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● ARIZONA
PHOENIX
Fred Arnold, DC, NMD

Kent L. Pomeroy, M.D.


SCOTTSDALE
Michael Cronin, N.D.
David Tallman, DC, NMD.


TEMPE
Robb D. Bird, NMD


TUCSON
Jorge B. Cochran, ND.NMD

● ARKANSAS
Merl B. Cox, D.O.

BRITISH COLUMBIA
Christoph Kind, N.D.

CALIFORNIA
ANAHEIM AREA
Hanson Wong, M.D.
Howard Rosen, M.D.

AUBURN
Rodney Van Pelt, M.D.

BAKERSFIELD
Payam Kerendian, D.O.


BEVERLY HILLS
Behzad Emad, M.D.
Payam Kerendian, D.O.


CLOVIS
Kevin Wingert, M.D.

GARDEN GROVE
Howard Rosen, M.D.

GLENDALE
G. Megan Shields, M.D

IRVINE
Allan Sosin, M.D.

Los Angeles
Donna Alderman, D.O.
Marc Darrow, M.D
Hanson Wong, M.D.


Los GATOS
Joshua M, Donaldson, N.D.

Marin County
Paul Handleman, D.O.
John Monagle, NMD


Monterey
Howard Rosen, M.D.


SAN DIEGO
Andrew Kulik, D.O.

Gary Matson, D.O.

SAN FRANCISCO EAST BAY
Donna Alderman, D.O.

SAN FRANCISCO NORTH BAY
Paul Handleman, D.O.
John Monagle, NMD


San Ramon

Richard I. Gracer, M.D.


SANTA BARBARA
Allen Thomashefsky, M.D.


SANTA CRUZ
Joshua M, Donaldson, N.D.

SANTa monica

Peter Fields, M.D.,D.C.

SANTa
ROSA
Justin Hoffman, NMD

Temecula
Edward A. Venn-Watson, M.D.

UKIAH AREA
Rodney Van Pelt, M.D.

● COLORADO
BOULDER
Gary Clark, M.D.


BROOMFIELD

Christopher J. Centeno, M.D.
John R. Schultz, M.D.


COLORADO SPRINGS
Mary Harrow, D.O,

DENVER
Joel A. Berenbeim, D.O.
Thomas Ravin, M.D.

FORT COLLINS
Mark Kelley, N.D. LAc

LITTLETON
Jo Ann Douglas, M.S.,D.O

PARKER
John A. Littleford, D.O.

STEAMBOAT SPRINGS
Jon Freckleton, D.O.

● CONNECTICUT
AVON
Valley Sports Physicians & Orthopedic Medicine
Paul Tortland, D.O.
Albert Kozar

WEST REDDING

Perry M. Perretz, D.O.

● DELAWARE
SOUTHERN NJ
Scott R. Greenberg, M.D.
SOUTHERN PA
Brian J. Shiple, D.O.

● FLORIDA
ORLANDO AREA
Nelson Kraucak, M.D.


ORMAND BEACH
Hana Chaim, DO

Clearwater
Felix Linetsky, M.D.

PLANTATION
Alvin Stein,M.D.

SARASOTA/TAMPA BAY
Mark Walter, M.D.
Wellington Chen, M.D.
Matthew Burks, M.D.

TAMPA BAY AREA
Felix Linetsky, M.D.
Robinson Family Clinic

● GEORGIA
WARNER ROBINS
E. Glynn Taunton, D.O.

MARIETTA
Robert C. Shuman, M.D.


● HAWAII
HAIKU
Kevin Davison, N.D.

HILO

Liza Maniquis-Smigel, MD

Honolulu, Hawaii
Liza Maniquis-Smigel, MD

● ILLINOIS
CHICAGOLAND

Ross Hauser, M.D

PEORIA
Yibing Li, M.D.
Jay Harms, M.D.

WESTERN ILLINOIS
Anwer Rasheed, M.D.

● INDIANA
CLARKSVILLE
Steven M. Johnson, D.O.

LAFAYETTE

Carolyn G. Kochert, M.D.

Mishawaka
Mark S. Cantieri, D.O.,

● IOWA
CLINTON
Anwer Rasheed, M.D.
IOWA CITY
John Macatee, DO.
WEST DES MOINES
Jacqueline M Stoken, D.O

● KANSAS
KANSAS CITY AREA

K. Dean Reeves, M.D.

TOPEKA
Doug Frye, M.D.

● KENTUCKY
LOUISVILLE
Steven M. Johnson, D.O.

● LOUISIANA
NEW ORLEANS AREA
Thomas K. Bond, M.D.

● MARYLAND
Rockville
Ingrid Gheen, M.D.

● MASSACHUSETTS
MALDEN
Albert V. Franchi, M.D.
WORCESTER

Jon Trister, M.D.

● MICHIGAN
Howell

Jerald Gach, DO
SHELBY TWP
Robert Krasnick, M.D.
Southfield

Jerald Gach, DO
WARREN

Robert Krasnick, M.D.

● MINNESOTA
EXCELSIOR/Menahga
Mark T. Wheaton, M.D.


MINNETONKA
George H. Kramer, M.D.


● MISSOURI
KANSAS CITY
Edward McDonagh, D.O

ST. Peters
Michael J. Adams


● MONTANA
HAMILTON
Mark Kelley, N.D. LAc

● NEVADA
CARSON CITY

Alfred N. Grimes, M.D.


RENO
Andrew C. Wesely, M.D.

● NEW JERSEY
BLAIRSTOWN
Walter R. Grote, D.O

CENTRAL NJ
Edward Magaziner, M.D.

WAYNE/NORTH NJ
Robert Kramberg, M.D.

SOUTH NJ/
PHILADELPHIA
Scott R. Greenberg, M.D.
(Cherry Hill)

Joseph P. Mullane, M.D.
(Hamilton)


Brian J. Shiple, D.O.
(Springfield PA)

● NEW MEXICO
Albuquerque

R. Dean Bair, D.O.

James E. Baum, D.O.
SANTA FE
James E. Baum, D.O.

Jonas R. Skardis, DOM

● NEW YORK
B
ALDWIN
Pandu Tadoori, M.D.

BUFFALO AREA
Timothy L. Speciale, D.O.
BROOKLYN
Neil Raff, MD, CNS
David Zirkitev, P.A.
EAST MEADOW

Christopher Calapai, D.O.

FLUSHING
Neil Raff, MD, CNS
HICKSVILLE
David Borenstein, M.D.

MANHATTAN
Richard Ash, M.D.
David Borenstein, M.D.
John H. Juhl, D.O.
Robert Kramberg, M.D.
NEW YORK METRO AREA
Perry M. Perretz, D.O.
Edward Magaziner, M.D.
Scott R. Greenberg, M.D.
ORANGE
Neil Raff, MD, CNS
ROCKLAND
Neil Raff, MD, CNS
WESTMINSTER
Neil Raff, MD, CNS

● NORTH CAROLINA
ASHEVILLE AREA

Stephen Blievernicht, M.D.
CARY

Catherine Duncan, D.O.

Huntersville
Dr. Mark Hines

● OHIO
AKRON/CANTON
Vladimir Djuric, M.D.
BLUFFTON

L. Terry Chappell, M.D.
CENTERVILLE
Rick Buenaventura, M.D.
CINCINNATI
Michael J. Bertram, MD

TOLEDO AREA

Jay W. Nielsen, M.D.

● OKLAHOMA
BROKEN ARROW
Shirley J. Welden, M.D.

● OREGON
ASHLAND
Allen Thomashefsky,M.D.
EUGENE
Thomas Peterson, M.D.
HILLSBORO
Kevin C. Wilson, N.D.

LAKE OSWEGO

Noel S. Peterson, N.D.

MEDFORD
Carl Osborn, D.O.
OREGON CITY
Joanne Gordon, ND,MS,PT

PORTLAND

Rick Marinelli, N.D.

Chiaoli Lu, ND. LAc. DAOM.
Patrick Chapman, N.D.
Joshua David, N.D.
REDMOND
E. Payson Flattery, D.C.,N.D.
SALEM
Donald McBride, Jr, ND


● PENNSYLVANIA
BALA CYNWYD
Harvey Kleinberg, D.O.
BETHLEHEM
James F. Frommer, M.D.
ELKINS PARK
Kab S. Hong, M.D.
JEANNETTE
Martin P. Gallagher, M.D., D.C.
MEADVILLE
Paul Peirsel, M.D.
PITTSBURG

Paul S. Lieber, MD
SOUTHERN NJ - PA
Scott R. Greenberg, M.D.
Allan Magaziner, D.O
Edward Magaziner, M.D.
SPRINGFIELD
Brian J. Shiple, D.O.
WOMELSDORF
Peter J Blakemore, D.O,

● SOUTH CAROLINA
GREENVILLE/SPARTANSBURG 
Robert Schwartz, M.D.
CHARLESTON
Marc N. Dubick, M.D.
MOUNT PLEASANT
Patrick Lovegrove, D.O.

● TENNESSEE
BRENTWOOD
Mark L. Johnson, M.D.
CLARKSVILLE
Rafael Prieto, M.D.
JACKSON
Marcus E. Meekins, M.D.
MEMPHIS
Marcus E. Meekins, M.D.
NASHVILLE
Mark L. Johnson, M.D.

● TEXAS
AUSTIN
Mihnea Dumitrescu, M.D.

David K. Harris, M.D.
Brad Fullerton, M.D.
DALLAS
Michael Ellman, M.D.

DENTON
Carlos J. Garcia, M.D.
FORT WORTH
Gerald Harris, DO
Dennis E. Minotti II, D.O
David E. Teitelbaum, D.O.
HOUSTON
Robert Battle, M.D.
Adam Weglein, D.O
HOUSTON AREA

Joseph G. Valdez, M.D

John P. Trowbridge
MESQUITE
Michael Ellman, M.D.
PARIS
Gregg Diamond, M.D.
Norberto Vargas, M.D.
PLANO
Michael Ellman, M.D.
RICHARDSON
Gregg Diamond, M.D.
Norberto Vargas, M.D.

SAN ANTONIO
Annette M. Zaharoff, M.D.
SHERMAN
Gregg Diamond, M.D.
Norberto Vargas, M.D.
SUNNYVALE
Gregg Diamond, M.D.
Norberto Vargas, M.D.

TOMBALL
Shaun Lehmann, M.D.
Curtis Fandrich, D.O.


● UTAH
PARK CITY
Harry Adelson, N.D.
Kenneth Hurwitz, M.D.
SALT LAKE CITY
Harry Adelson, N.D.
E. Alan Jeppsen
SPANISH FORK
David Taylor Roberts, M.D

● VERMONT
WINOOSKI
Jonathan E. Fenton, D.O

● VIRGINIA
ALEXANDRIA
Robert H. Wagner, M.D.
BLUEFIELD
Lenny Horwitz, DPM
FAIRFAX
Mayo Friedlis, M.D.
McLEAN
David Wang, D.O.

VIRGINIA BEACH
Lisa Barr, M.D.

● WASHINGTON
ISSAQUAH
Jena Schliiter., M.D.

SEATTLE AREA
Richard A. Sandler, M.D.
JoAnna Forwell, N.D.

Adam R. Geiger, N.D.


● WEST VIRGINIA
MORGANTOWN

Nori Onishi, D.O.


● WISCONSIN
EAU CLAIRE
Deborah Raehl, DO

WAUWATOSA
Neal Pollack, D.O.

MILWAUKEE
William J. Faber, D.O.
 

Ligament and Tendon Laxities
Ross A. Hauser, M.D.

A tendon attaches a muscle to the bone and involves movement of the joint. A ligament connects two bones and is involved in the stability of the joint. A strain is defined as a stretched or injured tendon. A sprain is a stretched or injured ligament. Once a body structure is injured, the immune system is stimulated to repair the injured area. Because ligaments and tendons generally have a poor blood supply, incomplete healing is common after injury. (Browner, B. Skeletal Trauma. Philadelphia, PA: W.B. Saunders Company, 1992, 1:87-88.; Deese, J. Compressive neuropathies of the lower extremity. The Journal of Musculoskeletal Medicine. November 1988, p. 68-91.)

This incomplete healing results in decreased strength of the area. The ligaments and tendons are normally taut, strong bands of fibrous or connective tissue but, because of injury, become relaxed and weak. The injured ligament or tendon then becomes the source of chronic pain and weakness for the athlete.

Ligaments and tendons are also more prone to injury because of the natural aging process. The water content in our joints and connective tissues (ligaments and tendons) decreases with age, the articular cartilage see also Articular Cartilage Growth (see research paper) (which lines the joints) gets brittle and shrinks.

Cartilage is so vital, especially in weight-bearing joints like the knee, because it causes an even force to be generated at the underlying bone. It also causes the force generated on the bone to be less. When cartilage is degenerated, the force to the bone is greater and uneven and arthritis develops. Since cartilage decreases the force inside the joint, it becomes obvious that as cartilage deteriorates as we age, other structures are going to have to bear this force. Since tendons move the joints and ligaments stabilize the joints, it is primarily these soft tissue structures that are involved. Because ligaments stabilize the joints, a weakening of these structures causes a further force to the bones of the joints. This increased force hastens the arthritic process.

The greatest stresses to the ligaments and tendons are where they attach to the bone, the
fibro-osseous junction. The most sensitive structures that produce pain, according to Daniel Kayfetz, M.D., are the periosteum (covering of the bone) and the ligaments. It is important to note that in the scale of pain sensitivity (which part of the body hurts more when injured), Dr. Kayfetz notes that the periosteum ranks first, followed by ligaments, tendons, fascia (the connective tissue that surrounds muscle), and finally muscle. (Kayfetz, D. Occipital-cervical (whiplash) Injuries treated by Prolotherapy. Medical Trial Technique Quarterly, June, 1963, p. 9-29.) articular cartilage contains no sensory nerve endings. If you are told that your cartilage is the cause of your pain, that is not possible and is, actually, quite ridiculous. The cartilage cannot hurt because there are no sensory nerves to sense pain located in the cartilage. If there is cartilage damage, what hurts? The ligaments are typically the structures that hurt. Ligaments are weakest where they attach to bone. The periosteum is the most sensitive area to pain and the ligaments second. It is now easy to understand why this area hurts so much. This is where the Prolotherapy injections occur and thus eliminate the chronic pain of many conditions including arthritis, mechanical low back pain, degenerative disc disease, cartilage injury, and, of course, sports injuries.

Prolotherapy works by stimulating the body's healing system, a process called inflammation. The technique involves the injection of various solutions that cause a mild
inflammatory response that "turns on" the healing process. The growth of new ligament and tendon tissue is then stimulated. These new ligaments and tendons should not be confused with scar tissue, which is a chaotic matrix of collagen. The ligaments and tendons produced after Prolotherapy, appear much the same as normal tissues, except that they are thicker, stronger, and contain fibers of varying thickness, testifying to the new and ongoing creation of collagen tissue.


 

Prolotherapy
Information and Research
Prolotherapy
Prolotherapy
How Does Prolotherapy Work?
Why Does Prolotherapy Work?
How Prolotherapy Helps?
Indications - Contraindications
Introduction to Prolotherapy
Why Get Prolotherapy?
What is Prolotherapy?
How Does Prolotherapy Work?
Are You A Prolo Candidate?

Ligament Reconstruction
How Safe Is Prolotherapy?
Finding a Prolotherapy doctor
When Prolo May Not Work
20 Questions - Prolotherapy
The History of Prolotherapy
Curing Chronic Pain
Sclerotherapy?
Turning to Prolotherapy
Prolotherapy and Chronic Pain
Proof Prolotherapy is Working
Creating Collagen
How To Support Treatment

· Platelet Rich Plasma PRP

Prolotherapy and Inflammation

Prolotherapy In The News
 


Prolotherapy
Videos Online

Prolotherapy to the knee
Back and Spine treatments
Shoulder treatments

· Prolotherapy Information sites

The Journal of Prolotherapy


Prolotherapy Research at
The Journal of Prolotherapy




 

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