Prolotherapy: Injections to Build Healthy Tissue

The good news is there may be more than just physical therapy and rehab to help fix the problem. “Is there anything that can be done to treat torn ligaments, tendons or cartilage besides surgery?” We have many patients with partially torn ACLs and meniscus tears ask this question all the time. Many MMA athletes are often devastated and fear the worst when we tell them they have a torn ligament in the knee or shoulder. The good news is there may be more than just physical therapy and rehab to help fix the problem.

Prolotherapy, which is also known as proliferative therapy, ligament reconstruction therapy, or sclerotherapy is an orthopedic procedure that is specifically designed to repair weakened and damaged tissues without surgery. This is done by injecting a mild irritant solution into torn or stretched tissues, which creates an inflammatory response that stimulates the formation of new fibrous tissue. Prolotherapy treatments are designed to stimulate the regrowth of collagen and connective tissues in areas of the body that typically have little healing properties like ligaments and cartilage. Over time, this may lead to tightening of lax ligaments which can potentially stabilize weak joints and prevent future injury, even in a partially torn ACL.

The solution that is injected is typically a mixture of an irritant like dextrose (a concentrated sugar solution) or an oil based solution, combined with saline and an anesthetic like lidocaine. Some physicians will even mix in growth factors or parts of a patient’s own blood sample that has been centrifuged to create the desired response. The number of injections required varies, but can range anywhere from a just a few to as many as eight or more given once every few weeks. Since prolotherapy is an invasive procedure involving injections, there is a certain amount of discomfort to be expected. Some possible side effects may include bruising, mild swelling, stiffness, and localized pain. However, since the desired effect of prolotherapy is to produce a temporary low grade inflammatory response, a patient receiving treatment should not be taking anti-inflammatory drugs like aspirin, ibuprofen, or Tylenol to reduce pain. Any prescription drugs designed to decrease inflammation like corticosteroids should not be taken during prolotherapy treatments as well.

Though this form of treatment seems to be relatively new and cutting edge, something similar has actually been done hundreds of years before as early as 500 B.C. The Roman soldiers with shoulder dislocations were often treated by using hot branding irons to fuse together torn ligaments in the shoulder. Modern day approaches are obviously far less painful and much safer, but they are essentially designed to do the same thing by stabilizing damaged ligaments by creating new tissue.

Prolotherapy is not for everyone, and results will vary from person to person. This all depends on the extent of tissue damage, general physical health, and any underlying conditions that would interfere with normal healing. The success rate is also highly dependent on the experience and skill level of the doctor performing the procedure. Though it has been received with mixed reviews by the medical community, The Mayo Clinic has recently stated “prolotherapy may be helpful” when chronic ligament or tendon pain fails to respond to conservative treatments like physical therapy and rehabilitative exercises. It is important to remember that prolotherapy should only be performed by a licensed physician trained by the American College of Osteopathic Pain Management & Sclerotherapy. A directory of licensed prolotherapy practitioners in your area can be found at

Contact info: Dr. John H. Park, D.C., C.S.C.S.Progressive Spinal & Sports Rehab10076 Darnestown Road Suite 200Rockville, MD 20850www.ProSpineRehab.comwww.yourMMAdoctor.comPhone: (301) 294-5101

Dr. Park is a chiropractic physician specializing in sports medicine and orthopedics. He has studied martial arts for over 10 years including tae kwon do, Muay Thai, and Brazilian jiu jitsu, and he works with professional and amateur athletes in MMA.

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Dr. John H. Park