Prolotherapy is a regenerative injection therapy that aims to stimulate healing in damaged tendons, ligaments, and joints by injecting a solution, typically hypertonic dextrose. The success of this treatment relies heavily on adhering to specific guidelines regarding physical activity after the procedure. Recovery timelines for resuming exercise are highly variable, depending on the severity of the original injury, the specific area treated, and the individual patient’s overall health. Following the detailed post-treatment instructions provided by a physician is necessary to maximize the therapeutic benefits of the injections.
Why Post-Treatment Rest is Important
Immediate post-treatment rest is necessary because prolotherapy works by inducing a controlled, localized inflammatory response. The injected hypertonic dextrose solution creates irritation at the injection site, signaling the body to begin tissue repair. This initial phase involves recruiting healing cells and releasing growth factors, which lays the groundwork for new collagen formation.
Strenuous activity or excessive strain immediately after the procedure can disrupt this inflammatory process, potentially negating the treatment’s intended effect. For the first 24 to 72 hours, patients are advised to keep activity to a minimum, focusing only on basic daily tasks. During this acute phase, avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen for at least three weeks, as these suppress the inflammation needed for healing. Acetaminophen is recommended for managing the expected post-injection soreness, which can last up to a week.
The First Week: Light Activity and Mobility
Once the initial 48-to-72-hour period of acute soreness subsides, the focus shifts to maintaining mobility without overstressing the treated area. Gentle walking and performing normal daily chores are acceptable activities during this time to encourage blood flow and range of motion.
Light, passive range-of-motion stretching may be permitted if cleared by the healthcare provider to prevent joint stiffness. Movements should be performed slowly, ensuring they do not recreate pre-existing pain or cause a sharp increase in new discomfort. Avoid lifting heavy objects, high-impact movements like jogging, or over-stretching, as these place tension on the newly irritated tissues. The treatment site may feel stiff and sore for two to seven days, which is a normal healing response.
Resuming Strenuous Activity and Sports
The transition from light activity to more moderate or strenuous exercise should be gradual and begins after the initial inflammatory phase subsides, around the two-week mark. The two-to-six-week window is when the proliferative phase intensifies. During this time, patients can start introducing low-impact exercises, such as stationary cycling, swimming, or using an elliptical machine.
For activities like weight lifting or jogging, wait a minimum of two weeks, and often four to six weeks, before attempting a return. When reintroducing any strenuous activity, start at a significantly reduced intensity, often around 50% of the normal routine. The principle of gradual reintroduction involves focusing first on rebuilding muscular endurance and strength before attempting speed or power training. Full return to contact sports or heavy resistance training requires a minimum of six weeks, and this timeline can be longer depending on the severity of the original injury and the number of treatment sessions received.
Monitoring Your Body’s Response
As you slowly increase your activity level, the body’s response guides progression. It is normal to experience mild soreness or generalized muscle fatigue after a workout, but a sharp, localized increase in pain at the injection site signals overexertion. A good rule of thumb is that pain lingering for more than two hours after exercise suggests the activity was too intense or lasted too long.
Should you experience adverse symptoms, such as a significant increase in swelling, redness, warmth, or a fever, stop exercising immediately and contact your physician. These symptoms can indicate a complication beyond the expected healing response. The goal is to gently encourage the tissue to remodel and strengthen, not to push through pain that could compromise the long-term success of the prolotherapy.