Prolotherapy for sports injuries

Because the muscles, ligaments, tendons and joints become injured playing sports, prolotherapy should always be considered as a primary treatment.

by Dr. Fred G. Arnold — 

Nearly anyone who has ever experienced a sports- or exercise-related injury can tell you that sports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of those injuries. Although sports teams have employed physicians for many years, it is only since the late 20th century that sports and exercise medicine have emerged as distinct entities in health care.

Because the muscles, ligaments, tendons and joints become injured playing sports, prolotherapy should always be considered as a primary treatment. Prolotherapy is a safe and proven orthopedic injection procedure that strengthens and regenerates injured ligaments, tendons and articular cartilage.

Common sports injuries that benefit from prolotherapy

Neck (cervical) injuries — Neck sprain and strains, disc problems, cervical radiculitis, whiplash, cervical arthritis, headaches and temporomandibular joint syndrome (TMJ)

Shoulder injuries — Rotator cuff tears, clavicle injuries, impingement syndrome, dislocations, tendonitis, bursitis, shoulder sprains and strains, adhesive capsulitis (frozen shoulder) and shoulder labrum tear

Elbow injuries — Tennis elbow (lateral epicondylitis), elbow sprains and strains, and golfer’s elbow (medial epicondylitis)

Wrist injuries — Wrist sprains and strains, carpal tunnel syndrome, wrist osteoarthritis and wrist tendonitis

Low back (lumbar) injuries — Herniated disc, lumbar osteoarthritis, sciatica, lumbar sprain/strain, and piriformis syndrome

Pelvic injuries — Hamstring pulls or tears, iliopsoas syndrome, sacroiliac pain and sacroiliac sprain

Hip injuries — Iliotibial band syndrome, labrum tear, hip arthritis, hip sprain or strain, and hip bursitis

Knee injuries — ACL injuries, chondromalacia, knee cartilage injuries, knee meniscus injuries, patellofemoral pain syndrome, knee tendon injuries, knee osteoarthritis, medial and lateral collateral ligament injury, posterior cruciate ligament (PCL) injury and Osgood-Schlatter Disease

Ankle injuries — Ankle sprain or strains, Achilles tendonitis, Achilles tendon ruptures, ankle arthritis, heel spurs and plantar fasciitis

Prolotherapy treatment

The most common prolotherapy injections generally use a mixture of dextrose (sugar solution) and an anesthetic, such as lidocaine. A small amount of vitamin B12 can be added to promote healing. This specialized solution is injected into the ligament and/or tendon where it attaches to the bone or the joint space, such as with the knee.

The sugar (dextrose) acts as an irritant, which causes a localized inflammation in these weak, damaged and degenerated areas. The blood supply and flow of nutrients then increases, stimulating the tissue to repair itself. This process causes a strengthening and tightening, thereby stabilizing the area. The anesthetic (lidocaine) is given to reduce the discomfort at the injection sites. Morrhuate sodium, derived from cod liver oil, can be added to the injection solution to promote local irritation and the healing response.

The patient may be a little sore for a day or so, but this usually subsides. Depending on the pain threshold of a patient, prescription medication may be prescribed. Most patients do well without any or simply use over-the-counter Tylenol®.

After the initial treatment, the patient is reassessed in two to four weeks. The response to treatment varies from individual to individual, and depends on each person’s healing ability. The average patient requires four to six treatments. A mild case may need only one to four treatments, while a moderate condition may need five to eight treatments; more severe conditions can require nine or more treatments.

Before receiving prolotherapy treatment, each patient should be thoroughly evaluated with a personal history and physical examination, including observation of the gait. Palpation of ligaments or cartilage that produces pain is usually associated with weakened tissues and can, at times, be more beneficial in identifying the problem areas than diagnostic testing. On an individual basis, further evaluation may include ultrasound evaluation, X-rays and/or an MRI before receiving prolotherapy.

Sports injuries and steroids

Although steroids are frequently used for the treatment of sports injuries, they should be used with caution. Steroids, such as cortisone shots, can actually weaken rather than strengthen ligaments, tendons and cartilage, which may then lead to surgery.


Prolotherapy is a safe and proven orthopedic procedure that has provided significant relief to thousands of patients with painful sports injuries. Prolotherapy provides relief when other treatments have failed because it treats the cause of the problem — weakened ligaments, tendons and degenerative conditions related to sports injuries. Strengthening weakened ligaments and tendons and rebuilding cartilage slows down and even reverses the degenerative changes associated with sports injuries.

Prolotherapy should always be considered for sports injuries when other treatments have failed and when surgery has been recommended. It treats sports injuries without the negative effects of chronic pain medications.


Fred G. Arnold, D.C., N.M.D., specializes in prolotherapy/pain rehabilitation services. A Diplomate of the American Academy Health Care Providers, he is one of the few physicians in the nation with both naturopathic and chiropractic degrees. 602-292-2978or

Reprinted from AzNetNews, Volume 31, Number 1, Feb/Mar 2012.

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