PROLIFERATIVE THERAPY
By Norman Zale
WALTER Mellin has been a powerlifter for more than 20 years, during which time he's suffered his share of training-related aches and pains. While doing heavy parallel bar dips with a weight hanging from his waist more than a year ago, he felt a sudden "pull" in his left shoulder. When the pain refused to abate after a few weeks, he consulted an orthopedic surgeon, who took a CAT scan and ordered rest, physical therapy, two 30-minute ice treatments daily and anti-inflammatory medication.
Walter continued training, doing only lower body work-squats, leg presses, leg extensions, leg curls and light deadlifts, along with a number of different abdominal exercises. Still after four weeks he suffered daily pain and couldn't use the arm without increasing the pain. The doctor recommended that an X-ray be taken with dye being injected into the shoulder so that the cause of the injury could be pinpointed.
After receiving the radiologist report, Walter's doctor told him that he had a rotator cuff tear and that the only way to fix it was via surgery However, a fellow powerlifter advised Walter against getting the surgical procedure on the grounds that he has known many lifters who had it without getting any better...and some actually were worse.
A bit confused, Walter decided to get a second opinion at a medical school, where a specialist reviewed his scans and X-rays-even taking additional X-rays of another type After evaluation, his diagnosis was exactly the same as the first examining specialist.
Remembering the advice of his lifting pal, Walter decided to travel to a sports medicine clinic located in a different state. Nevertheless, after a physical exam and a review of who knows how many X-rays, he received the same news-rotator cuff tear that requires surgery. By this time, Walter had suffered shoulder pain for nearly a year and was still unable to do any type of upper body exercise, so he went ahead and scheduled the surgery.
Fortunately, prior to going under the knife, another lifting friend told Walter of a clinic that used a special technique for counteracting similar problems. After checking him out, the clinic's doctor told Walter that, providing his body had adequate healing abilities; he thought the injury would respond to proliferative therapy as many other patients with difficulties of this type have obtained fine results with this modality.
After his first treatment, Walter noted a marked improvement. However, contrary to instructions, after his fourth treatment his shoulder was doing so much better that he did some light bench presses, lat pulldowns, presses, curls and a few chins, which, predictably, caused a setback.
The doctor explained that many times after a patient starts feeling better-typically, noticing a lessening of pain early in the treatment process - he wants to do too much too fast. Since proliferative therapy is a building modality, and because it takes awhile for the new tissues to become fully strengthened, heavy stressful-type work should be avoided. With proliferative therapy, the main effect is strengthening the area; the side effect is less pain.
The good news is that Walter resumed treatment and fully recovered, although he avoids doing dips with weight. Therefore, at 5-8 and roughly 180 pounds, he has worked up to 60 consecutive bar dips with bodyweight.
Ray Blank, a 25-year-old bodybuilder, was doing heavy flyes on an incline bench when he felt a "ripping" sensation in his right shoulder. He had X-rays taken and was treated-rest, ice packs and anti-inflammatory drugs-and was told that nothing more could be done.
Unfortunately, Ray's shoulder became progressively worse, to the point where he had difficulty taking it out of the sling to do simple tasks such as shaving and feeding himself. Being somewhat desperate, Ray sought out a skilled chiropractor, who helped him, but Ray still did not recover sufficiently to do any upper body training. So, after a number of months of pain and incapacitation, he realized that he had to do something and went to the same clinic that had helped Walter.
The doctor examining Ray told him that he had torn ligaments, plus a slight tear in the deltoid tendon and that both trouble spots needed strengthening in order for him to regain normal, pain-free mobility. Of course, Ray took the recommended proliferative therapy injections, receiving marked relief, improved strength and endurance. Soon he was able to return to bodybuilding; but he carefully avoids doing any exercise that requires him to stretch and extend his shoulder joint maximally, learning to stop such movements a brief quarter-inch away from full extension or contraction. In retrospect, Ray's only regret is that he didn't get the treatment earlier as it could have saved him months of pain and frustration.
WHAT IS PROLIFERATIVE THERAPY?
Also known as sclerotherapy, it is a method of injecting an anesthetic irritant into a joint or weakened, torn or pulled ligaments and tendons. This causes healing cells (fibroblasts) to travel to the weakened area and strengthen it. Scientific studies going back as far as 1956-when Dr. George Hackett did extensive investigations-have proven its validity. More recently, the University of Iowa did studies (1983 and '85)- as well as a double-blind study by the Sansun Research Foundation in 1987- substantiating earlier findings regarding its efficacy.
HOW DOES IT WORK?
Ligaments hold bones together at the joints, while tendons-being somewhat like ligaments in structure-hold muscles to bones. Due to injury or repeated use, the ligaments and tendons may become torn, stretched or loose, which causes pain, lack of endurance, loss of strength and perhaps arthritis. Contrary to popular belief, arthritis is the body's way of attempting to strengthen a joint. With proliferative therapy, sodium morrhuate-a derivative of cod liver oil, a though other substances can be used-is injected into the lax or torn areas causing healing cells to migrate to the weakened area and create new, strengthened tissues.
Since the concept of proliferative therapy is no doubt new to most of you, you probably have a multitude of questions about it. Allow me to address some of the more common ones: What are the results of therapy? Successful treatment is a permanent fortification of a formerly painful or incapacitated area. Hence, the patient is usually able to resume activities which previously were prohibited.
Is the treatment lasting? Because the therapy causes one's body to create new tissues, it can be considered permanent: Studies have shown that tendon size can increase from this treatment by as much as 35-40%.
Does proliferative therapy work on all areas of the body? All joints respond to treatment. In fact, the treatment has also been successful in cases involving almost all types of back pain-disc herniation, sciatica, back fractures and arthritis...as well as unstable joints, heel spurs, tennis elbow, rotator cuff tears and knee-joint problems.
Are there any indications or symptoms which tip off that someone may benefit from proliferative therapy?
What about side effects? Some people may have a sensitivity-in the form of swelling, headache, nausea and tiredness-to the proliferative agent and/or the anesthetic. This reaction is only temporary as it rarely lasts longer than two to four days after the injection. However, experiencing soreness and stiffness a couple of days afterward is normal.
How many treatments are required to receive maximum benefit? This is an individual matter depending on many factors.
The American Osteopathic Academy of Sclerotherapy states that maximum benefits are derived when the patient regains full strength and endurance and all other symptoms have been resolved, all examinations returned normal and the examining physicians note that all ligaments, tendons and joints have become very firm. Hence the number of treatments needed is going to vary.
It is important to reemphasize that proliferative therapy is NOT a pain treatment-it's a strengthening treatment. Thus, strengthening is the main effect; the reduction of pain is a side effect!
An obvious question on many people's mind is, "If this therapy is so good, why aren't more doctors using it?" Specially trained doctors throughout North America, Europe and New Zealand are using it. However, this style of treatment is not taught in medical schools; though it is taught in post-graduate courses. Moreover, most doctors are too busy in their own private practices to spend the time necessary to take this specialized training. On top of that an overwhelming percentage practicing physicians in this country are not aware of this treatment method because the substances used are not patented, and therefore the pharmaceutical companies are not interested in marketing it to doctors. On the plus side, the American Academy of Sclerotherapy is actively working to provide courses to teach this therapy to doctors.
And finally, many of you are probably wondering where you can get this therapy. Check your local telephone book to see if the American Academy of Sclerotherapy or the American Academy of Sclerotherapy have nearby offices. Contact them and ask if there are any doctors in your area that use this method.
If you require additional information, there are references available through the larger medical research libraries. Ask the librarian to tune in Medlar Research on her computer.
Originally published in MUSCULAR DEVELOPMENT, September 1988