Prolotherapy for Plantar Fasciitis Video

Prolotherapy for Plantar Fasciitis?

Doctor Darrow: Prolotherapy are injections that we give right into the foot.

First, we anesthetize the foot so you don’t feel the needle, and then we get right down to the part where the spring ligament, which creates the arch of the foot, attaches to the calcaneus (heel bone) at the bottom of the foot. Prolotherapy treatment stimulates an inflammatory response that grows back and strengthens that attachment.

After Prolotherapy treatment, we like for people to use a walking boot because every time we step off the foot during walking we stretch that attachment from the ligament to the back of the foot to the heel. The boot helps the area heal. Most people think that Plantar Fasciitis pain is from the bone spur, it’s the reverse. What happens is that the ligament starts to loosen up and starts pulling on the back of the heel and a bone spur forms to help stabilize that ligament. With Prolotherapy we can thicken the ligament, tendons, and joint capsule.

Foot and Ankle Pain Information

Ankle

Prolotherapy for Plantar Fasciitis?

Prolotherapy are injections that we give right into the foot.

First, we anesthetize the foot so you don’t feel the needle, and then we get right down to the part where the spring ligament, which creates the arch of the foot, attaches to the calcaneus (heel bone) at the bottom of the foot. Prolotherapy stimulates an inflammatory response that grows back and strengthens that attachment.

Foot Pain

When I perform Prolotherapy treatments on the foot, depending on the area, I often prescribe a walking boot for faster healing.

The reason for this is that the body’s weight continually impacts the forces on the foot and stretches it as we walk, often blocking a quick healing. The walking boot keeps the foot in a neutral position and stops the stretching motion that causes the inflammation and the foot pain.

Plantar Fasciitis is a painful foot problem associated with excessive standing or walking, or running on hard surfaces. The arch of the foot is often collapsed, especially if the patient is overweight. The pain is most often felt on the bottom of the foot near the front of the heel bone.

A good start in healing this inflammatory problem is to have us mold orthotics specifically for your foot (not off the shelf) to create a good arch support.

In conjunction with orthotics, I often use Prolotherapy injections to treat foot pain, I inject 3 cc of dextrose and lidocaine after spraying the area to be injected with a coolant to numb the skin.

The needle is very thin and is tolerated well. For complete healing of foot pain, it often takes about 4 injections over a period of a month, and results do vary depending on the patient’s activity level.

Another common foot pain problem is the improper diagnosis of Morton’s Neuroma. I have yet to see an actual case of a nerve entanglement between the toes or at the base of the balls of the foot bones near the toes.

The real problem is most often Metatarsalgia, which very simply is inflammation of the same area. The Prolotherapy that I do in that area is with a 30 gauge needle that is similar to an acupuncture needle. The cold spray is also used to numb the area, and a walking boot is often prescribed for quicker healing.

There are many other foot problems that are healed with Prolotherapy. Basically, if I can touch a needle to bone, Prolotherapy is the answer.

Obesity and Tendinitis

Researchers writing in the medical journal Foot & Ankle International say that “being overweight or obese significantly increased the chances of having tendinitis in general,” and that “Tendinitis, plantar fasciitis, and osteoarthritis usually are secondary to overuse and increased stress on the soft tissues and joints, which may be directly related to increased weight on these structures.”
Frey C, Zamora J. The effects of obesity on orthopaedic foot and ankle pathology. Foot Ankle Int. 2007 Sep;28(9):996-9.

Problems With Your Ankle After A Sprain?

It may have never healed properly

It is estimated that 40% of all people who suffer an ankle sprain will suffer chronic pain and weakness in that ankle long-term. The reason? Your ankle never healed properly. Here is why: Our ankles are held together by ligaments and tendons, strong bands of connective tissue. Ligaments hold the ankle bones together while tendons attach the muscles to the bones.

When ankle sprains occur, the ligaments of the ankle are stretched and torn. Most commonly, ankle sprains occur when the athlete lands unevenly from a leap or jump, or has someone fall on their ankle during contact sports. Sprains can also occur when stepping into a hole or divot on a playing field or golf course. The severest of ankle sprains are the extreme or violent twist or “roll-over” of the ankle causing a hyperextended turning in or turning out of the foot. The turning out injury causes a sprain of the anterior talofibular ligament, and this is the most commonly injured part of the ankle.

When ankle sprain is suspected, the severity of the injury is then graded by a medical professional and a treatment suggested.

Grading the sprain

Grade 1 sprain:

A grade 1 sprain is the least severe of ankle sprains. The ligaments are slightly stretched with a minimum of tearing to the ligament fibers. More of a discomfort than pain is felt as the athlete can usually “walk it off.”

Grade 2 sprain:

There is stretching of the ligaments and partial tearing causing an unstable or loose joint. The condition is also referred to as ligament laxity, as the ligament, now stretched beyond its normal range has become weakened or lax, as an overstretched rubber band. There is noticeable swelling and tenderness and depending on extent of injury, instability when walking.

Grade 3 sprain:
A complete tear of the ligament causing extreme instability, swelling, and pain

Grading the treatment:
Grade 3 sprains are not the most common forms of ankle sprains and surgery may be prescribed, but this is rare since the ligament usually scars over during healing.

Is it the treatment at fault?
The “gold” standard of treatment in Grade 1 and Grade 2 sprains is RICE. Rest, ice, compression, and elevation. Recently however this therapy has been debated by some physicians because of the high incidence of chronic or recurrent ankle sprains.

Among the theories put forth questioning the RICE treatment is that it does not fully allow the ligaments to heal because it reduces and impedes inflammation that is needed to stimulate new tissue regeneration.

Creating inflammation to heal the ankle sprain
Basic medicine tells us that the body’s natural healing response is inflammation. Inflammation is the trigger for the immune system to begin the cascade of events in injury repair. When ligaments do not heal completely, they weaken and put the athlete at risk for chronic ankle sprain.

Preventing with Prolotherapy
When there is not enough inflammation to heal a ligament injury, some physicians have turned back to a new “old-fashioned,” treatment to jump start the healing processes. Prolotherapy was first introduced in the 1950′s as a means to cure chronic pain by strengthening the ligaments of weakened, loose joints by creating inflammation – not suppressing it.

Prolotherapy works by introducing a mild irritant through injection to the exact spot of the ligament damage. This irritant is usually something as benign as simple dextrose. What the dextrose does is create a small, controlled inflammation at the spot of injury accelerating healing and returning strength and resiliency to the ligament and stability to the ankle. In remittent cases, PRP (Platelet Rich Plasma) is used as a stronger proliferant.

Prolotherapy is gaining adherents among athletes because it is minimally invasive, does not require long periods of inactivity and in fact, a Prolotherapy doctor will usually recommend supervised activity or a recommend training plan to get the athlete back on the field as fast as possible.

One to six treatments is typical for the competitive athlete, spaced at weekly intervals.