knew after 2 weeks of "training" that there was no way I could get ready for November Worlds so I settled into my decision and focused on Beijing.

The cortisone worked enough so that I could race at 75% and have a blast doing it! By the time I got back from China I knew I wasn't healed...something was still wrong. I called Dr. Nichols and scheduled PRP but I never really felt good about it because he has no plan for follow up, rehab or a protocol for anything after the shot. Take a few days off and then run. If it hurts stop. That may sound logical to you however I was really worried about doing more damage and wasting my $1,200+ investment. PRP is not covered by insurance. OUCH! I also considered having Mazzola do thte injections because he has a sound protocol and that made me feel a little better...honestly neither option felt good and John knew it. He could tell the closer the date for the injection got the more anxious about it I got.

In my search for information I had posted a note on Irongirls endurance on FB and asked if anyone knew about PRP and the like. I had some great conversations and it sounds like others suffer from the same "pain in the ass" that I do! Then Deb emailed me and suggested I check out a local DO who does injections. Dr. Jo Douglas at Regenerative Solutions. She is right down the street from me and she saw me that evening...3 days before my scheduled PRP injection. Dr. Douglas focuses on Prolotherapy and PRP for patients with arthritis and injuries. I had no idea what I was getting into when I walked into the office and now I can say I am a PROLO patient.

http://regenerativesolution.com/

In all my reading about PRP I had seen info about prolotherapy but didn't know what it was all about and I had never had it suggested to me. Her assessment of my issues included a lengthy ultrasound session from the top of my SI joint all the way down and around my hamstring. She is training a young man for his boards so she was very instructive and it was wild to see the good and the bad happening in my butt and leg. It turns out that I have 2 very weak ligaments trying to hold my pelvis in place and since they are failing miserably my pelvis is rotated backwards and my hamstring tendons are under constant strain. Hmmm news to me. And, there are 3 attachment points for my hamstring and all 3 are deteriorating and need help. Enter prolotherapy. Here is the best explanation of prolotherapy I could find:

The term "Prolotherapy" is short for "proliferation therapy." Proliferation, of course, means "rapid production." What Prolotherapy rapidly produces is collagen and cartilage. Collagen is a naturally occurring protein in the body that is a necessary element for the formation of new connective tissue—the tissues that holds our skeletal infrastructure together. These tissues include, tendons, ligaments, muscle fascia and joint capsular tissue.

Prolotherapy helps make collagen through a series of injections, not of collagen, but of mild chemical or natural (such as dextrose-sugar) irritants, which stimulates the immune system's healing mechanism to produce collagen naturally. The making of new collagen makes for strengthened and restored joints. Restored and strengthened joints make for permanent pain relief.

Is that wild info or what? I had no idea that we could treat ligaments or that connective tissue was made from collagen like our skin! So, I bared my butt Friday night and took far too many shots in order to initiate the healing! I would be lying if i said it didn't hurt. Maybe because I was so inflamed or maybe because of the location but whatever the reason it hurt more than most things I have endured! And I was swearing like a truck driver (no offense to truck drivers!) and loudly too. It hurt so much it made me cry! Ugh! The next 3 days were equally bad because I couldn't sit or lie on my back...and NO ICE OR IBUPROFEN! Stupid rules! But they make it clear I don't want to do anything to inhibit the healing process! Ha! I have to admit my hamstring doesn't hurt only because the freaking ligament and needle spots hurt so much! Geesh!

What's next? Little to no activity for 10 days while my body works its magic and begins to lay down new tissue and strengthen and heal! Then I start to run a little, ride a little and see how I feel. I go back to Dr. D. in 3 weeks and will likely have to endure another round but she promised it would hurt less! It better!

Cost for Prolotherapy? I whole lot less than PRP and it covers a whole lot more spots than one injection of PRP! Let me know if you want to learn more as I am going to see this through to the end! IMCD here I come!