Can We Help Older Athletes with Back Pain?

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A man from the waist up in blue athletic clothing, standing in a green field with hands behind his head


We’ve treated many older athletes through the years. How do they do? Today I’ll cover one with chronic low back pain and a zeal to return to his Olympic level roots. Let’s dig in.

Tom’s History

Tom is a high-level 63-year-old male endurance athlete who had back pain radiating into the bilateral lower extremities since the 80s. He had two traumatic incidents while he was attempting to qualify for Olympic trials for distance running. He had multiple steroid injections in his back (a total of 6-8 of these over a number of years). To be able to go on trips such as white water rafting and kayaking, he had to take oral prednisone. He then saw a neurologist and ended up with subsequent radiofrequency ablations.

When he first saw Dr. Markle in the spring of 2019 his back pain was extremely debilitating as he was no longer able to sit for long periods of time. His ability to walk was thrown off and his running gait was abnormal with a constant 2-10 pain to a 9-10/10 intermittently. Running would generally improve his symptoms while most bike riding made it worse. He was unable to sit for long car rides as well as long plane rides because he could tolerate at most an hour of sitting.

This was Tom’s MRI:

As you can see he had an old compression fracture and two bulging discs with some evidence of facet joint arthritis.

Learn about Regenexx procedures for spine conditions.

Treating Tom’s Back-The DDD Procedure

Tom was treated several times over a short window and then 1 year later. He got the Regenexx DDD procedure which uses precise image-guided injections of the facet joints, ligaments, epidural (around irritated nerves), and into atrophied muscles. Here, Dr. Markle used three different blood-based injectates:
  • High dose PRP-Used in the facets
  • High dose platelet lysate-Used around nerves and in ligaments in two configurations-anti-inflammatory (nerves) and pro-inflammatory (ligaments)
  • PPP-Platelet Poor Plasma-Used in atrophied muscles

To learn more, see my video below:

How Did this Mature Athlete Do?

He wrote Dr. Markle a letter about his results (which I edited down to make it more easily readable):


I will write a short write up then you can tell me how much detail you want. Feel free to edit. The original injury was in October of 1982. At the time I was running 5,000 miles per year…Won just about every race local…Won prize money.

It was dark that October and I was out running country roads. I…stepped into a hole about a foot deep, maybe 8” across. My leg went forward and my torso backwards and a giant lightning bolt ran down my left leg. For the next 10 months I had to lift my leg to get in and out of the bathtub. No feeling in my left big toe. Top of my left foot was mostly numb…

After 10 months I improved but never got the feeling completely back.,,I went to several back specialists over a short period. All wanted to operate and stabilize the L2-S1. (He had a positive discogram and the doctor’s)…advice in 1984 was no surgery, stay active as possible and wait for the future.

Over the years I did stay active. I road the road bike competitively for a time. Back pain limited the training I could do. I could jog occasionally but by the time I was in my late 50’s I could only walk without pain on level terrain, any up or down grades were painful. By this time, my life was restricted by sitting. I could not ride in a car more than an hour without agony down the left leg, could not ride in a plane without the pain, could not sit and work more than an hour without moving around. The pain was so intense I would sweat through my clothes. In addition, I could not stand more than an hour without the same pain. I would have back spasms that would last for days even with medication for the spasms and it was nearly unbearable. Still staying active as best I could was the best medicine. Rest made the back worse. My wife and I have spent 10’s of thousands of dollars trying to find a mattress I could sleep on…

Life changes (since the DDD procedures):

I heard initially about Dr. Markle from a friend that had torn an ACL out riding his bike. His recovery was six weeks and back riding normally with no pain. He is still riding and in his 60’s. I mentioned the Regenxx Clinic to my wife that had severe knee pain and she scheduled a procedure and had unbelievable results. Her results went from having trouble grocery shopping to back hiking in the mountains. I went on a follow-up visit with my wife and asked Dr. Markle about my back problem that I had had since 1982…

My first procedure was 5/19/19. During the procedure I could feel the results were in the right places, my IT, down my left leg, the numb spot in my right calf, my left big toe and the top of my left foot. The feeling was tingling and slight burning sensation during the procedure. Immediately getting off the table I felt different. I went through the short rehab sessions to work on tightening muscles that had been dormant. Started walking after one week. No pain. Began a slow running progression program up to 15 miles per week. Began riding my bike on the indoor trainer up to an hour. Numbness was much improved. Still could not sit comfortably.

Second procedure was 6/11/19. Felt the sensation in the same areas during the procedure. Took off three days of mostly bed rest. Fourth day I walked a mile. Felt 100%. Riding the bike was 100% better. Running the low back was stiff at first, but no pain. All the feeling was back. By September 2019 I was running 30-40 miles per week with spring back in my stride. The wear patterns on my shoes were similar which told me the dysfunction in my pelvis was better. The important part of the procedure is it continues to get better noticeably for me over a three-month period. It is not just after the treatment. The healing continues. On my follow-up visit I told Dr. Markle about my improvements, but Dr. Markle thought I had room to improve. Sitting more than an hour was still painful down my left leg. Not nearly as bad as originally but difficult.

The third procedure was 10/9/19. After a week of recovery, three days bed rest then walking on day four, back jogging the third week post treatment, the results were beyond belief. By the end of November, I had built my mileage to 30-40 per week running, 100 per week riding, 25 per week hiking and walking the dogs. Still taking it easy and slow but I was back. I had my follow up visit and asked Dr. Markle what were my limitations? His opinion was just increasing the workload and see what I could do physically. Really ramp up the intensity also. Try and find the limits to the back on activity.

By the spring of 2020, I was doing track workouts…I turned 65 in 2020.

After about 10 months of just hammering the body through two, 20-week pyramid training builds, I had some stiffness in the low back. No pain. I thought normal considering the workload. I got a new MRI and another procedure 11/05/2020. The degenerative disc disease had improved over the last year even with the workload. Only a three-week recovery, then back to endurance base. The fourth procedure Dr. Markle also focused on the knee pain on the left leg and the inability to sit for long periods. I can now sit almost unlimited amounts. COVID effected the racing in 2020, but at the time of the fourth procedure I was ranked #1 Nationally in the 65-69 in the Duathlon. Currently I am building up mileage slowly to 70 per week running by June. Thinking about going for the 65-69 record at Pikes Peak in August. Focusing on building the mileage this year then adding intensity. Riding 500+ per month. Walking the dogs another 100 miles per month. Any precautions I take are the other parts of my body from the training. No limits on the low back.”

The upshot? We are proud to say that we were able to help an athlete return to his Olympic roots by competing with the best in his age range. All of that was done without the surgery they all told him he needed. What can we do for you?

Join us for a free Regenexx webinar.
Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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