Joint Preservation Blog

January 10, 2009

Ankle support in london?

As a physician, you might say that I have an American MD specializing in Regenerative Medicine and a “doctorate of hard knocks” in ankle braces.  When I came across people searching for “Ankle support in london” I had to throw in my two cents.  I don’t live in London, far from it, I’m in beautiful Boulder, Colorado.  If you’re looking for an ankle support brace, I can tell you first hand that I’ve tried them all.  The winner?  The Malleoloc.  However, my quest for the perfect ankle support didn’t end there, I then tried prolotherapy which allowed me to get rid of the ankle support brace.  This technique involves injecting substances into the ankle ligaments to kick off an inflammatory healing response.  This worked pretty well, even allowed me to take a run every once in a blue moon.  What would I do today instead of the ankle support?  I’d try this cutting edge procedure where they inject your won stem cells into the ankle ligaments to heal and repair the damage.  The video below shows a patient where this was done in the U.S.:

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ankle sprain with bone bruise that has taken 5 months

ankle brace

ankle brace

I recently saw the call for help, “ankle sprain with bone bruise that has taken 5 months appear on the Internet. It reminded me of my own problems some 15 years a go as a young doctor just out of residency. I was running and slipped off the concrete path and severely twisted my ankle. It was so bad that I had to limp home at 1/4 walking pace. I placed myself in an immobilizer and waited for it to heal, no healing after 1-2 months. I then began an Odyssey of ankle braces. The air cast was popular at the time, it was a joke, a great way to cut off my circulation without helping any stability. Then 2 months, then 3 months… I was onto seeing specialists. The people who worked with ankle sprains in my community at the time were all podiatrists. I went one who told me he had nothing to offer. Then 3 months became 4 months. I was still limping around the house when I did anything active. I then tried more braces. I bought the old fashioned lace up type, some stability, but getting the beast on and off was a nightmare. I was in a physical free fall of sorts, going from a very active young man to a couch potato. My weight ballooned. 4 months became 5 months. I then finally found my first savior, the Malleoloc brace. While this helped, 5 months became 6 months, 7 months, 8 months, 9 months, a year. Finally I tried prolotherapy, which wasn’t perfect, but got me to the point where I could function and even go out running every once in a great while. If I had injured this today, I would have certainly chosen injecting my own adult stem cells to fix my ankle ligaments. We’ve had great success with this new cutting edge injection treatment using the patent’s own stem cells. The video below tells more:

December 24, 2008

Sports Ankle Brace

Several years ago I injured my ankle while running. It didn’t completely heal, so as a physician, I set out to find the perfect sports ankle brace. My first stop was the then famous “air cast”. This was a great way to stop the circulation in my ankle, but did little to help the pain and swelling. The next sports ankle brace I tried was the old fashioned lace-up models. They were a nightmare to get on and off, but did supply some stability. After trying 10-12 braces, I finally settled on something that worked, the Bauerfeind Malleoloc.  This was an easy sports ankle brace to get on and off and actually provided some stability. Alas, after walking around with this thing for years, I finally decided to get the ligaments fixed using prolotherapy. This worked reasonably well and took a few injections. Today there are even newer ways to fix these ligaments with the injection of stem cells. The video below will provide more information:

December 15, 2008

How to Heal a Torn Ligaments Shoulder

How to heal a torn ligaments in the shoulder.  There are many ligaments that help to support the shoulder.  Ligaments are the duct tape that hold the shoulder bones together.  These include the coraco-acromial ligaments (the duct tape that holds the collar bone to the front of the shoulder blade).  Other ligaments include the joint capsule of the AC joint (duct tape that holds the AC joint together) and the shoulder joint capsule (the duct tape that holds the shoulder ball in the socket).  An injury that injures these ligaments can cause instability, meaning that the ligaments can be stretched an lose their ability to hold the shoulder bones together as you use the shoulder.  This can cause many issues, including early arthritis and pain.  Treatment options have traditionally been surgical.  However, newer non-surgical torn shoulder ligament cures are now available. 

Surgery for this area usually means sewing the torn ligament together or back to it’s attachment to the bone.  While for a complete tear of one of these ligaments this may the only way to get the two ends back together, for partial tears, this is an older method of repair that may have more problems than benefits.  For example, sewing a partially torn ligament often over tightens the ligament.  Newer treatments are injection based.  This means that adult stem cells can be injected into the ligament to help it mend, rather than needing surgery.  The newer stem cell based treatments (links above) also mean much less down-time and immobilization for the patient.   No more blue pillow immobilizer!

As an example, a patient with an AC joint injury often has chronic and painful popping and cracking in this joint.  The shoulder muscles underneath can become sore.  The surgical option is to sew a cadaver ligament or synthetic material around the injured ligaments to try and stabilize the joint.  However, there is huge down-time, with the patient being unable to use the area for months.  In addition, over tightening is common, and this leads to more arthritis.  The newer technique of injecting stem cells into the ligament requires no or little down-time and likely results in a more physiologic repair (without the over tightening) because the goal with this procedure is to get the ligament to heal back to it’s pre-injured state (or as close to it as possible).

supplements that help prevent torn tendons

Supplements that help prevent torn tendons usually involve various components of tendons such as collagen.  Collagen is a natural substance that acts as the mortar for the brick building blocks (cells) that make up much of the body.  Taking more of this collagen “mortar” may help provide better masonry building blocks in areas like tendons.  In addition, another major component of tendons and ligament repair is Vitamin C or ascorbic acid.  Vitamin C is a catalyst for this repair and building up of collagen.  Think of it as the food for the brick mason so he can lay more cellular bricks to make more tendon and ligament using the collagen mortar.  Another major tendon and joint component are GAG’s (glycoaminosglycan’s).  These are the chemicals that help to hold onto water and help provide elasticity to tendons, ligaments, and joints.  GAG’s include glucosamine and hyaluronic acid.  Another major strategy for preventing torn tendons is activity.  Activity helps to build up tendons and ligaments and make them stronger.  In this case, walking the mall may not be enough activity, but walking to the mall is more like the kind of activity levels needed.  Once a tendon tears, avoiding surgery should be the goal.  Sewing a partial tendon tear may make the tendon too tight and cause other problems.  Non-surgical methods to heal the tendon can include prolotherapy or adult stem cell injections.  Prolotherapy involves injecting substances to cause a brief inflammatory healing reaction to try and get the torn tendon to heal.  Injecting stem cells into the tendon provides more building blocks or bricks in our mason example above.

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