Playing Pain Free: The Joys of Tennis and Golf
Noel Peterson, ND
Pamela had always loved playing 18 holes of golf with her friends on Wednesdays, and doubles tennis on Tuesdays and Saturdays, but now she was having constant elbow pain. Even raising her morning coffee mug caused sharp pains in her right arm and elbow. Her doctor had diagnosed tennis elbow, or lateral epicondylitis, and had advised high-dose ibuprofen before every game. But the pain had worsened and she eventually had to give up tennis. At least she still could play golf!
She increased her golf to 2 rounds a week, but after 4 months of golf (and no tennis!) she began having pain on the medial side of her elbow, and she was diagnosed with medial epicondylitis, or golfer’s elbow. Her doctor prescribed physical therapy and she tried to continue golf even though she could barely grip the club. Now and her stomach was getting upset by months of high dose ibuprofen, and the physical therapy was expensive and not helping. She had read our newsletters about prolotherapy, also known as regenerative injection therapy’ and wondered if her elbow could be treated.
“Unlike muscle tissues, exercise cannot build, strengthen or repair ligaments or tendons”
Epicondylitis is the term used to describe a painful inflammation of the boney projections on the medial and lateral sides of the elbow. The epicondyles serve as the attachment points for the muscles and ligaments of your arm. With the repetitive strains that happen with tennis and golf, these tendons and ligaments can be sprained and weakened, with fraying and thinning of the connective tissue. This connective tissue has a rich network of nerve endings, as anyone experiencing the pain of tennis elbow can attest. Unfortunately, these tissues have poor blood supply which makes them slow to heal. Unlike muscle tissue, exercise cannot build, strengthen or repair ligaments and tendons.
“Experiments have shown prolotherapy increases the size of tendons and ligaments up to 40%, while increasing their tensile strength by as much as 200%.”
How can prolotherapy strengthen tendons and ligaments?
Prolotherapy induces the growth of healthy new connective tissue that is strong and flexible. Once the ligament or tendon has been repaired, the nerves are no longer stretched or irritated, and normal function follows. Experiments have shown prolotherapy increases the size of tendons and ligaments up to 40%, while increasing their tensile strength by as much as 200%.
The elbow: a versatile joint.
The elbow is an amazing joint. The radius bone not only flexes and extends on the humerus, it also rotates within its ligamentous capsule, allowing you to rotate your hand and flex or extend it simultaneously. When I examined Pamela I found the attachment of the radius bone at the elbow was inflamed and unstable. These ligaments that stabilize and control this movement must be strong enough to support the great forces exerted on the arm, and elastic enough to allow the flexibility and full range of motion we enjoy. Pamela had exquisite tenderness over these attachments and a painful, weakened grip.
When you swing a golf club or a tennis racquet, it places extra strain on the flexor muscles of the forearm, and the weak link is where these muscles and ligaments anchor into epicondyles. Injury at this attachment is common, and occurs from repetitive strain in many activities. Hairdressers, gardeners, kayakers and windsurfers are all susceptible to repetitive strain of these tissues.
Since 1999 I have used prolotherapy to successfully treat every case of epicondylitis I have seen. I have even treated my own elbow with great results, so I knew that Pamela would respond to treatment. But first she had to be taken off all anti-inflammatory drugs, as they can inhibit the healing response induced by prolo injections.
At her first treatment on June 25, 2004, I injected a prolifirative solution of dextrose and a local anesthetic into her incompetent ligaments, followed by physical therapy consisting of sine wave, deep massage and ultrasound to enhance circulation and help dissolve the chalky calcium deposits that accompany the chronic inflammation of tendonitis. We followed up with these physical therapies twice a week, and then repeated the prolo injections once more on July 8, and followed up with 2 more physical therapy sessions. Pamela played her first pain-free 9 holes of golf on August 5, 2004, and resumed playing tennis on September 2, 2004. Now, one year later, Pamela continues to play golf and tennis without pain.
Total cost of her treatment: less than $1200.
Joy of playing tennis and golf with her friends: priceless.
For more information on prolotherapy, visit our website www.myctm.org or www.GetProlo.com