Innovative procedure helps routine patients, athletes

Courtesy of Landstuhl Regional Medical Center Public Affairs

An innovative therapy is now being practiced at Landstuhl Regional Medical Center that helps recreational athletes as well as athletes competing at the highest levels.

Prolotherapy and Platelet Rich Plasma (PRP) injections have been performed at the LRMC Physical Medicine and Rehabilitation Service since 2010. The LRMC PM&R Clinic was one of the first clinics in U.S. Army Medical Command to adopt these innovative treatment modalities. These injections have proven effective in treating a variety of chronic musculoskeletal ailments such as tennis elbow, jumper’s knee, Achilles tendon disorders, ankle sprains and shoulder ligament sprains, as well as an emerging treatment for knee and hip osteoarthritis.

One patient in particular experienced tremendous improvement, allowing him to compete on the wrestling mat after a potentially devastating injury.

Senior Master Sgt. Steve Horton has been a competitive Greco-Roman wrestler for nearly four decades and is no stranger to competing at the highest levels of his sport. As a world-class athlete, he is also no stranger to musculoskeletal injuries, but the most severe of these occurred in August 2012 while training for the Greco-Roman World Championships.

While training, he injured a muscle in his leg and was treated by Maj. (Dr.) George Smolinski, chief of LRMC PM&R, who recommended prolotherapy.

“Prolotherapy can help heal chronically damaged soft tissue in the body by using the body’s own mechanisms to heal itself,” Smolinski said.

Prolotherapy involves injecting an irritating solution into a damaged muscle, ligament or tendon, which then causes inflammation. Inflammation heals – that’s why you have some redness that appears around a cut – and we rely on that process to then heal damaged muscles, tendons and ligaments. Ligaments and tendons have very poor blood supply, and if they’re chronically damaged there’s a significant chance that they won’t heal.

PRP injections are similar to prolotherapy injections. PRP injections involve taking a patient’s own blood, spinning it in a centrifuge to extract the platelets, and then injecting the platelets into the damaged muscle, tendon or ligament.

Platelets lie at the heart of this treatment, as platelets are responsible for not only stopping a cut from bleeding, but are also responsible for healing damaged tissue. Much in the same way prolotherapy works, platelet rich plasma causes release of the body’s own chemicals called “growth factors” at the site of injury. By injecting these platelets into damaged soft tissue, these growth factors are then released from the platelets, allowing the soft tissue to heal.

Horton received the injection and was able to successfully compete in the championships in Budapest, Hungary, and represent the U.S. As the matches progressed, however, he re-injured his leg and again sought treatment at LRMC.

“The initial prognosis from the doctors was that my wrestling career was over and that I would never have the strength back in my leg that I once had,” Horton said. “I was also told that the healing time would be at least one year. Once again, I sought out Dr. Smolinski’s advice to see if prolotherapy would help.”

After seeking Smolinski’s advice, Horton received a PRP injection in February and was able to return two months later to the mat at the U.S. National Championships in Las Vegas. He said coaches and other wrestlers were amazed at the recovery he had made. Horton placed second in the Freestyle and third in the Greco-Roman competitions at nationals, losing only to the defending world champion from Russia.

These therapies are available to all DOD beneficiaries. See your primary care manager for a referral.

To see a PRP demonstration, visit

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