USA TODAY US Edition
Healing is name of game
Athletes willingly try new methods
Downhill skiers are known as a daring lot, and even more so practitioners of the new Olympic sport called ski cross, so it might come as no surprise some would turn to innovative medical treatments to accelerate their recovery from injuries.
American skiers Casey Puckett and Daron Rahlves made it back from re- cent severe injuries to compete Sunday in the Vancouver Games, though neither reached the medal round.
Experts on the field say the pursuit of cutting-edge treatments for injuries is common among Olympic and pro athletes in all disciplines who make a living with their bodies and have plenty to lose by extended absences from the arena.
Puckett overcame a Jan. 10 shoulder dislocation that requi-
red surgery with a combination of physical therapy, acupuncture and time in a hyperbaric chamber. Rahlves raced three weeks after dislocating a hip, thanks to sessions of physical therapy, magnetic pulse therapy, acupuncture and treatment with platelet-rich plasma (PRP).
“My doctor was really sur- prised at how far I’ve come,” says five-time Olympian Puckett, formerly an Alpine skiing specialist. “I got a CAT scan, and my (shoulder) bone is still broken. He was amazed (at) how much it had healed in a short period of time.”
Rahlves also seemed pleased with his recovery time.
“Just to be back, take this kind of beating and be on my feet three weeks after a dislocated hip was pretty outstanding,” he said.
Other elite athletes are sure to take heed.
The menu of treatment options for sports injuries has never been richer, as old staples such as anterior cruciate ligament and Tommy John surgeries have been joined by new alternatives such as PRP, minimally invasive sports hernia surgery, low-intensity laser therapy and prolotherapy.
In addition, researchers at the Steadman Philippon Research Institute in Vail, Colo., recently have concluded a study on the effects of stem cells on cartilage regeneration, and New York surgeon David Altchek, the New York Mets’ medical director, reports encouraging results in a new procedure to repair rotator cuff tears in pitchers.
But the quest for a speedy cure doesn’t always bear fruit, and sometimes it can lead to unexpected consequences.
In December, Mets shortstop Jose Reyes, Denver Broncos quarterback Chris Simms and Olympic swimmer Dara Torres found themselves answering news media questions about Anthony Galea after Canadian authorities charged the Toronto-area doctor with criminal conspiracy to import drugs such as human growth hormone and Actovegin into the USA and Canada. Actovegin, made out of calves’ blood, can improve the transport of sugar and oxygen to muscles.
The New York Times also has reported U.S. authorities are investigating whether Galea supplied athletes with performance-enhancing drugs. According to the newspaper, Galea and his lawyer, Brian Greenspan, have denied those allegations and dispute the charges.
Torres and Simms, who declined interview requests for this story, told The Times and the Den
ver Post, respectively, that they had gone to Galea for legitimate purposes and had not received performance-enhancing drugs from him.
On the recommendation of fellow players, Reyes went to see Galea in August for PRP treatment on a hamstring tear that sidelined him for the last four months of the season. The treatment did not heal the injury, and Reyes eventually had surgery.
Peter Greenberg, Reyes’ agent, says the shortstop was not troubled about being linked to Galea because they had done their due diligence about him and kept the Mets informed.
“Now with all the controversy, I wouldn’t go back to him, but before that he checked out with all the referrals we got,” Greenberg says. “They were big-name referrals: the Steadman Hawkins Clinic, the Denver Broncos and the Toronto Argonauts.
“A lot of athletes swear by him. A lot of big-name athletes had used him and said he got them back on the field and really speeded up the recovery with non-surgical techniques.”
On the public radar
Avoiding the operating room is a strong motivator for athletes who have tried PRP, a procedure that involves taking a small syringe of blood from a patient’s body, spinning it in a centrifuge to isolate the platelets — which act as healing agents — and injecting about a teaspoon of the richer plasma into the injured area.
The treatment is approved by the World Anti-Doping Agency as long as the injections are not applied to the muscles, because that could promote their growth.
Allan Mishra, an orthopedic surgeon in Northern California who pioneered the use of PRP, says the therapy has shown promising results in treating patients with acute tendinitis in the elbow and knee.
“For patients who have failed other things and then are seeking surgical intervention or an alternative to that, platelet-rich plasma, in my opinion, will continue to play a role,” Mishra says.
PRP drew national attention last year when Pittsburgh Steelers wide receiver Hines Ward used it to speed his recovery from a sprained knee ligament before the Super Bowl. Even PRP’s skeptics acknowledge the treatment is safe — some believe it’s overhyped or doubt its effectiveness — and Mishra says researchers are trying to figure out the ideal formulation, concentration and use of it. An article in the American Journal of Sports Medi
cine this month detailed a study that found PRP significantly more effective than cortisone for tennis elbow.
New York Giants defensive tackle Chris Canty says he didn’t know much about PRP when team trainers suggested he try it for a stubborn hamstring injury last preseason. Canty was so pleased with the results that he used PRP again later in the season when he had an injured calf.
“You can kind of call me the spokesperson for the PRP procedure in our locker room,” Canty says. “I tell guys that are having problems with tendinitis or problems with tears in muscles that it’s painful, but it is well worth it, and you start feeling better within days, not weeks.”
Mishra’s initial encounter with PRP illustrates how the community of elite athletes — a small, often insular group — is constantly on the lookout for remedies to sports ailments.
A year after his 15-year career as an NFL quarterback ended in 1999, Steve Bono tore his left Achilles tendon playing basketball and had it operated on by Mishra. About six weeks later Bono heard about PRP from former San Francisco 49ers teammate Joe Montana, who owned horses and learned veterinarians used the technique on them.
Mishra did research. When Bono tore his other Achilles a year and a half later — playing basketball again — they made PRP part of the repair, even though the procedure was in its infancy.
“Athletes are very willing to go to great lengths and try innovative techniques and treatments,” says Bono, who recovered in six months, two to three months faster than the first Achilles surgery. “You’re willing to experiment, take a chance, to be stronger, come back so oner, stay healthy.”
Word spreads fast
Trainers, agents and players unions can provide guidance for athletes seeking medical help, but often word of mouth — especially coming from a well-known figure — provides impetus for some to try specific doctors or cutting-edge approaches.
Richard Steadman, a co-founder of the Steadman Hawkins Clinic in Vail and a specialist in knee injuries, operated on former German soccer star Lothar Matthaus in the early 1990s and soon found his services in demand among European players.
Fellow or thopedic surgeon Marc Philippon, a hip specialist at the same clinic, made a name for himself when he treated golfer Greg Norman in 2000.
Last year, Philippon performed arthroscopic surgery to repair the labrum on the right hip of threetime American League MVP Alex Rodriguez, using a procedure he calls “a little bit outside the mainstream.” The modification allowed Rodriguez to return to action after two months, instead of the usual 10 to 12 weeks, and also to avoid a second operation that was part of the original plan.
Philippon says he gets great satisfaction out of helping athletes return to their previous form after a severe injury, as was the case when Rodriguez helped the New York Yankees win the World Series title with the best postseason of his career, but acknowledges the risks of treating such high-profile figures.
“If you provide a high-level service and you have a very good track record but you have one bad result, it’s going to reflect on you,” says Philippon, who has operated on more than 550 pro and Olympic athletes.
Los Angeles Dodgers trainer Stan Conte says players are better informed and more inquisitive than five to seven years ago, but with word of mouth carrying so much weight, he warns against them relying solely on what they hear from peers.
“In orthopedic treatment, 60% success is not very good. But you still have six out of 10 guys out there saying this guy was great, even if four others are limping,” Conte says. “It depends on who you run into first and who has a platform.”
Puckett has used prolotherapy, a relatively new technique not fully embraced by the medical community, to treat a right knee that has endured six operations.
He says prolotherapy’s popularity among members of the U.S. ski team spread after two-time World Cup champion Bode Miller had successful treatment in 2005. In prolotherapy, a sugar solution is injected into the affected area as an inflammatory agent to prompt ligaments and connective tissue to proliferate. According to Prolotherapy.com, the average number of treatments is four to six an injury.
Puckett also has tried prolozone — a variation that uses three molecules of oxygen instead of sugar — at the West Clinic, a holistic and natural medicine center in Pocatello, Idaho.
In 2005, Minnesota’s renowned Mayo Clinic accepted prolotherapy as a valid alternative for dealing with chronic pain.
“It definitely did something. My knee was better in the fall than it was in the spring,” Puckett says of his June 2009 treatment. “It certainly didn’t completely fix the problem, but it was better, and that’s what I needed. I will continue to do it in hopes it will be 100% some day.”
Looking for help
Oakland Athletics third baseman Eric Chavez doesn’t expect to return to his 100%, Gold Glove- winning days. He’ll settle for getting on the field regularly.
Chavez, who has played in 121 of a possible 485 games in the last three seasons because of back and shoulder woes, spent more than $10,000 each on two machines meant to stimulate blood flow to his injuries and help them heal.
The latest machine, which emits a red laser light, comes on the heels of trying acupuncture, chiropractors and massage therapists.
“The way I heard about it was somebody told me Tiger Woods was using it,” Chavez says of the laser therapy. “That’s how those things get going. ‘Oh, you know, so-and-so uses it, so it must be good.’ ”
Chavez says the machines provide relief from pain but don’t address its source. Then again, he has had surgeries on both shoulders and two back operations since 2007, without the desired results.
Therefore, like so many athletes seeking a return to action, he’s willing to experiment.
“There’s been a few guys along the way who believed psychologists or therapists can free your mind from feeling your body’s pain, and I’ve tried them,” Chavez says. “There’s been a wide scope of things that I’ve tried, but I’m still left with two years of injuries.” Contributing: Seth Livingstone in Vancouver