Mcgin­ley Vas­cu­lar Pressure Treat­ment

Runner's World (UK) - - In­jury Treat­ment -

WHAT IS IT?

Bo­tox – the neu­ro­toxin that has been pop­u­larised by the cos­metic surgery in­dus­try – is in­jected un­der ul­tra­sound and com­puted to­mog­ra­phy (CT) guid­ance into the prob­lem spot of a mus­cle that’s com­press­ing blood flow, in ef­fect freez­ing it for three to four months.

‘The goal of this patented pro­ce­dure is to iso­late the part of the mus­cle that is caus­ing an is­sue and use bo­tulinum toxin to turn it off,’ says sports medicine physi­cian Joseph Mcgin­ley, who pi­o­neered the treat­ment. Mcgin­ley, a keen ath­lete, has com­pleted the 300-mile ad­ven­ture race the Cow­boy Tough, so his in­ter­est is more than just pro­fes­sional.

WHAT DOES IT TREAT?

Bo­tulinum in­jec­tions are used to treat two lower-leg in­juries: chronic ex­er­tional com­part­ment syn­drome (CECS) and func­tional popliteal artery en­trap­ment syn­drome (FPAES). In af­flicted ath­letes, a small part of the calf mus­cle com­presses veins or ar­ter­ies, which can cause a buildup of pressure in the lower leg (CECS) or a lack of blood flow to the lower leg (FPAES). The re­sult is in­tense pain, swelling and numb­ness in the calf, an­kle and foot. Surgery has tra­di­tion­ally been the only op­tion for run­ners with CECS or FPAES. Now, an­other op­tion is to in­ject bo­tulinum toxin into the area of mus­cle that is im­ping­ing blood flow. ‘The

in­va­sive­ness and risks are min­i­mal, es­pe­cially when com­pared with surgery,’ says Mcgin­ley, Al­though run­ners lose some mus­cle func­tion in the ‘frozen’ area, it is gen­er­ally a small loss and, over time, the body com­pen­sates.

HOW EF­FEC­TIVE? Us­ing bo­tulinum toxin in this man­ner is new; only one study has been pub­lished. But that re­search, pub­lished in The Amer­i­can Jour­nal of Sports Medicine, found it elim­i­nated pain in 94 per cent of CECS sub­jects. Al­though 69 per cent of sub­jects ex­pe­ri­enced some loss of strength, the au­thors re­ported this had ‘no func­tional con­se­quence’.

WHO’S HAD IT? US run­ner Laura Stamp was the first pa­tient to be treated with bo­tulinum toxin for CECS. She had al­ready un­der­gone surgery three times to treat her in­jury. The Vas­cu­lar Pressure Treat­ment worked and Stamp went on to en­joy a successful col­lege ca­reer in cross coun­try ski­ing and run­ning.

DOES IT HURT? The in­jec­tion hurts no more than a flu jab, says Mcgin­ley.

WHO OF­FERS IT? Mcgin­ley is cur­rently the only provider of bo­tulinum toxin ther­apy. So, if you want the treat­ment, you will need to travel to Casper, Wy­oming, in the US, where Mcgin­ley treats ath­letes from all over the world.

WHAT’S THE COST? De­pend­ing on the amount of bo­tulinum toxin needed for the pro­ce­dure, the treat­ment costs be­tween $5,000 and $8,000 (£4,000 and £6,400).

TREAT­MENT PLAN? Most ath­letes need a sec­ond treat­ment six to seven months after the first, adding $3,000 (£2,400) to the cost. Then, the por­tion of mus­cle that’s im­ping­ing blood flow should at­ro­phy, says Mcgin­ley, be­com­ing so small it no longer causes a prob­lem.

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