Sunday was the Mercedes Marathon and I was a spectator, which put me in a foul mood for most of the day. Fortunately, I had something in which to look forward. The next morning, I hit the road for Nashville, TN, which is one of my favorite cities, to see a doctor who has lots of experience with runners who have struggled with chronic pain. Have any of y'all heard of prolotherapy? I didn't think so. Then again, adrenal fatigue is not exactly well understood in the medical community and tests such as neurotransmitter and tissue mineral analysis are almost never done yet are far more effective than conventional treatments. I had heard about it through one of my alternative medicine contacts. Noel from California, a triathlete who is also being treated for adrenal fatigue. He really recommended it. Then a prolotherapy doctor who is also a runner found this blog and made a comment. After that point, I went with my gut. If I tweaked the Achilles tendon again, which I did, I would make the appointment for prolotherapy. Also, I wanted to get my hip/groin area examined. I hurt it when I was 19 and because of the hormonal imbalances (I was hyperthyroid at the time and that condition would worsen in subsequent years), I felt that it never properly healed. The pain was usually about a 2 on a scale of 1-10 and yes, it was there when I set my most recent 13.1 PR of 1:32:57. I could usually feel it during the day but it was never any worse when I ran. Amino acids would help but the fact that it never fully went away made me feel uneasy. I thought that it was an inflammatory condition but my latest medical report proved that it was not. Perhaps it would improve when I got my thyroid/adrenals in balance but that has not been an easy task so I listened to my gut and made the trip up to Nashville.
Monday- I slept in as long as I wanted and would not leave until about 9:30. For breakfast, I simply picked up a Special K protein bar at a gas station in Fultondale (just north of B'ham). From there, it was a smooth ride up I-65 to Nashville. It was in the 30s in B'ham and it would be even colder in Nashville. It never got out of the 20s and there was a couple of inches of snow on the ground when I arrived. As planned, I got there before 1:00 and hoped to have lunch at Nashville most famous bar and grill, the Wild Horse Saloon. Unfortunately, it was closed and I did not have many other options. I ended up going to a basic bar and grill and ordered a beer and a double cheeseburger. The place was almost empty so I chatted with the bartender for a bit then took a short tour of downtown to preview a night of fun after the Country Music half with my friend Nick (I hope). Broadway seems to have a lot of fun spots so I can look forward to that race and man, I better be healthy. For dinner, I stopped at a truck stop stop on the west side of town for fish and fries then headed back to my hotel in Brentwood, about 10 miles south of town and just a few minutes from the doctor's office.
Tuesday- The appointment was at 9:30 and I got there 15 minutes early. So, what is prolotherapy and when is it useful? The short answer is that it is an injection of a special solution into the site of the injury. The contents of the solution vary based on the nature of the injury and the doctor treating it but my doctor most often uses platelet rich plasma. It triggers an inflammatory reaction which "tricks the body" into treating it as if it's another injury, which frequently results in newer and stronger tendons, ligaments and connective tissue. My doctor claims a success rate of over 80%, which is well above the long term success of standard treatments such as NSAIDs, cortisone shots and physical therapy. If the problem is connective tissues, ligaments or degenerative wear on the tendons, not inflammation, it follows that treatments geared toward reducing inflammation will not produce the desired result.
Here are some links of interest:
I probably would not have gone for prolotherapy if I had not injured my Achilles. I found out that Achilles injuries are usually not tendinitis but tendinosis, or micro tears in the tendon which cause degeneration. Still, most Achilles injuries heal on their own through a rest period of 4-6 weeks followed by a gradual build up but there is a higher risk than most injuries that it develops into a chronic condition. Because of my imbalances, I felt that my risk was higher than most. I take Sam-e to fight the low dopamine associated with not running and it helps but I still don't feel as well plus most of my social life revolves around group runs so stopping running is not a good option. The doctor found little tenderness upon examination and gave me a shot in the affected area. I'm not worried at all about the Achilles. Even now, I can handle a 3 mile run. I just can't go longer or run on back to back days. I had planned on resting for another 3 full weeks and my doctor actually cautioned me against resting for too long. He expects that I will have full connective tissue healing within 3-4 weeks and I can and should be running with decent intensity by then. I'll set my comeback date at Saturday March 6 with a gradual buildup.
Sat- 1 mile, Mon- 2, Weds-4, Fri-6, etc.
As for the groin/hip area, the doc found significant tissue damage to the point in which it could develop into a serious degenerative condition if left untreated for a few more years. I will spare my readers the grisly details about getting multiple shots near a very sensitive area but let's say that it was about as painful going to the dentist for a root canal. I asked if the tissue damage could be hurting my performance and the answer was "I would not be surprised." Could I develop into a stronger runner after all of this is over? Only time will tell.
I liked my doctor from the get go and he even prayed for me before he started the treatment. I told him about my adrenal fatigue website and my devotionals and he said the he would "definitely check it out." I hope I can lead other runners to healing and if I do, then missing 2 races is a small price to pay.