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Prolotherapy
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Prolotherapy
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How
Does Prolotherapy Work?
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How
Prolotherapy Helps?
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Indications and Contraindications
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Introduction to Prolotherapy
● Why Get Prolotherapy?
● What is Prolotherapy?
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How Does Prolotherapy Work?
● Are You A Prolotherapy Candidate?
● Tendon, Ligament, Reconstruction
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How Safe Is Prolotherapy?
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Finding a Prolotherapy doctor
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When Prolotherapy May Not
Work
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20
Questions About Prolotherapy
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The History of Prolotherapy
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Curing Chronic Pain
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Sclerotherapy?
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Turning to Prolotherapy
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Prolotherapy and Chronic
Pain
● The Proof Prolotherapy is Working?
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Prolotherapy: Creating Collagen
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How To
Support Treatment
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 Labral
tear, rotator cuff tendonopathy, and headaches
treated with prolotherapy and PRP (platelet rich plasma) in a
competitive athlete
Scott Greenberg,
MD
Having taken care of many professional athletes, you come to
realize that most have learned to play hurt, chronically so,
with injuries lingering for years. They prefer to keep their
injuries out of the spotlight, and come into my office often
referred for Prolotherapy or PRP
from a friend in the sport, not with a referral from the team
physician or trainer, and fear for their careers, contracts, and
scholarships. They do not want to be seen as hurt to prevent a
competitor from knowing they may have an advantage in an area of
weakness or injury.
JW was one such athlete who walked into the office seeking
prolotherapy, this time referred by her coach. JW was at the top
of her game in women's gymnastics, poised for a college
scholarship, until a year and a half ago when her shoulder began
to ache. She was seen by her local orthopaedic surgeon who
recommended an MRI, one that revealed a superior labral tear.
Wanting to obtain a college scholarship, this level 10 gymnast
refused surgery, and continued to battle thru the pain. However,
the most important matches of her career were coming up, with
only a few months to prepare. But the question lingered in her
mind, could she win if she was not performing at the top of her
ability. Pain and injury had caused her to compensate during her
movements, to hold back in practice. Furthermore, from her
compensation, her
headaches
became more severe and more frequent, often requiring her to go
home from school and lay in bed for a day, missing crucial
practice time.
When I first examined JW, she was visibly in pain and sat
quietly. She told me of the pain in her shoulder, how she felt
it in both the front and back of the shoulder, and sometimes how
it travelled either down the arm or up her neck. She said that
past few days have been especially rough, and had missed the
past 2 days at school, bedridden by headache. When she would
move her neck, she would experience pain, and moving her
talented arm produced the same. Otherwise she was quite healthy,
and had no significant medical history. She was prescribed a
host of migraine medication by her primary care physician which
helped to take the edge off of her nasty headaches. From her
symptoms, I thought prolotherapy would be a possible solution to
her headaches, but we may need PRP to treat her labrum.
On examination, she guarded her arm. An anterior compression
test of the labrum was positive, and assisted movement revealed
pain in arm flexion, abduction, and external rotation. Hawkins
was negative; Neers and Speeds tests were equivocal. She did
have a significant scapulothoracic discrepancy, with the right
scapula (shoulder blade) significantly higher than the left.
Palpation reveled pain in the C2-C5 facets on the right, in the
right C3 transverse process, and in the superior and inferior
nuchal line - joint damage in these areas is known to cause
severe headaches (as a former headache sufferer, I know!).
Palpation of the shoulder revealed not just pain over the
superior labrum, but also in the biceps tendon at its short and
long head, in the coracohumeral and coracoacromial ligaments,
and also in the supraspinatus and infraspinatus. I also felt her
joint capsule to be lax.
After having a discussion with JW and her mother, we decided to
use prolotherapy in the areas of her cervical spine, occiput,
and rotator cuff muscles, shoulder ligaments, and biceps
tendons. Because the bicep attaches to the superior labrum, it
is often injured concurrently with a labral tear, or could
actually cause the labral tear. The torn labrum, in my medical
opinion, required more intense therapy. Because her labral tear
dated back over 1 1/2 years, and labral tissue is avascular
(without a good blood supply) I decided to treat this area with
PRP (platelet rich plasma). Furthermore, even though I am an MD,
I decided to use manipulation to correct the discrepancy in the
scapula that I described above. It corrected immediately.
After a few sessions, JW's headaches were gone, her shoulder was
feeling much better, and the pinching pain felt from the labrum
was gone. She began to train more vigorously, and a few more
sessions of prolotherapy were required on the bicep tendon and
rotator cuff. As her arm improved, her coach began to see JW
move like she had never before, but competing on a national
level requires more. She began to train for 8 hours per day, and
her routines developed stronger. It was time to compete. JWs
routines were flawless, taking both first place in her category,
but also winning the entire meet. Now JW knows what it feels
like not to have pain, and gets to experience the thrill of
victory.
Contact Dr. Greenberg
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Shoulder Prolotherapy
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Rotator cuff tendonitis
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SLAP lesions
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Shoulder Injuries
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The Rotator Cuff
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Labral
Tear - Rotator Cuff
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Shoulder Prolotherapy
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Shoulder
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Platelet Rich Plasma PRP
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Shoulder Prolotherapy
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