21st Century Pain and Sports Medicine

Sports injuries are an every day occurrence in today’s world. Dr. Starr has performed thousands of injections into injured muscles and ligaments. He performs physical therapy and rehabilitation. Dr. Starr has treated numerous athletes for strains and sprains of muscles and ligaments, including partial tears. He has had great success rehabilitating fractures as well.

Kraus Principals

Dr. Starr follows the tenets put forth by Hans Kraus, M.D., who was known as the originator of Sports Medicine in America, and a pioneer of modern rock climbing. Kraus worked as an orthopedic fracture surgeon specializing in muscle pain, sports injuries, and physical medicine and rehabilitation. He was the first to mobilize sprains and certain fractures beginning in the late 1930s. Dr. Kraus treated more than 10,000 patients including many professional and amateur athletes during his long career. He successfully pushed President Eisenhower to launch a physical fitness campaign for children. Kraus’ methods won him a huge clientele including Katharine Hepburn, Eleanor Roosevelt, Johnny Unitas, Rita Hayworth, Oleg Cassini, and the skier Billy Kidd who said that Dr. Kraus’s treatments made it possible for him to win the World Championship.

Dr. Kraus was called to the White House in 1961 after John Kennedy’s physicians became alarmed by the president’s condition. Kennedy had found it difficult to rise from a chair, and often relied on crutches when not in public. Kraus’s files, made public in 2006, suggest that Kennedy made dramatic progress, taking stairs instead of elevators, and resuming golf. Kraus’s biographer, Susan E. B. Schwartz, contends that, had JFK lived another year, the enduring image of his presidency would have been “Kennedy jogging, hiking, or lifting weights.”

Trigger Point Injections

Trigger point injections offer great relief from pain and allow the vast majority of people to avoid orthopedic surgeries, particularly when coupled with proper thyroid treatment. Trigger point injections are useful for many different types of musculoskeletal pain including arthritic joints, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, chronic tendonitis, and partially torn ligaments.

Degenerated or herniated discs, and sciatica may be diagnosed by MRI or x-ray, but the underlying cause is frequently muscular or hormonal.  There often is no correlation between chronic pain and imaging data – x-rays and MRIs. For example, a 40-year-old woman entered my clinic on crutches. She was to undergo major knee surgery for a bucket-handle tear of her cartilage. My questioning revealed that she had a ski injury to that knee two years earlier. After limping around for a week or two, she had recovered. Her physical exam showed a localized bursitis on the knee. It was injected several times with lidocaine to break up the injured tissue. After electric stimulation and Kraus exercises for three days, she completely recovered – no surgery needed.

Almost all of us have degenerated (budging) discs by age 50. Patients are told the discs are the cause of their back or neck pain. However, if their thyroid and muscles are treated properly, the pain resolves despite the disc issue. The soft tissue and hormone deficiencies are the real problem.  My teacher, Dr. Hans Kraus, believed problems caused by discs were rare. He is right. Dr. Norman Marcus, past president of the American Academy of Pain Medicine and director of the Marcus Pain Institute in New York, also follows the tenets of Dr. Kraus. Muscles, he says, are the main cause of chronic pain, and muscle problems “are not found with X-rays, CT scans, and MRIs.”

Sometimes the reason for chronic pain is ligament and tendon weakness. Tendons, ligaments, and cartilage have a poor blood supply by nature, which sometimes leads to incomplete healing. Trigger point injections are a non-invasive alternative to prolotherapy, physical therapy, and surgery.

Trigger points are hyperirritable spots located in a taut band of skeletal muscle. They are painful and may cause pain to radiate elsewhere. Hypersensitive nodules in muscles of harder than normal consistency and taut bands of muscle are the physical exam findings typically associated with trigger points and tender points. If I push on a trigger point over the shoulder blade, the pain may radiate all the way to your fingers. That is why trigger points can be the cause of migraines, headaches, sciatica, TMJ, decreased range of motion in the limbs and neck, and back pain. Trigger points are often mistakenly diagnosed as pinched nerves because of the radiation of pain and tingling in the fingers. I have seen numerous failed back and neck surgeries due to undiagnosed trigger points, and other muscle problems often due to hypothyroidism.

Treating the trigger points allows for full range of motion, and takes the stress tendons and allows them to heal. Trigger point therapy uses injections of lidocaine, a local anesthetic, directly into the nodule which breaks up the injured tissues, cools off the nerves, and restores blood flow to the injured or swollen tissues. The renewed blood flow brings oxygen and nutrients and removes the substances causing inflammation and pain.

If we are working with something simple, such as an isolated rotator cuff muscle with trigger points that are causing shoulder pain, weakness, decreased range of motion, it may take less than a weak to heal. If we are working with something more complicated such as chronic back pain, that usually involves three to four weeks of injections and physical therapy. I have learned that severely hypothyroid patients must be treated with thyroid and the biomodulator (voltage) for several months prior to starting trigger point injections.

How effective can trigger point therapy be? Consider the case of first baseman Bill White who was playing for the Cardinals in 1964 but had a bad first part of the season, thanks to a shoulder injury. Team doctors had given him steroid injections into the front of his shoulder to no avail. A friend took White to see Dr. Kraus who diagnosed and treated trigger points in a rotator cuff muscle over the shoulder blade. White felt immediate relief. Several days later playing a double header, White had six hits including two home runs and five RBIs. The Cardinals went on to win the World Series that year. Writer David Halberstam wrote the book “October 1964” about it.

Ligaments are the structural “rubber bands” that hold bones to bones in joints. Lax ligaments are a classic sign of low thyroid. Thyroid supplementation helps strengthen ligaments because it addresses root cause of the problem. Everything is healthier when thyroid is normal – nails are strengthened, hair grows, reflexes are faster, muscles are stronger; muscles and ligaments are a prime target of low thyroid. Trigger point injections fail when the underlying metabolic and hormone problems are not treated.

Ligaments also can become weak or injured because of sports injuries. They may not heal back to their original strength and endurance, especially if they are immobilized at the point of injury. Dr. Kraus was the first doctor to mobilize some fractures and partially torn ligaments immediately. He used ethyl chloride spray, a topical refrigerant, to mask pain and allow the injured part to perform gentle exercises. The Olympic skiers he treated recovered much faster and more completely than similarly injured athletes who were immobilized. One of Dr. Kraus’ favorite sayings was, “muscles are like horses – they have to move or they atrophy and ache.” Billy Kidd, the Olympic ski racer said, “Had it not been for Dr. Kraus and his preventative and rehabilitative techniques, I would not have won my gold metal at the World Skiing Championships.” Robert Boyle, a famous Sports Illustrated reporter said, “I continue to think that if I had the money to buy a losing major league baseball club, or even a new franchise, I could quickly turn it into a winner by having Hans Kraus recondition those cast aside because of supposedly permanent injury.”

Immobilization causes weakness, atrophy, and scar tissue is laid down within days. Many athletes never recover full strength and range of motion when their knee for example had been put into a brace for weeks prior to physical therapy. Trigger points are a frequent finding within injured ligaments and respond remarkably well to trigger point injections and Kraus’ therapy. I recommend immediate mobilization in many cases – moving the body – and use thyroid, laser, trigger point injections, and the biomodulator to expedite healing and avoid most surgeries.

Prolotherapy is the injection of an irritant in the ligament to cause an inflammatory, healing response. However, this process results in scarring in the ligaments which produces tightening in the ligaments.  Scarring is not good for the body; scars block energy flow.

Tendons are the name given to tissue which connects muscles to bones. Occasionally tendons are severely injured by violent accident or sports injury and require surgical repair.  But most often, patients will come to me with a diagnosis of tendonitis. From my experience, these patients have muscles that harbor trigger points that attach to the affected tendon. When I treat the trigger points, and the frequently associated hypothyroidism, the muscles recuperate and tendonitis resolves.

Thyroid has a tremendous influence not only on muscles, but on connective tissue such as tendons and ligaments, even the arches in feet.  The hypothyroid youngsters with flat feet that I treat with thyroid go on to develop normal arches.  Flat feet are usually due to lax ligaments because ligaments can be weak when you are hypothyroid.

Thyroid is often a factor that affects professional athletes. Several prominent endocrinologists whose research is featured in my book estimated that at least 50 percent of the American population is affected with hypothyroidism. I treated a golf pro who had trigger points in his left knee from playing golf. I treated the calf and quadricep muscles, and his medial and lateral knee ligaments. The treatment however, had to be repeated until we addressed his underlying hypothyroidism. Today, he plays golf – a lot of it – free of knee pain. To hear his story, :: Click Here ::

Dr. Starr has built a loyal following with athletes looking to ensure the viability of their careers, and wanting to stay ahead of the curve.

Healing Light

Dr. Starr’s clinic offers the latest technology in laser therapy to treat sports injuries, arthritis, and a wide variety of musculoskeletal pathologies.

Light is part of the electromagnetic spectrum. Albert Einstein first theorized that light was made from a stream of little packets of energy called photons. When light interacts with skin, photons stimulate cellular regeneration. Infrared light penetrates more deeply than other parts of the light spectrum and is used for healing because it can:

• Raise white blood cell count
• Improve cellular growth
• Prompt DNA or protein synthesis in cells
• Produce relief of muscular pain and spasm
• Stimulate blood flow and circulation
• Increase metabolism

Exposure to red light naturally stimulates skin cells to produce collagen, elastin, and enzymes that provide support for your skin.

Laser light is “coherent” light meaning it is very orderly, not random, and is used for healing. A higher percentage of non-coherent light is either reflected or absorbed by the skin. Every cell membrane has receptors able to read different frequencies of energy contained in the electromagnetic spectrum.

The different frequencies of light communicate information to the cells. This energetic information eventually reaches the cell’s DNA, which directly controls cell function. Light is energy and energy is information. When cells are able to receive more energy in the proper format, be it laser or voltage or thyroid, cells are able to recover normal function. The body is an amazing thing:  With enough energy – it capable of remarkable healing.

Infrared, red, and low intensity lasers put energy into the body. They help the body heal naturally. They are particularly good for sports medicine. They are complementary to the Tennant Biomodulator which works with voltage.

The BioFlex Professional Laser is the most advanced laser therapy system available, and is designed as a non-invasive, non-toxic therapy for a wide variety of medical conditions. It has been approved by the FDA, Health Canada, and EU.

Meditech International Inc. offers the most advanced and comprehensive Low Intensity Laser Therapy System for the treatment of sports injuries, arthritis and a wide variety of musculoskeletal pathologies.

Dr. Starr also realizes that many lingering injuries are due to hormone imbalances and environmental illnesses and treats these accordingly.