Advanced Wellness Center

We spent several days with some of the top physicains in the world listening and sharing our findings in our offices on the use of concentrated blood platelets in the use of regeneration of joints and other body structures. We found the ultrasound to be a valuable tool to use when injecting PRP and also with prolotherapy. We now offer this service to our patients. We are very excited to be a part of this emerging science and art.

John Lieurance, DC
Wellington Chen, MD

advancedwellness.us
941 330-8553

By STEPHEN F. HOLDER

Thanks to a special therapy, also performed by Sarsota Clinic Advanced Wellness, Michael Pittman is expected to return from a severely sprained right ankle quicker than doctors predicted. He is expected to play Sunday.

Earnest Graham has 70 touches in two games.
Sports News Video

TAMPA – The drive lasted 10 plays. Earnest Graham touched the football only a single time. And when it was over, the Bucs running back was utterly exhausted.

Who wouldn’t be, considering the long to-do list he has each Sunday, much of which doesn’t involve carrying the ball. Or did you think running backs in the Bucs’ system take a holiday when the ball doesn’t come their way?

“He stayed in there every snap,” running backs coach Art Valero said, recalling a snapshot from last month’s game against Jacksonville. “He never came out.”

What was Graham doing? You name it: carrying the ball, running pass routes, blocking pass-rushers.

The Bucs never intended running back to be an individual endeavor. But with injuries to Cadillac Williams and Michael Pittman, and Michael Bennett not up to speed in the Bucs’ intricate offense, the Jaguars game was not an anomaly for Graham.

Now with Pittman due back for Sunday’s pivotal NFC South matchup at Atlanta, Graham will get some support. And it couldn’t come soon enough for the career backup with 34 and 36 touches, respectively, against Detroit and Arizona.

“It’s a big boost,” Graham said. “I took 70-something snaps against Arizona on Nov. 4. And the best back is a fresh back. With me and (Pittman) complementing each other, it makes us that much more dangerous. I think we’re both professionals, and we understand it’s not realistic for anybody to carry that load over an NFL season.”

Other teams attempt that, but not the Bucs.

“Earnest in the past few weeks has been in a situation that has never been experienced here,” Valero said. “You have to go back a long time to find a guy who carried this kind of load, who was an every-down guy to this extent. It’s basically been by committee. Even with Cadillac, he was the first- and second-down guy, and Pittman came in on third down. And it was difficult to get Earnest in the game because we also had Mike (Alstott).

“Earnest, he’s got all these catches, all these rushes, and he’s on special teams, and he’s blocking his (tail) off. Whew! That’s a lot.”

The Bucs are fortunate Pittman fulfilled his promise to heal quicker than team doctors predicted. He credits the swift recovery from a severe right ankle sprain to aggressive rehab and the work of Dr. Ross Hauser of Chicago, a specialist in prolotherapy. During the procedure, a dextrose solution (similar to sugar) is injected into the joint, which increases blood flow to the area and stimulates the tissue to repair itself.

Meanwhile, as Pittman healed, Graham had days such as the one Oct. 28, in which Valero said the Jaguars blitzed nearly every down in a span of 20 plays. That meant Graham was involved in a collision of some sort during each snap.

There also was the 19-play drive against Arizona during which Graham had 10 touches. Late in that game, when the Bucs were trying to run out the clock, Graham, 27, was on fumes and had to give way to Bennett.

“It’s like a boxer,” Valero said. “Their body tells them, ‘Enough.’ It’s instinct. You can look in their eyes and see they’re not the same. When you see that, you say to yourself, ‘Before he gets hurt or gets somebody else hurt, I have to spell him.’”

But the benefits of having Pittman back go beyond the reduced workload for Graham. The reality is the pair has worked well together.

Against St. Louis on Sept. 23, when Williams was benched for much of the game, Graham and Pittman combined for 131 yards on 15 carries. Against Carolina a week later – when Williams sustained his season-ending knee injury – the pair tag-teamed for 138 yards on 32 attempts.

With the coaching staff seemingly open to the idea of using a rotation for the balance of the season, perhaps Graham and Pittman can turn in more performances such as those.

“We’re trying to make a playoff run, so we definitely need each other,” Graham said. “I think we’re going to make it tough on some teams.”

Comment:

This was also the treatment performed on Tiger Woods Knee injury and dozens of other star athletes which is offered at Sarasota Clinic, Adavanced Wellness Cener.

Your’s in Health,

Wellington Chen, M.D.
Prolotherapy / PRP
Sarasota, Florida
941 330-8553

by Scott Greenburg, M.D.

Patients who present with sinus pain and pressure or who describe constant pain in the jaw, temple or temporomandibular joint should be evaluated for referred pain. Referred pain or the sensation of pain in an area distant from its origin is commonly seen in patients whose leg pain originates from the back or in an amputee who suffers from phantom limb pain. While sciatica is diagnosed more frequently than referred jaw and facial pain, its occurrence is quite common.

Many cases of jaw and facial pain and headaches unresponsive to traditional measures such as analgesics, night guards, bite plates, or antibiotics for sinusitis can be traced to the occiput, cervical facet joints, cervical interspinous ligaments, and the trapezium.

Patients should be fully evaluated by physical examination including but not limited to the strength of the arm and hands, integrity of the cranial nerves, sensory nerves and deep tendon reflexes, and range of motion of the neck. Furthermore, careful evaluation of the cervical facets, occiput, interspinous ligaments, and trapezium should be performed by a physician skilled in diagnosis and treatment of such injuries. Injury in the latter regions, caused either by trauma, overuse, or degeneration is often responsible for causing headaches, jaw aches, and facial pain.

Cervicocranial syndrome (Barre-Lieou syndrome) can also occur from injury to the cervical facet joints. This syndrome is often manifest by a variety of findings such as vertigo, tinnitus, visual blurring, nasal stuffiness, and facial numbness.

Radiological studies such as plain radiographs and MRI may be useful in some cases of referred head, face, and jaw pain but often diagnose incidental findings that do not contribute to a patient’s pain syndrome. Findings such as degenerative disc disease, herniated cervical discs, or spinal arthritis may be incidental, as a significant percentage of the population (over 60% in some studies) demonstrate similar findings and remain asymptomatic. The author strongly believes that a careful physical examination with clinical correlation is paramount to diagnosis and treatment of referred pain problems and can help to spare the patient from the cost and inconvenience of further diagnostic studies, treatments, and unnecessary medications.

Treatment of referred pain should be directed to correcting the source of the problem. While analgesics, antidepressants, and anti-inflammatory drugs can help to temporarily eliminate chronic pain, they do not cure the underlying pain problem. In those with injury into the cervical facet joints, interspinous ligaments, trapezium, or occiput will likely benefit or be cured by Prolotherapy injections. Prolotherapy injections, placed directly into the fibro-osseus junction trigger the immune system to permanently rebuild and reorganize collagen tissue, thus regrowing damaged tendons and ligaments. Once this process is completed, the integrity of the joint is restored, and the patient’s chronic pain should be alleviated. Prolotherapy injections are the only documented treatment to restore joint, ligament, and tendon damage without surgery and can permanently cure the origin of referred facial, temporal, and jaw pain.

Comment:

I agree that the These patients need repair of damaged ligaments and tendons. In addition to prolotherapy we find class 4 laser therapy (K-laser) to assist in post prolotherapy or even as a first line therapy.

What almost all doctors treating TMJ and facial pain don’t recognize is the shifting of the facial bones. This is often related and can be dramatic when corrected. When it boils down to it if a cranial adjustment fixes these problems, everything else is just a fancy patch job. The underlying problem with almost all TMJ patients is that the skull moves and the mandible can’t. It’s a fixed bone but the temporal bones that float outside of the sphenoid bone do move and when they do usually one side of the jaw shifts off it’s tract. This puts stress on the ligaments tendons and muscles. Fix that and all the rest takes care of it. Even though we do prolotherapy at our office we often don’t need to perform them on most TMJ patients. NeuroCranial Restructuring is often the answer. Dr. Ross Hauser is also trained with NCR and performs it occasionally. In our office I focus on NCR and Functional Neurology. Using treatments to balance the brain hemispheres can often help with these cases as well as the motor function and position sense can be effected and the Jaw is a common area it shows up often. If you have chronic pain and are having trouble finding help we may be your answer. Watch any one of the dozens of testimonials on you tube by searching “theAWC”. I will always be available by e-mail as well at drj@advancedwellness.us.

Your’s in Health,

John Lieurance, D.C.
Functional Neurology / Cranial Manipulation
Sarasota, Florida
941 330-8553

Most doctors who are doing PRP (Platelet Rich Plasma) Prolotherapy are not Prolotherapists.
In a recent case, a young lady had seen an orthopedic surgeon who apparently had gone to a weekend course and now was doing PRP Prolotherapy. The orthopedic surgeon as far as we could tell had absolutely no training in Prolotherapy. All he was doing was injecting PRP into an area that he normally would inject steroids.

This is like a doctor that uses prolotherapy taking a weekend coarse in sugery. We don’t inject the same way as you would do so with steroids and years of practice and training and sometimes use of ultrasound are needed to become skilled in this procedure.

Your’s in Health,

Wellington, Chen, M.D.

New Research
The Case for Utilizing Prolotherapy as First-Line Treatment for Meniscal Pathology: A Retrospective Study Shows Prolotherapy is Effective in the Treatment of MRI-Documented Meniscal Tears and Degeneration
Ross A. Hauser, MD, Hilary J. Phillips, and Havil S. Maddela

The Hackett-Hemwall technique of dextrose Prolotherapy used on patients with MRI documented meniscal pathology including tears and degeneration, interviewed an average of 18 months after their last Prolotherapy treatment, was shown in this retrospective pilot study to improve patients’ quality of life. Most patients reported statistically significantly less pain and stiffness and major improvements in range of motion, crepitation of the knee, medication usage, walking ability, and exercise ability. The improvements with Prolotherapy met the expectations of the patients in over 96% of the knees to the point where surgery was not needed. Prolotherapy improved knee pain and function regardless of the type or location of the meniscal tear or degeneration. The improvements were so overwhelmingly positive that Hackett-Hemwall Prolotherapy should be considered as a first-line treatment for pain and disability caused by meniscal tears and degeneration. If these results are confirmed by further studies under more controlled circumstances, with larger patient populations, and with MRI confirmation, surely Hackett-Hemwall Prolotherapy will become a first-line treatment for meniscal tears and degeneration.

Comment:

96%! Tell me a drug or surgery that can offer those odds. We have found that PRP and prolotherapy is successful with meniscus injury. In fact I had a snow board injury 10 years ago and my MRI showed a cleavage tear in the medical meniscus. I had pain with full flexion. This made many yoga poses and classes difficult for me for many years. I found PRP corrected the tear and I’m now able to do all knee bends without limitations or pain. It’s nice to be able to speak to people from experience as a physician who went through the treatment himself. Dr Chen did an excellent job!

Your’s in Health,

John Lieurance, D.C.
Chiropractic Neurology

Wellington Chen, M.D.
Prolotherapy & PRP

Advanced Wellness Center
Sarasota, Florida
941 330-8553

Click link for explanation from NBC news on Prolotherapy as we have performed since 1999 in our Sarasota Clinic.

Your’s in Health,

Wellington Chen, M.D.
Prolotherapist / PRP
Sarasota, Florida
941 330-8553.

http://abcnews.go.com/Health/TreatingPain/story?id=4047795

USA TODAY ARTICLE JANUARY 16, 2009

http://www.usatoday.com/sports/hockey/nhl/2009-01-16-2018525195_x.htm

Gagne returns to pre-concussion form
PHILADELPHIA — Simon Gagne hated the mornings he would wake up with that familiar pounding headache.

He couldn’t even blame a night of revelry.

The throbbing would surface, and no pain reliever would cure it. His neck ached, and there were days when he felt woozy or had blurred vision.

All Gagne wanted was to grab a stick and play hockey again for the Philadelphia Flyers. But even when he did skate, well, good luck keeping track of the whizzing puck.

Missing the playoffs, losing in the playoffs, none of it pained Gagne like the agony of living with a concussion.

“Last year,” Gagne said, “was a tough situation. Tough. I wouldn’t wish it on anyone.”

The head injuries limited Gagne to 25 games and he missed Philadelphia’s run to the Eastern Conference final. Gagne had nagging fears about his future, about what another traumatic hit to the head might mean for his career. He wondered if he could resume the high-scoring pace that made him an All-Star and an Olympian.

Those doubts all seem behind Gagne, for now at least. While Gagne has cooled a bit from one of the fastest starts of his career, the quick forward has 18 goals and 42 points in 41 games this season. And the Flyers are in the thick of a tight race in the Atlantic Division, one point behind the New York Rangers headed into Friday night’s game at the Florida Panthers.

For Gagne, the miserable side effects and cobwebs in his nerves have vanished.

“The way I feel now is back to where it used to be,” Gagne said.

Gagne, who turns 29 next month, considers himself lucky. He might not even be playing this season had he not caught a local TV report about a doctor who eschews traditional anti-inflammatory drugs, cortisone injections, and surgery in favor of an approach that stimulates natural healing processes to strengthen joints, tendons and ligaments.

Gagne hoped the treatment would cure his chronic neck pain and headaches and, after checking with the Flyers trainer, met with Dr. Scott Greenberg last April. Greenberg, a Cherry Hill, N.J., physician, didn’t like what he saw.

“The damage that Gagne had was very significant,” he said.

The nerves running from Gagne’s neck and head, neck and shoulder blades and other joints, ligaments and tendons were all damaged. That was the cause of the dizzy spells, the loss of balance and blurred vision. Greenberg’s approach is to repair the joints and nerves with pinpoint injections into selected areas of the spine and the symptoms clear.

The treatment is called prolotherapy. The shots, a concoction that sparks the body’s immune system, regenerate the damaged tissue and strengthen joints. Greenberg said Gagne’s neck is now as strong as it was before he was hurt. The player needed 20 to 30 injections in his neck his first few visits, but he hasn’t visited Greenberg since November. Gagne might go again around the All-Star break for a checkup.

His neck and spine stable, Gagne proclaimed himself “good to go” the rest of the season.

All he has to do is look at recent Flyers history to know his day-to-day life could be much worse. Former Flyers captains Eric Lindros and Keith Primeau both had their promising careers curtailed because of concussions and still suffer from post-concussion trauma.

Gagne has had two minor setbacks this season – a bout with the flu and dehydration in December, and he was the victim of a blindside hit against Vancouver that caused a shoulder injury and kept him out of two games.

A scary moment came in November when Montreal’s Alexei Kovalev plowed his shoulder into Gagne’s head. Gagne was able to shake off the hit, but any shot near his neck or head is an immediate cause for concern.

Gagne believed Kovalev deliberately targeted his head and shared his view with NHL disciplinarian Colin Campbell.

If Gagne had his way, shoulder-to-head hits would be banned from the game.

“If you get hit shoulder-to-head, you’re going to have a concussion no matter what,” Gagne said. “You see it too much. Almost every night you look at highlights on TV and you see someone get knocked out.”

He also talked with Glenn Healy, the player affairs director for the NHL players’ association, about what could be done to better protect the players. Hockey will never become a non-violent sport, but Gagne and others feel it could be a safer one.

Healy said the NHLPA is working on adding soft caps, which are already on elbow pads, to shoulder pads to reduce the impact of hits. Last season, of the 65 diagnosed concussions, Healy said 39 were from a shoulder-to-head blow.

On the NHLPA’s fall tour of all the teams, videos were shown of players deciding not to finish their body checks in a situation where an opposing player was vulnerable or the outcome had already been decided. Healy also does not want to see players launching themselves at someone’s head.

“That’s going to take a lot longer to change that cultural view of how we play the game,” Healy said.

The NHLPA hopes to sit down with the league this summer and discuss possible solutions or punishments.

Gagne was diagnosed with three concussions (two in juniors, one early in his career with the Flyers) before last season. He suffered a fourth concussion after his jaw crashed into the shoulder of Panthers defenceman Jay Bouwmeester early last season. Gagne returned after only four games, then was hurt again and missed the next 26 games. He was reinjured in February and didn’t play again.

Gagne eventually learned that he didn’t suffer three more concussions, but that the first one in October never healed and was aggravated with each additional blow.

Gagne says he might have returned too quickly from the initial hit and wonders whether last season would have been different had he been more patient.

“Until you go through a tough time like that, you know nothing about concussions,” Gagne said. “Now I know the brain takes a lot of time to heal.”

But this pre-season, Flyers coach John Stevens was so encouraged by Gagne’s play that he had no reservations about playing him his regular minutes.

“We didn’t expect him to get back to where he was so quickly,” Stevens said.

Gagne totalled 31 points in his first 22 games and was on pace to at least match his career high of 47 goals set in 2005-06. Gagne’s numbers have tailed off lately and the winger has gone eight straight games without a goal entering Friday’s game.

Some of the scoreless slump can be blamed on the shoulder injury. Another factor is just simple fatigue. Gagne, the Flyers’ first-round pick in the 1998 draft, is still working his way back to his physical peak after a seven-month layoff.

“People forgot, I didn’t play for a while last year,” he said. “For me to play at that level again, it takes time to get back.”

When he’s playing, Gagne can’t think about absorbing a hard hit, he just has to attack the net and play as hard as he did in an Olympic or playoff game.

He does admit to a different approach this season. Gagne comes to the rink to have fun, be able to play all his shifts and feel good when the game is over. He’s not concerned with goals, points and other personal achievements. So far, that style has worked out fine.

“It’s just fun being back to normal and being able to play the game that I love to play,” Gagne said.

Comment:

We have enjoyed similiar success in our clinic since 1998!

John Lieurance, D.C.

Wellington Chen, M.D.
Sarasota, Florida
941 330-8553

Studies show Arthroscopic Surgery no better than pleceibo!

In July 2002, research showed that arthoscopic surgeries worked as well as shame (fake) sureries where as effective as the real thing! Half the pateints got real arthroscopic surgery and the placebo group got 2 holes poked and they pretended to fix it. These people had as good or better results then the surgery pateints. Many people that had the real surgery had there “bad old” knee returnm with a vengeance months or a year or so later. The goal of these surgeries is to clean out debris from the knee joint in an effort to repair the knee.  The surgery is usually based on finding from an MRI. There are currently 500,000 performed each year. Lets face it when you tear your knee up from an accedent, skiing or such, thank godness for a great surgeon! Here we are talking about thousands of surgeries each year that studies have shown aren’t effective. So often I see pateints haveing treatments that are more lucrative for the doctors vs whats really best for the pateint. It seems that there must be a  less invasive alternative to releive your knee pain.I always think back to the three basics with any joint pain I see in my office: STRUCTURE, , FUNCTION and INTEGRETY. Is the knee or whatever joint in the body positioned correctly (Structure)? Does the joint have friction free effortless motion and balanced musculature (function)? Is there any tissues that are damaged that might be causing pain that could be stimulated to heal (integrity)? If all of these factors are considered than you will have the best chance to have a healthy joint. Many times new therapies such as prolotherapy, or the new generation of class 4 lasers can quickly health damaged tissues such as cartilage, ligaments, and tendons. This will provide for less pain when stregthening and alignment are then addressed. It’s not any one therapy that seems to be the majic bullet, it’s the blend of the right ones for each individual pateint that really makes a difference. Before considering any surgeries it would be best to get the advise from someone who specializes in conservitive treatment, your surgeon might not be a specialist in that area therefore unable to best advise you of ALL of your options. What do you think a peach farmer would say if you asked him if you should eat more peaches? Probably YES! The same could apply to a health care specialist towards there specialty.

John Lieurance, D.C.

Functional Neurology

Wellington Chen, M.D.

To make an appointment for a free consultation with Dr. John Lieurance at Advanced Wellness Center call 941 330-8553.