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Chronic
Ankle Instability and Pain
Jenny had severe ankle pain. She
was an avid athlete, playing several sports. After evaluating her, I
determined that she was suffering from significant
ligaments in her
ankles, which was the cause of her pain. Jenny did not know how she injured
herself so severely.
Jenny also exhibited tenderness
on various parts of her body in addition to her ankles. I surmised this was
related to
nutritional factors. When delving into her history, I discovered
that her ankle pain started a couple of years prior to her visit in our
office, just after she had started taking birth control pills because of
painful, irregular menstruation. The medication she was taking contained an
analogue of
estradiol. Her
diet consisted of nearly 100 percent carbohydrates,
very small amounts of protein, and she was averse to taking vitamins.
Jenny was, however, open to
receiving
Prolotherapy on her ankles, but not to correcting the multiple
factors that were related to her systemic
connective tissue deficiency
problem. She had multiple signs, or symptoms, that confirmed this diagnosis
such as non-healing sports injury with no overt trauma causing the original
pain; multiple tender points in other parts of her body especially about the
knees and hips; dry skin; brittle nails and hair; menstrual problems; improper
diet for her metabolism; and finally, her taking synthetic estradiol.
In order for the Prolotherapy to
be maximally effective, I needed to address Jenny's inability to heal and
convince her that she needed to do something about this in order to make the
Prolotherapy worth enduring the shots! Reasoning alone would be insufficient.
Prolotherapy is a treatment that
causes the body to grow strong connective tissue. This connective tissue is
primarily
collagen, which makes up ligaments and
tendons. Thus, Prolotherapy
causes the growth and strengthening of ligaments and tendons. When an injury
lingers beyond the usual healing time, it typically involves the ligaments and
tendons. This weakening of the connective tissue can be graphically
represented.
Prolotherapy injections,
(Watch where do
Prolotherapy injections go and do they hurt?)
reverse this by stimulating the
connective tissues to heal. As the connective tissue grows and strengthens
after Prolotherapy, the athlete reaches the eventual point where the pain has
ceased. For the person with a strong immune system, no more treatment or
additional medical care is needed. Prolotherapy was indeed a cure for this
person.
The person with systemic
connective tissue deficiency, on the other hand, experiences no specific
traumatic event to start the pain because the condition itself is weakening
the connective tissues. In such an instance, all (or a majority) of the body's
connective tissues are weakening. This process occurs normally with age, but
with a systemic connective tissue deficiency (perhaps more appropriately
called The Hauser Syndrome) a person experiences an accelerated decline in
connective tissue strength. This may result in sagging of the skin, thinning
of the hair, and a myriad of other symptoms, the most prominent of which is
pain. The first area to become painful will typically be the one that the
athlete uses the most. For the pitcher it will be the shoulder, for the runner
the knee, for the
golfer the back, and so on. If the golfer, in such an
instance, just receives Prolotherapy, the pain relief from Prolotherapy will
only last a certain amount of time. Once the connective tissue strength
decreases below the pain threshold point, the pain will recur. A cure will
only be obtained when the athlete receives Prolotherapy along with additional
treatments to correct the connective tissue deficiency problem.
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Prolotherapy
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