SPORTS INJURIES
Ligament and Tendon Laxities
Sports and athletics involve tremendous forces. Tennis players serve
up to 140 miles per hour, pitchers throw a baseball 100 miles
per hour, marathon runners run five minute miles for 26 miles,
and so on. Is it any wonder that the body starts to break
down? Most athletic injuries involve strains and sprains
to tendons and ligaments, respectively. 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 (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.
For More on Prolotherapy.
Would you like information of how to be our patient? Click Here
Want to talk to us first? Click
Here
< Back to Sports Injuries
|
