Ligament injuries can be more painful and take longer to heal than a broken bone. They are common in traumatic injuries like a car crash, fall or sports injury. A ligament is a tough band of white, fibrous, slightly elastic tissue. They are an essential part of the skeletal joints; binding the bone ends together to prevent dislocation and excessive movement that might cause breakage. Some people like to compare ligaments to duct tape; they hold bones together. Another way of seeing this is to compare ligaments with elastic. Have you ever had favorite clothes where the elastic goes and loses its ability to follow and cling to your body? This is how lax ligaments work in your body. Torn ligaments could be compared to a fan belt in your care or a belt in your clothes dryer or vacuum cleaner, once it tears there is no real way to fix the problem because each time the appliance is used it puts pressure on the belt. Ligaments contain signaling features which tell the bones how much to move. Ligaments also protect the joints and nerves. When these structures are injured, the body works to rebuild them but this is a slow process. A severe ligament tear can take 18 months to heal whereas a broken bone heals in weeks. When the tear is bad and the ligament can’t heal the surrounding muscles work overtime and the nerves do not have the same degree of protection which can lead to chronic pain and atrophy of the surrounding muscles. Severe ligament injuries that can’t heal produce instability in the surrounding structures. When this happens, deep supporting muscles get weak, nerves get irritated (causing more muscle weakness), and joints get inflamed and painful. Ligament injuries may be accompanied by popping and cracking. Tight muscles and bad posture that come from the strain of chronic pain and injury can also cause cracking and popping however in this case the popping and cracking relieves pain and pressure. When popping and cracking makes you feel worse and produces more pain, numbness, or burning; it may be due to instability. Special x-ray techniques called flexion-extension views could be done to rule-out any type of instability. Ligament injury can be treated with prolotherapy and adult stem cell treatment. Ligament repair can treat the injured areas as well but surgery is invasive, there is extensive rehabilitation and considerable down time. Targeted physiotherapy can be used to strengthen the area around the ligament to give it the opportunity to heal. Sometimes bracing is used to rest the area to give it time to recover however this is a temporary solution to reduce pain and used long term can make the situation worse because the surrounding support areas weaken with lack of use. There are some antibiotics such as ciproflaxin which can make hinder ligament repair. Anti-inflammatories can also slow the healing process for ligament injury. Supplements that promote cell health such as vitamin C, Glucosamine, Fish oil supplements and anti-oxidants can help. It is important to have high quality protein in your diet to promote a healthy balance of amino acids which help your cells increase the building blocks needed to heal. Getting enough sleep and regular exercise is important. Stress slows your body’s ability to heal. Learning stress busting techniques or avoiding stressors promotes health.
By Amy Price PhD
My husband underwent adult stem cell therapy in hopes of staving off hip replacement. The technique in the USA was in the early stages and his hip degeneration was acute. In the end he underwent bilateral hip resurfacing in the UK. The procedure was successful and gave him his life back. The UK surgeons were most interested in stem cell therapy and they were working on getting stem cells federally funded particularly for revision surgery which happens when the artificial hip wears out after about fifteen years.
It was exciting to learn about six hip patients who underwent a very creative stem cell procedure in Spire Hospital, Southhampton UK. This procedure could prevent thousands of people from needing to have an artificial hip fitted.
Here is a short breakdown on how they are doing this. Surgeons are using the patient’s own stem cells to rejuvenate the affected bone and donor bone to speed the process. The stem cells are extracted from the patient’s pelvis, purified and cultured in an organic mixture that promotes growth. When the cells had multiplied they were mixed with cleaned, ground-up hip bone from other patients who had hips replaced.Surgeon then excised dead tissue from the ball of the hip and filled the cavity with the mixture of stem cells and donated bone.
Professor Richard Oreffo of Southampton University explains that stem cells send out chemical signals to attract blood vessels. “Bone is a living vibrant tissue. These stem cells generate new tissue and drive new blood vessel formation to bring in nutrients,” he said.
Dr Dunlop is hopeful that this therapy will fix the hip for life. Early reports look promising with good results in 5 out of 6 study participants. The television footage on this was stunning. One patient who had his procedure a year ago looked like he had never experienced a hip problem.
Scientists and doctors are working together to expand this study and to explore the viability of using artificial bone. This would eliminate the problem of donor generated deficits being passed on although I suspect those already in need of new body parts are happy to take their chances.
This news is hot on the heels of research by scientists in New Jersey USA who have successfully isolated nerve growth factors in mesynchemal stem cells and grown them out as published in the latest issue of the Journal of Neurochemisty. Cell biology and Genetic engineering advances may soon provide real answers for those with untreatable neurodegenerative conditions and even those who have sustained brain injury.
Scientist and doctor teams are now considering how this therapy could be applied to other degenerative conditions.
Prolotherapy prompts the body to naturally heal damaged and degenerated tissues. This is not a steroid which can block healing by inhibiting the natural inflammation cycle whereby new cells can regenerate and repair tissue, but a natural substance that promotes healing. In Roman times, soldiers with joint injuries would have those wounds cauterized to promote healing and reduce infection. While modern techniques are much more sophisticated, the concept is the same.
Prolotherapy works by prompting your body’s natural repair mechanisms to heal damaged or degenerated tissues. It’s done when ligaments have been stretched/damaged or torn. This technique can be used in most joints that are unstable. It’s most commonly used for SI joint dysfunction with instability or chronic low back pain. This technique can help repair some of the ligaments and provide normal support to the joint. While most of our daily injuries heal completely, severe ligament tears, degenerated and worn out tissues, and those with a poor blood supply (such as in the knee) don’t usually mend themselves. This is because low grade inflammation is taking place and causing pain but it is not strong enough to signal initiation of the repair process.
Prolotherapy practitioners start by injecting a growth factor stimulant which is not a growth hormone or steroid, but contains a mild irritant such as glucose mixed with local anesthetic to trigger healing response in the damaged area. This otherwise harmless, natural substance, causes a brief period of inflammation 3-5 days after the injection which triggers inflammation that causes the body to release it’s own natural growth factors in the injured tissue.
Most practitioners do these injections in a series, with 3-6 times being considered the norm. This technique can be used in most joints that are unstable. It’s most commonly used for SI joint dysfunction with instability or chronic low back pain. These go to work immediately, directing your body’s natural healing mechanisms to repair damaged and degenerated tissue. The first stage of healing usually takes about a week, but the tissue continues to restore itself for 4-6 weeks after the injection.
It is very important that this treatment is done with fluoroscopy guidance. Fluoroscopy is like an xray movie. Some doctors inject with out xray guidance. For this treatment to be effective it needs to be precisely targeted and done by a practitioner who is getting consistently good results for treatment. It may be good to ask the doctor for the name of a couple of satisfied recipients. They will be able to tell you about the procedure and what to expect as well.
Adult stem cell viability is on many minds. I have had queries from UN ambassadors to children of only nine asking me about stem cells. The curiousity is international but the questions are the same. People are not sure who to trust and they need stem cells now. Many can not travel to other countries because they are too ill and others lack funding for private stem cell clinics. Some of these feel the FDA or the NHS is unreasonable in thier demands for testing while others feel patient testimonials should be outlawed. My own training is in mental health/psychology so patient to patient information is all I can offer.
I personally like patient testimonials especially when they are accompanied by forums where people discuss how and if the treatment worked and what the hurdles were in getting treatment. I have often learned more from groups of patients with an experience than from professionals with just a theory. Forums are not meant to be professional research, they are peer to peer information only. Google stem cell or regenerative medicine forums and you will get many choices.
I agree clinical trials and time are important to assess treatments but realistically it will be 15 or 20 years before long term results are on the table for clinical trials. There are some companies that have obtained FDA approval for trials, others are listed at clinicaltrials.gov It may be useful to look at this Doctor’s description of FDA off label drug use for drugs to understand how the rules were set up and to get an inkling of how this could all translate to cell biology.
My concerns are that engineering any living object is not a simple process and what looks simple from the outside in a needle in/needle out sort of process is very complex from a laboratory perspective and all the answers may not be in. Some clinics are reputable, give good patient care and patients are reporting good long-term results. Some patients are fortunate enough to get into a university sponsored trial that is tied to a major research hospital. Other clinics are still using methods that were proven ineffective many years ago. Patients are vulnerable and need protection sometimes even from themselves. I can no longer count the number of friends I have lost to questionable therapies after spending family fortunes in a quest for a cure. There are no easy answers…
Having said this and knowing from personal experience the agony of chronic unrelenting pain and the sadness of life lost because of disability I would not likely wait until the votes were in but would join in the age old clamor of patients trapped by pain “Just fix me!” The International Society for Stem Cell Research has released guidelines which are helpful to use when considering any new therapy. The PDF is available here
Of the 1.4 million who sustain a TBI each year in the United States: 50,000
die; 235,000 are hospitalized; and 1.1 million are treated and released from an
emergency department. The number of people with TBI who are not seen in an
emergency department or who receive no care is unknown.
Major causes of TBI are: Falls (28%); Motor vehicle-traffic crashes
(20%); Struck by/against events (19%); and Assaults (11%). TBI costs the USA
approximately 60 billion dollars per year in care and lost productivity (Statistics supplied by BIAA)
TBI can cause a wide range of functional changes affecting thinking, language, learning, emotions, behavior, and/or sensation. It can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.
Survivors report the areas they most need help are: Improving memory and problem solving; Managing stress and emotional upsets; Controlling one’s temper; and improving social and employment skills.
A mind is a terrible thing to lose…if you have sustained a head injury all is
not lost help is available .The links above in blue contain help and information.
We are often asked how do I find a good treating professional? Ask your local brain injury association. Word of mouth is good. Check with healthcare facilities, neighbors and friends. Find a professional who will work with you or your family member to get results rather than just tell you to learn to adjust to the problem.
Here is a place where you can try brain games for free. This site is monitored by scientists from Stanford university who are collecting brain function data for a mega study.
Brains have axons. These are tiny fibers that are like an electronic circuit board. Axons make brain communication possible. If these are stretched past ten percent of their length they can not function and the connection is broken. To put this in perspective you can stretch your hair sixty percent beyond its length before it breaks. Broken connections mean lost function. Hair can be broken simply by running a brush through it. We seldom question the news when we are told the ninety pound teenager shook the baby to death. Yet when an adult brain is shaken by the impact of a 2500 pound car people think this could not happen. The injured are often asked if they were unconscious.
The sad truth is that most brain injured people will not know if they were unconscious and will just say no.
The brain…you can build it a team can help!
Dr. Gail Denton author of the best selling book Brainlash states the Brain Injured person needs a team to restore their potential. Dr Denton wrote the first addition of this book after she sustained a brain injury. She is a successful artist, author and therapy consultant. She is presently working on research to determine the optimal brain diet and has contracted with her publisher to produce a new book featuring food for the brain and great recipes. Brain Injury does not have to be a death sentence! For helpful strategies for yourself or others take a look at this book!
Every brain injury is unique. Recovery usually does not mean returning to who and how you were before, but rather finding a new relationship to your abilities and your world. Lisa sustained a brain injury in 1993. She used her recovery to create a remarkable tool for individuals and families that struggle with brain injury. The kit was developed with Sandra J. Knutson, CRC, CDMS, CCM, Lisa’s former brain injury caseworker, and a thirty-year veteran in the brain injury recovery community. The Brain Injury Recovery Kit™ (BIRK) was created by Lisa Keller.
In MVA involving injury memory deficits can become an issue. Pain and lack of sleep contribute to this as do many of the medications prescribed to make it go away. There is anxiety and grief over financial loss or changed status. This compounds the issue. Each year more money is spent on pet food than for treatment to restore survivors of mild traumatic brain injury. Eighty percent of individuals diagnosed with mild brain injury have needs pertaining to the injury that are not presently met by current legislation. Treatment is described as too little, too late.
It was once thought that if there was no improvement in cognitive status in the first six months following an injury further progress would be minimal. Advances in science show this is no longer an absolute. Progress is possible.Every year Traumatic Brain Injury causes 20 times more disabilities than AIDS, Breast Cancer, Spinal Cord Injuries, and Multiple Sclerosis combined. Traumatic Brain Injuries have claimed more lives than all U.S. wars combined since 1977. Approximately 1.5 million Americans sustain a Traumatic Brain Injury each year. Traumatic Brain Injury is the number one cause of both death and disability in children and young adults.
WHAT IT DOES & HOW IT WORKS
Do you need help fixing your broken brain? Even if you don’t this article contains great strategies for improving memory skills and coping with life.
Want help with your memory? Let us look together at where the problem might be so we can suggest solutions. Information is first filtered through the senses (seeing, hearing, touching, smelling) or sensory memory. The sensory input combines with what we already know as the brain attempts to classify the information before it is encoded into our memories. Before it can be encoded accurately we have to pay attention or attend to it. The brain has only a few seconds of what is called working memory to encode material. When the information is needed we call on it to come out. This process is called retrieval.
POSITIVE STRATEGIES FOR A VARIETY OF SITUATIONS
Retrieval can be enhanced by rehearsal. The most common kind of rehearsal is saying something like a phone number over and over until it sticks in the brain. This is a problem for a person with memory deficits as by the time they get to the last number they forget what it is! In this case there is an unorthodox but useful strategy called chunking, instead of remembering numbers digit by digit such as 301 5700 think of three hundred one, fifty seven hundred. There are other solutions, write information down while repeating it to your self or ask someone else to write it for you. This is most useful when someone is giving you directions. The next step is to read the information back to who ever you got it from and ask them if your version is correct. This is also good for reinforcing understanding in conversation as sometimes what someone says to us is different to what we heard them say or is not what they meant.
To deal with problems of losing things here is some help. Pick places where you are comfortable storing things like keys, licenses etc. Make it a habit to always put them back in those places only. Write down where these places are and put it somewhere you will see it everyday in case you forget. When you go to a store only take something that can be attached to your body, forget about the purse that could be left in the shopping cart or car keys you carry in your hands.
When the memory is less than stellar even a parking lot can seem like a hopeless maze. Most cell phones have voice recorders on them as do many other devices. Record where you parked the car, for example the car is at exit c parking lot level three, third car down. Pay attention to which store you enter and what is close to the door, for example Macy’s, men’s shoes. This way if you get lost you can ask someone where these landmarks are and find your way.
Here is another strategy A piece of paper/card with a grid (kids math jotter paper with the little blocks) with place for a couple of stores names around the periphery or a land marks/monument, a McDonalds or a gas station and make an X in the block of the area where you best estimate your car is. A good place to put ID, credit card, money, parking lot stubs is in a ‘fanny pack’. If you can not remember how to get somewhere or get home buy a turn by turn GPS or phone a non judgmental friend.
There are many kinds of memory, visual auditory episodic, semantic, conceptual and more. This is good news because it means that you can use another kind of memory to enhance which ever kind is not working for you right now.
Here are some useful strategies. To remember an event think about what else you did, where it happened, the conditions around the event, ask your self how you felt that day, who was with you even what you did afterwards. Anyone of these can release a cue to help you remember.
To remember Peoples’ names, think about where you first met the person or go through the alphabet mentally, sometimes it helps to recall their significant others’ names or occupation. Just one piece of information can trigger the missing link. If all else fails ask them for a business card and read it or ask how they spell their names.
Learning something?-To remember something you need to learn, teach it to someone else, read your notes on tape and play them as you walk or at the gym, create a mind map or make the information into a story. Trouble finding words, look up a word that means the same in a good dictionary usually the synonyms will be displayed and your missing word will show up. A good dictionary can also show you how to pronounce words you have forgotten how to say. Forget how to spell it and spell check is not bright enough to figure it out? Break the word into syllables and spell the part you can figure out, from here spell check may pick it up or you may remember the whole word.
In the kitchen-For kitchen memories….don’t leave the room or be otherwise distracted when you have a pot on the stove. The same people that distracted you will remind you over and over about how you forgot something again! Do one thing at a time until your memory is healed, your ability to multitask will usually return. Buy appliances that turn off automatically, this may be expensive initially however it is cheaper than a house fire! Discipline yourself to use timers.
Often individuals forget steps of a process/task. In this case it is useful to lay everything out ahead of time. Think through what steps you need to take to complete a process/task. If this is difficult get someone to help you and write it down or record it for yourself.
For schedules…got an appointment write it down, put it on the computer, in the day timer or on a PDA. Another method is to call your telephone answering service and leave your self messages as they come up. Alternately make a list and number it for priorities then cross them off when you are finished. Too busy to prioritize…you are too busy! Make changes or you will get buried.
I Hope this helps some, nobody remembers everything so don’t beat yourself up. Keep working at it slowly and surely the more you use your brain the better it will get.
MRIs have gone through a lot of changes and improvements in the last few years. A first class radiologist is the best way to get an accurate diagnosis but great equipment helps too. People ask how can I know that my radiologist does quality work? The best way is to ask who others consider the best. Ask at your Doctors, at physio and at the hospital. Soon you will find some names come up over and over again. It is important to find out what kind of MRIs they are best at reading. Some specialize in the brain, tumors, or spines. all radiologists are not considered equal so choose with care! For an explanation of how they work and the history of MRI click here
Before you agree to an MRI it is good to find out who will be explaining the results and the technical terms in your report to you. At SIF we get multiple requests to explain results of MRIs. We can not help with this as an MRI is only a part of the picture, diagnostics are made in conjunction with detailed physical examinations and patient/physician consultation.
MRI machines work with magnets and the strength is measured by Tesla. The Tesla strength can vary anywhere from .046 to 8 Tesla. Before you book an MRI ask what the strength is of the machine they will use for your scan. The strongest Tesla in common use outside of research settings is a 3 Tesla. The stronger the Tesla the clearer the image. Large herniations can be seen with an .02 Tesla. Using a 3 Tesla even ligament damage is quite visible. Click here It used to be thought that 7-8 Teslas would not be safe for patients because of the radio frequency but these fears proved groundless click here and this Tesla strength is used for revealing vascular structure and for detailed brain scans.
MRIs can be with or without contrast. A contrast MRI makes it easier for the diagnostician to see scar tissue that may have formed because of the injury. The contrast is a small amount of water soluble dye that is injected at the time of your MRI. MRIs can be static or functional (fMRI) fMRIs measure function. Oxford University has an interesting and informative site detailing how fMRI works and the strengths and perceived weakness of this approach click here
Technology combining MEG (measures brain’s electrical activity) and fMRI are bringing hope for treatment in previously uncharted territory Click here Software can convert images into 3D For more info and to see axonal motion in 3D click here The software technology in detail click here
Stand Up MRIs are thought to show structural patterns more clearly and can signpost where a client is feeling pressure. Some ligament damage can also be shown more accurately with the stand up MRI. Click Here Research done on this method click here A new and promising technology is on the horizon to reduce MRI costs and also create a machine that can be used for those with metal implants or even to assist in surgery! Click here
Thought For Today “” “Nobody can go back and start a new beginning, but anyone can start today and make a new ending.”- Maria Robinson quote
