WORKOUT AND SPORTS INJURIES AND ARTHRITIS

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The notion that sports and recreational activities cause an inevitable wear-and-tear on the joints just does not hold up when the scientific studies are evaluated. Because few competitive or recreational long-distance runners suffer severe joint injuries, and many regular runners can recall how long and how often they have run, studies of these people provide some of the best opportunities to examine the relationship between exercise and osteoarthritis. In one investigation, 41 long-distance runners were compared with 41 matched controls. Runners with a mean age of 60, who had run an average of 180 minutes per week for 12 years, did not have a greater prevalence of osteoarthritis, although they did have a 40 percent greater density of their vertebral bones. Another investigation compared 17 people with a mean age of 56, who had run an average of 28 miles per week for 12 years, with 18 non-runners. Runners had no more complaints of pain and swelling of the hips, knees, ankles, and feet than non-runners, and radiographic examinations of the joints of the two groups did not show any differences.

Impact Injuries and Arthritis It is not uncommon for athletes to injure joints. It is this injury or the nonhealing of it that causes the degenerative process to start in the joints. Additionally, repetitive low-grade impact from athletic events can be enough to damage the soft tissues and start the arthritic process.

People who participate in sports that subject joints to more intense impact and torsional loading than running may have an increased prevalence of osteoarthritis. Participants in sports with a high degree of torsional loading and levels of impact must be extremely careful that all of their sports- related injuries heal completely, otherwise degenerative joint disease is likely to occur. The sports with the highest levels or impact, torsional loading, and thus have the highest rates of injury are baseball/softball, basketball/volleyball, football, handball/ racquetball, competitive running, squash, lacrosse, soccer, rugby, singles tennis, water skiing, and karate.

The hope for the older athletes is to be as fit as when in the prime of their athletic careers. Often, however, this is not the case because of the degeneration that has occurred due to non-healed sports injuries. It is very evident that the main sports injuries that lead to symptomatic osteoarthritis in later years are those that occur to the ligaments, causing joint instability. It has to be this because the body, in a homeostatic attempt to stabilize hypermobility and protect joint structures, responds by depositing calcium along lines of stress. This produces bone spurs, or exostoses (calcium deposits where ligaments attach to bone), at the attachments of postural muscles and ligaments to bone. Calcification of the whole ligament can occur, as happens in ankylosing spondylitis. Typically, however, bone spurs develop in the ligaments/fascia (as in plantar fasciitis) and these are generally a sign that the ligaments were no longer able to stabilize the joint so "reinforcement" was brought in, in the form of additional bone. This additional bone is called osteoarthritis.

ARTHRITIS RISK FROM ARTHRITIC INJURY
Athletes are primarily given NSAIDS (nonsteroidal anti-inflammatory drugs) and steroid injections because it is the standard of care. Just because something is the standard does not mean it is correct. Cortisone and other steroid shots are given to athletes joints, especially the knees, when exercise and NSAIDs don't relieve the pain. In essence, they are given because the family physician, team physician, or orthopedic surgeon has no more treatment options. As depicted in Prolo Your Sports Injuries Away!, continued pain in the athlete signifies that a structure is still injured. Nutritional supplements such as glucosamine, MSM, bromelaines and others help athletes heal sports injuries. In addition, the athlete may need Prolotherapy to directly stimulate the joint or joint structures to heal.

WHAT CAUSES ARTHRITIS? It is commonplace of an athlete to have a sports injuries and go through exercise, physical therapy, NSAIDs, then a stronger NSAID, and eventually progress to cortisone shots. Once this level of care is reached it is only a matter of time before arthroscopies follow. Arthroscopies are offered to "clean up" the area. They do not repair anything typically just scrape away damaged tissue. Well the athlete should be asking "why is the damage there?" It is there because of all the NSAIDs and steroid injections, which were given by the same physician that is going to the arthroscopy and eventually the joint replacement.

If one looks at the pathophysiology of arthritis it is clearly a condition that occurs when a joint becomes loose because of ligament injury. Non-healed ligament injury causes an excessive amount of pressure on the other joint tissues such as the menisci. Once these go, the cartilage deteriorates. Arthritis means that the joint is deteriorated as manifested by a thinning or degeneration of the joint. Excessive bone forms to try and stabilize the joint which is loose from the underlying ligament laxity. Ligament laxity or weakness is thus the underlying problem in most degenerated joints. Because Prolotherapy gets at the root cause of arthritis it is very successfully in treating this disorder. Prolotherapy helps all stages of arthritis but is best done as early as possible. Prolotherapy can help stimulate the repair of all the structures inside the joint including the ligaments, tendons, menisci, cartilage, and joint capsule. Prolotherapy is the future of sports medicine and eventually will be the future of arthritis care.

CAN I PREVENT MYSELF FROM GETTING ARTHRITIS? It is extremely easy to prevent arthritis from forming. All an athlete has to do is heal completely all sports injuries. Since physicians who utilize Prolotherapy are experts in ligament injuries it is best to have one of them on the athletes treatment team. Prolotherapy physicians can help an athlete determine when complete healing has occurred. If an athletes ligaments and tendons are as strong or stronger than before the injury there is no risk for arthritis forming in the future. If an athlete continues to play on an injured joint or ligament then arthritis is sure to form. It has to! Arthritis is the bodies response to stabilize a loose joint. A bone spur or bone overgrowth is occurring because the underlying joint and joint stabilizing structures (ligaments) are still weakened and stretched. By obtaining Prolotherapy and strengthening the weakened structures, the impetus for the arthritis forming stops and so does the pain.


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