In this article we will present three non-surgical treatment options for chronic ankle pain. Prolotherapy, Platelet Rich Rich Plasma Therapy, and Stem Cell. In this retrospective observational study of chronic unresolved ankle pain, Hackett-Hemwall dextrose prolotherapy helped promote a. The ankle is the joint where the human foot and leg meet, consisting of a complex network of bones, ligaments, tendons and muscles. The ankle is strong.
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My ankle hurt A LOT immediately! I had gone up to block the spike and came down on the foot of the spiker who followed through under the net! The ankle quickly swelled and the throbbing pain prevented me from sleeping at all that night. I had severely sprained the lateral ligament complex while playing my favorite sport, volleyball. I quickly began a series of Prolotherapy treatments on my own ankle.
It went like this initially. I sprained my ankle on Thursday night. On Friday morning I treated the ankle with Prolotherapy. By the following Thursday it felt good and the swelling was down, I played volleyball Thursday night which led to swelling and pain again you think? I love volleyball and it was difficult, but I gave up my Thursday evening recreation while treating myself weekly I was in a hurry with Prolotherapy. After six an,le and two and a half months I returned to my beloved volleyball without pain or swelling!
It has been 15 years since my ankle was restored by Prolotherapy. Since then I have done any recreational activity without pain or swelling of my ankle! Currently, I hike, water and snow ski, snow shoe, and cross country ski without pain or swelling! Prologherapy ankle is a small but important joint.
Injuries to the ankle are the anle common orthopedic injuries in sports, especially volleyball, basketball, football, and jogging. In this article, we will look at the treatment of ankle and foot injury with Prolotherapy. Prolotherapy treatment of the ankle and foot is very successful.
Ankle and Foot Treatment with Prolotherapy
It takes an average of four to six treatments, spaced two to six weeks apart, to achieve full healing. There are prolotyerapy primary joints at the ankle: I almost always treat them both when either one is involved. Ankle arthritis can be set up by repeated severe sprains and the ensuing instability. Osteoarthritis is another common cause of ankle arthritis. Identify the ankle joint by feeling anteriorly while flexing and extending the foot at the ankle.
Feel for the dorsalis pedis ank,e so the injection can be given lateral or medial to it and the accompanying anterior tibial nerve. Cleanse the skin, prolotheeapy the ankle to open up the joint, then insert a 25G, 1. After withdrawing the needle, repeatedly flex and extend prolotheeapy joint to distribute the proliferant throughout the ankle joint. HGH may be added to the Prolotherapy solution if the joint is severely degenerated. The sub-talar joint is readily identified as a palpable depression about 1 cm anterior and distal to the lateral malleolus.
It is opened up by extending and internally rotating the foot at the ankle. The skin is again cleansed, and a 25G 1. The joint is flexed pro,otherapy extended several times to distribute the fluid throughout the sub-talar joint. As with the ankle joint, HGH may be added depending on the clinical indication. The lateral ligament complex is all too easily sprained. The lateral ligament complex is weaker than the medial, resulting in ankles being sprained laterally much more akle than medially.
The anterior talofibular is the most common injury at the ankle, usually at the fibular attachment. Examine carefully for injury to each of the major ligaments extending from the distal fibula anterior and posterior talofibular, and the calcaneal-fibular ligaments. Also, check the calcaneo-cuboid ligament 1 cm proximal and above the fifth metatarsal prominence laterally.
Dextrose Prolotherapy Injections for Chronic Ankle Pain
This ligament is often prolottherapy along with the sprain to the lateral ankle. Place a double paper towel under the foot. Cleanse the area to be treated. A 10cc luer lock syringe is filled with standard Prolotherapy solution and fitted with a 25G 1.
I begin at the proloterapy distal fibula and inject 0. Next, I will inject the injured ligament attachments to the calcaneous and talus abkle the calcaneo-cuboid ligament, if necessary. The medial deltoid ligaments are injured much less commonly. Examination will reveal tenderness at the ligament attachments to the medial malleolus and calcaneous, navicular and talus anterior and posterior talo-fibular ligaments, calcaneo-fibular ligament, and talo-navicular ligament.
In this area, we will exercise caution at the posterior aspect of the medial malleolus due to the tibial nerve and posterior tibial artery. After identifying the injured areas and prepping the skin, we utilize 6 to 10cc of standard Prolotherapy solution. Using a 10cc luer lock syringe with a 25G 1.
Next we will inject 0. Injury to the Achilles tendon is common. If the tendon has a complete rupture then orthopedic surgery is required and referral prollotherapy be made promptly. This injury is not difficult to identify. Ankke offending spots are very tender to palpation and in many cases there is a tender swelling mid-tendon not merely at the teno-osseous junction. After identifying the injured areas I will draw up 3 to 6cc of standard Prolotherapy solution.
The patient will be requested to do no jumping, running, climbing, or sudden starts and stops. I routinely ask them to wear prolotherapj heel about 1. For men, this is challenging, cowboy boots work for many. Fortunately they have come to us for treatment with Prolotherapy! There are three primary areas for the injury to the plantar fasciitis: The patient can accurately point to the offending spot, and palpation confirms the diagnosis.
Ankle and Foot Treatment with Prolotherapy – Journal of Prolotherapy
Position the patient on the table face down with the knee bent and the foot up in the air. To inject the calcaneal attachment we will avoid the thick plantar heel callus. The entry point is just medial plantar just distal to the heel pad. It is a good idea to warn patients that injecting the heel and ball of the foot is usually very painful. The 25G 2-inch needle is angled back to the attachment on the calcaneous See Figure Prolotherapy to this area is extremely effective.
And interestingly, it is not very painful to inject here. The insertion point is just plantar to the navicular tubercle. The needle is inserted straight across the arch to contact the bone on the lateral side of the under-surface of the arch. Approximately 3 to 5cc of Prolotherapy solution are injected here using a 25G 2-inch needle.
For an hour or two after the injections the patient will feel like he or she is walking on a golf ball. For plantar fasciitis, there are a couple of concurrent treatments that are helpful. The most important is Functional Orthotics. If the patient has hyper-pronation at the ankle, and they almost all do, then orthotics are a must. Otherwise, the plantar fasciitis is likely to recur if we can get it to heal in the first place.
The second helpful treatment is again, elevating the heel about 1. This decreases tension on the plantar fascia and is effective in relieving pain this will not, however, heal the plantar fasciitis by itself. Injuries at and around the MTP joints are quite painful. Careful palpation will reveal if the injury is at the plantar fascia attachment to the distal metatarsal, or to the joint itself or between the MTP joints. Each joint is palpated individually and sometimes while moving the joint.
After identifying the injuries, we will treat the distal metatarsal head by cleansing the skin and if the injury is plantar, will enter through the skin just proximal to the callus of the ball of the foot and pepper the fibro-osseous junction See Figure For injury at the proximal end of the MTP phalanx, approach is made from the skin just distal to the callus of the ball of the foot directly over the phalanx.
When the injury is on the dorsal side of the MTP, the approach is from the top. This is a fairly common condition.
Here we have some good news and some bad news. The good news is that we can heal the injured ligaments and tendons so the pain is relieved. The treatment is straight forward. Begin by cleansing the skin over the first MTP medially. Using a 25G 1. The foot and ankle are very complex structures with many more ligaments and tendons and joints than we have covered in this article.
I have tackled the most common ajkle. Prolotherapy injection to the ankle joint. Prolotherapy injection of the sub-talar joint. Joint prrolotherapy and stability.
Injury to the above ligaments leads to chronic ankle instability and its associated symptoms. These include ankle pain, weakness, and frequent sprains. Prolo Your Sports Injuries Away! Prolotherapy injection of the lateral ligament.