Runner's World (UK)

Mcginley Vascular Pressure Treatment

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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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