Drew Brees suffered severe injuries to his throwing shoulder, injuries worse than expected prior to Brees going into surgery in January, as he had damage to not only his labrum – the fibrous cartilage covering the bone in the shoulder joint – but to his rotator cuff as well. In January, it was said Brees wouldn’t be ready to start throwing until June 1, but he started in May. By early June, Brees stated how quickly his shoulder was healing and how great it felt.
Most people may not realize it, but the throwing shoulder of a quarterback has a much tougher life than that of a baseball pitcher. Quarterbacks throw more often, just as hard, throw a heavier ball, frequently throw with their bodies in awkward positions and on the move, and have to worry about getting hit by other players and hitting the ground after getting hit.
So back to my question: How is it these three guys are recovering so quickly from injuries requiring major surgeries?
Are they getting extra help from substances the rest of us don’t have access to, or stuff us regular folk don't know about?
Eighteen months ago I wrote a piece critical of Terrell Owens’ workout as it appeared in an edition of Muscle and Fitness magazine. I was shocked when I received an angry and poorly written email from someone claiming to be Dr. Hank Sloan, a doctor who was mentioned in the M & F item as a doctor who injected Owens with a substance alleged to help strengthen and re-grow connective tissue.
The person identifying himself as Dr. Sloan took exception to a statement I made in which I said "there are no known legal substances that can regrow tendons and ligaments. The stuff doesn't exist."
By the way, the entire piece and the emails generated as a result of this item have been archived.
Here is the email exactly as I received it.
Wow,
I just came across your editorial piece and read this rediculous piece of bias nonsence. I am the Doctor ( trained in Europe and yes sports medicine) that works with T.O. for 2.5 years now. I currently work with 12 NFL teams and Biotech companies and we are healing tissues, ligaments, tendons, cartilage, etc, without surgery. And yes they are mostly natural ingredients. Why do you take an attitude of opposition about things you have no idea about. I will attatch some research to this email just to prove the results of IFG-! injections repairing tissue. We are on the same team. My goal is to help everyone overcome their injuries. You have no idea about TO and his injuries and what ourteam has dome for him. Have you read his MRI's and x-rays. How did he comeback so fast last year after completely braking his clacicle and having surgery?My emphasis) And as far as his core training is concerned, that part of his training is specifically for a groin injury, which you have no idea about. No matter how much genetic potential you have, NFL players will get hurt and our job is rehab. I am an honest, dependable scientist and physician who has helped thousands of people in pain. We are proponants for training and you take the attitude that for some reason we are against you. Next time, give me a call and we can discuss there things before you put information out there for others to see. Your comments on "Um, there are no known, legal substances that can re-grow tendons and ligaments". Are you a doctor or just printing thoughts with out doing one shread of research. So I guess you think TO is stupid for having his team around. Dont you think a player of his caliber will have the best. And by the way, who are you?
Dr Sloan. MD, NMD, MD(AM0, NMT FICAM
Article comments
1 - Matthew T. Sussman
I'll never forget when I brok my clacicle. Hurt for days.
2 - sal m
it's a little known secret, but within the medical circles doctors use different names for body parts when talking amongst themselves...i guess this was just a slip....
3 - Victor Plenty
So, is the guy behind these emails any more likely to be a real team doctor than the people behind the emails I keep getting from "wealthy Nigerian exiles" are likely to be who they claim to be?
4 - sal m
he's not a team doctor, but a person who worked with owens privately.
5 - DJRadiohead
One more reason it is stupid to try to compare athletes of this era to those of another era- not because today's athletes are necessarily better but because today's athletes have access to so many more resources (good, bad, and indifferent).
6 - sal m
and these resources will be more powerful as we move forward.
7 - Matthew T. Sussman
One more, then I'll pretend to be serious:
What's Dr. Sloan's favorite Mason Williams song? Is it "Clacicle Gas?"
8 - DrPat
There are legitimate techniques that speed healing which were unheard of a decade ago. Some that were scary fringe ideas when I had joint surgery 20 years ago (like micro-volt stimulation) are now respected techniques used in conjunction with keyhole surgery and even non-surgical techniques to make the treatment more effective and healing much speedier.
9 - Dr Sloan
The technique is called prolotherapy. It uses a sugar water solution with procaine. Nothing illegal or banned. www.getprolo.com The baseball player that was mentioned in the article was off for a year for rehab. Dont read so much into it Sal. We are not injecting anything banned or illegal. This is similar to injecting Glucosamine and MSM into an arthritic knee joint. I'll be glad to speak with you so that we can put an end to your speculations.
10 - sal m
yes, but we've already had this "discussion," the one in which you wrote:
"IGF-1 is extremely beneficial and works very well for healing ligament, tendon and cartilage. I just recently healed a 60% tear in the ulnar collateral ligament in a Pro Baseball Player using a combination of GH, IGF-1, and prolotherpy. We have the team MRI, pre and post, to prove it. Also, I have healed a couple of anterior meniscus tears without surgery. There are others as well."
in the above passage you make it quite clear that you aren't using sugar water and procaine, regarless of the techique that you use. you also didn't include any research to indicate that this solution is effective in re-growing connective tissue. although i'm sure it would be interesting to read about how a local anesthetic could do this.
the research that you did provide as backup to your statements about the re-growth and strengthening of connective tissue dealt with IGF-1 and HGH.
11 - Dr Sloan
I also wrote " I'm very cautious and use almost all natural agents, seeing that I am trying to heal tissue, not band aid the injury. IFG-1 is used sparingly and in very specific protocols." We were involved in a trial from a Biotech Co. from Colorado at that time. And, the Baseball player was not active that year. I thought you would find that study amazing but you just focused on acusations. That is why I emailed you that research. I do apologize that I gave you the impression that we use IFG-1 on all patients. I would appreciate the courtesy that you wouldn't assume that I am performing procedures with banned substances. In this world today of controversial athletic practices, those practitioners dealing with athletes have to be very careful. I am in no way performing procedures on athletes with banned substances like most of your article assumes. At this link you will find plenty of research on prolotherapy and other natural injection techniques. Hope this helps to clear the air. I would like for us to have a professional relationship in which we may help educate each other. getprolo.com
12 - sal m
dr. sloan:
i think you need to go back a re-read the source documents, as i didn't make any accusations at any time. i made the statement that there are no known substances that regrow tendons and ligaments, and in turn you provided info that indicated that there is and that igf-1 is the substance.
i contacted the company that held the rights to study the use of igf-1 in humans, and they informed me that igf-1 was indeed a highly experimental substance that was not approved for use in humans except in the case of children who suffer from short stature.
you say that prolotherapy using a sugar solution and an anesthesia can regrow and/or strengthen ligaments, where the vast proponderence of data doesn't support this position, aetna.com
In case people don't visit the link, here's an excerpt from the above report,
"Prolotherapy refers to the injection of sclerosing solutions into joints, muscles, or ligaments. The effectiveness of prolotherapy has not been verified by scientifically controlled studies. As early as 1978, the Medical Procedures Appropriateness Program of the Council of Medical Specialty Services (CMSS), based on input from the American Academy of Orthopedic Surgeons, the American Association of Neurological Surgeons, and the American College of Physicians, concluded that prolotherapy had not been shown to be effective. Furthermore, the clinical practice guideline on “Acute Low Back Problems in Adults” by the Agency for Health Care Policy and Research does not recommend ligamentous and sclerosant injections in the treatment of patients with acute low back pain. In a recent report, Yelland et al (2004) concluded that prolotherapy is no more effective than saline injections for the treatment of chronic low back pain. Additionally, the Canadian Coordinating Office for Health Technology Assessment (2004) stated that “evidence from further controlled clinical trials of prolotherapy is clearly needed.”
of the orthopedists and physical therapists that i have spoken to none of them have spoken to any possiblity whatsoever with regard to prolotherapy's - where prolotherapy consists of the solution that you mention - ability to do what you say.
the tone of my article was not accusatory, and as a matter of fact in manners of rehab, i'm all for anything that helps athletes get and stay healthy.
nor do i state that any athletes named in my piece are using anything. i merely am trying to get people to realize that there are things that athletes and their doctors are doing that push the envelope. nothing here says anything to the contrary.
13 - Dr Sloan
As you know, Insurance companies are far behind in accepting new therapies. Your quote is from Aetna. We’re lucky they cover chemotherapy. Prolotherapy, Schlerotherapy, Mesotherapy and other natural injection techniques are growing very quickly based on their effectiveness on speed of recovery. I dought a surgeon ever endorses these techniques because it takes money out of their pockets. The area of specialty my clinic works in is that of non-surgical soft tissue recovery. Typically, athletes are given the antiquated choices of stim and ice to recover from a hamstring pull, or a groin injury like osteitis pubis. So, if we are able to typically help an athlete recover 50% faster using multiple modalities, none of which I have mentioned here except therapeutic injections, we are progressing in a positive manner to help all patients, not just athletes, get back on their feet much faster. As for prolotherapy, surgeons have for years scraped under a tendon or ligament during surgery to stimulate proliferation of that tissue. As for effectiveness of our therapies, Takeo Spikes had his camera crew at my office to show his rehab to the fans of Philly and NY. Ed Hartwell just released a press release about his speedy recovery of his Achilles and check out T.O.’s book chapter 12. These I can mention because they are public.
Just a few articles I found quickly on a Google search.
The Medical Rationale for Prolotherapy.
Millions of Prolotherapy injections are given each year. But does it work? Numerous articles have been published, (some of the more important ones are listed below) to determine just that. Is Prolotherapy a placebo? According to the published research, Prolotherapy is not a placebo, Prolotherapy stimulates healing.
Scientific and medical papers
Banks, AR. A Rationale for Prolotherapy, J Orthopedic Medicine, 1991;13:55-59.
Hackett GS, Henderson DG. Joint stabilization: An experimental, histologic study with comments on the clinical application in ligament proliferation. Amer J Surg 1955;89:968-973.
Hackett GS. Referred pain and sciatica in diagnosis of low back disabilities, JAMA 1957;63:183-185.
Hauser RA. Punishing the pain. Treating chronic pain with Prolotherapy. Rehab Manag. 1999;12(2):26-28, 30.
Klein R, Dorman T, Johnson C. Proliferant injections for low back pain: histologic changes of injected ligaments and objective measurements of lumbar spinal mobility before and after treatment. J Neurologic and Orthopedic Medicine and Surgery. 1989;10:123-126.
Klein R, Eek B, DeLong B, Mooney V. A randomized double-blind trial of dextrose-glycerine-phenol injections for chronic, low back pain. J Spinal Disord. 1993;6:23-33.
Klein R, Eek B. Prolotherapy: an alternative approach to managing low back pain. J Musculoskeletal Medicine, 1997;May:45-49.
Liu Y, Tipton C, Matthes R, Bedford T, Maynard J, Walmer H. An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligaments and its junction strength. Connect Tissue Res. 1983;11:95-102.
Maynard J, Pedrini V, Pedrini-Mille A, Romanus B, Ohlerking F. Morphological and biochemical effects of sodium morrhuate on tendons. Journal of Orthopedic Research. 1985;3:236-248.
Myers A. Prolotherapy: Treatment of Low Back Pain and Sciatica. The Bulletin of the Hospital for Joint Diseases, April 1961, Vol. 22 No. 1. Initially presented at the 1960 Annual Alumni Meeting Hospital for Joint Diseases.
Ongley M, Dorman T, et al. Ligament instability of knees: a new approach to treatment. Manual Medicine 1988;3:152- 154.
Ongley M, Klein R, Dorman T, Eek B, Hubert L. A new approach to the treatment of chronic low back pain. Lancet 1987;2:143-146.
Reeves KD, Hassanein K. Randomized prospective placebo-controlled double-blind study of prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) Joints: Evidence of Clinical Efficacy. Altern Complement Med 2000 Aug;6(4):311-20.
Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med 2000 Mar;6(2):68-74, 77-80.
Schwartz R. Prolotherapy: A literature review and retrospective study. Journal of Neurology, Orthopedic Medicine, and Surgery. 1991;12:220-223.
Just to let people know. The first email that I sent to you was sent to your PERSONAL email address. Never did I know or intend for it to be plastered on the internet and made me to take a defensive stance. I was just hoping to start a personal, healthy dialogue with you. Im sure you have my email if you need me in the future. I will not be posting here again.
14 - sal m
it's easy to blame the insurance companies and make snide comments with regard to what they do and do not cover.
however, you ignore the fact that aetna based their decision of the lack of efficacy for prolotherapy on input from Medical Procedures Appropriateness Program of the Council of Medical Specialty Services (CMSS), input from the American Academy of Orthopedic Surgeons, the American Association of Neurological Surgeons, and the American College of Physicians.
this decision by aetna has been on their site for years and was updated on may of this year. of the studies that you provided the two most recent are from the year 2000, most are from the 80s and 90s, one study was presented in 1960 and another in 1957. is it common to defend the use of fringe treatments by citing studies that were performed over 40 years ago?
apparently - in your view - all of these organizations which are ostensibly made up of your peers are just as bad as the insurance companies, and should be ignored.
and you responded to an item that i posted on the internet and sent a reply to an email address through the website, not to a personal email address.
15 - DonC
This is good discussion. I am recovering from a labrum tear, but you know, not quite like these athletes are. I was cautious and dedicated, and was still shortly re-injured. Something does appear to be amiss here. Somebody is getting some type of alternate assistance. I just want to know what it is, so I can give it a shot. I'm just trying to be moderately healthy.
16 - Jorge
I think it's really weird how all the correspondence is written in the same style and vocabulary.
It's almost as if they were written by the same person.
17 - Joe
i dont see what the fuss is about, if athletes dont want to be injured and theres a method to heal faster its their right to use it. its a fucking injury for christ sake. its none of your business how someone gets over an injury. This is nonsense...