Revolution Health & Wellness

Podcast 17 – Knee Pain & Prolotherapy

Podcast 17 - Knee Pain & Prolotherapy

Knee Pain and Prolotherapy


Chad: Are you tired and fatigued? Are you frustrated with doctors because they don’t seem to listen? Do you want to fix your pain without surgery? If you answered yes to any of these questions, then we are the clinic for you. We offer Tulsa Prolotherapy, platelet-rich plasma therapy and stem cell injections, IV nutritional therapies, bioidentical hormone replacement therapy, and functional medicine to help you get back on track to optimal health. Call our clinic at 9-1-8-9-3-5-3-6-3-6 or visit us at to schedule your appointment today.


Male: Welcome to Against the Grain podcast, with Dr. Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to healthy lifestyle. Get ready, because we are about to go Against the Grain.


Chad: Welcome back. Thank you so much for coming to listen to us, this is Dr. Chad Edwards and I am excited to be here with Marshall. Thanks for being here Marshall.


Marshall: Yes, absolutely. I’m pumped; this is going to be awesome.


Chad: Yes, this is good stuff. This is one of the topics that I am passionate about. Obviously Bryan if you are anywhere out there listening, we miss you brother. But we are rolling forward and we’ll see Bryan soon. Today, we’re just going to get rolling with some Tulsa Prolotherapy discussion. A lot of people just wonder, “What is Tulsa Prolotherapy?” We are going to talk a little bit about that. We’ve had some podcasts about Tulsa Prolotherapy in general, we’ve had some podcast about back pain and MRI.s, and all kinds of things like that. Certainly I encourage anyone that has knee pain, because that’s what we are talking about today.


Anyone that has knee pain needs to understand why they have knee pain, that’s an important question. How you can have your knee pain evaluated. Some of the perils, or some of the pitfalls of going to your regular doctor, and here’s the normal flow of how we are going to evaluate knee pain, and then what can we do about it? Because I think that in traditional medicine, I think we miss a big chunk because we just don’t understand this process. We understand pain, and we understand, “I tore my ACL,” but as far as getting to the root cause of what’s really causing your pain, I think we missed the boat on that.


Marshall: Do you feel like many doctors in the industry would rather treat the symptoms than the underlying cause? Why is this such a hot topic?


Chad: I think part of it is just the training. I’d mentioned before in the past and some other podcasts about where in my training, I did family medicine residency and I wanted a good orthopaedics background. The reason for that is because I dealt with athletes as an athletic trainer. I was in special operations medicine and so those guys, many of them are like Olympic level bad guys. They do a really good job of injuring themselves.


They bring me this big broken egg and they are like, “Can you put Humpty Dumpty back together again?” I’m like, “Are you kidding me?” The healthcare motto in the army is, ‘To conserve the fighting strength.’ We’re trying to put Humpty Dumpty back together again from a medical perspective. One of the interesting things about army medicine is, we will actually go do a lot of what our guys go do. Our guys go jump out of planes, we go jump out of planes. Our guys go dive, we dive. We do a lot of those things. I was a flight surgeon, meaning I was a physician on flight status and I dealt with pilots. The army uses this term ‘Surgeon’ as doctor. It’s an old school term. Didn’t mean I did surgery in a helicopter.


Marshall: While you were flying through there.


Chad: Exactly. I wasn’t removing appendixes in the air. With army medicine, we’re doing, we’re experiencing what our guys are going through. I had to fly. I had a monthly requirement that I’ve got to fly a certain number of hours and things like that, in order to maintain those statuses. It was very important to me that I am able to appropriately advise these guys. I think many of our listeners especially athletes, for example, if you are a runner and you go to your doctor and you say, “I have knee pain.” Well, my experience has been so many doctors will say, “Well, you just need to quit running.” If you say that to many of these runners, they are going to say, “I’m out. That doesn’t work for me. I’m not going to quit running.”


Go tell that to a special operations soldier. That’s not only his passion and he’s put all of his eggs in that basket, that’s what he’s going to do, but that’s his life. That’s his income, that’s their world. If you tell those guys, “Well, you know you just need to quit doing the things that you do.” That doesn’t work. They are still going to go do it, until they kill themselves or until they are completely physically not able. But not only that, but you lost them. You’ve lost their respect, they are not going to come and talk with you, because they think that you are just trying to prevent them from doing their job. I wanted this strong orthopaedics background so that I can help take care of these guys. I went and did a bunch of orthopaedics rotations.


What I discovered is that the orthopaedic surgeons were really good at evaluating for orthopaedic surgery. This was just my experience. I can’t speak for all orthopaedic surgeons. This was just my experience in my training. They were really good at evaluating for surgery. But the guys that ran the clinic, they were doing the physical exams on what going on. They were actually the orthopaedic P.A.’s or the physician assistants. They were fantastic at what they did. They had a different perspective than the orthopaedic surgeons. Now, outside of the military, I haven’t seen nearly as much of the orthopaedic P.A. perspective. Certainly they exist and they manage certain things.


The exams that I was taught to perform are, do you have a torn ACL? Did you tear that ligament or not? That’s like way down the list. You are evaluating, do I need to send this patient to an orthopaedic surgeon so that they get stuff surgically corrected?


Marshall: Sounds pretty binary, either yes or no.


Chad: Very much. Yes, very much so. My typical thing with the way I evaluated, my traditional training, my traditional approach was, “Okay, I’m going to do what I can to figure out what structure is damaged. Did they tear their M.C.L? Did they tear their ACL? Did they tear their P.C.L?” Those kinds of things. If those tests are normal, then I might put them on rest for a little bit, I might do your anti-inflamatories, [unintelligible 00:07:13] those kinds of things. I might do a little bit of that, and I might send them to physical therapy. If we are not getting any better with that, then I’m probably going to get an MRI, let’s see what’s in there.


If our listeners will recall the podcast on MRI, and MRI is an incredibly sensitive tool, meaning it picks up all kinds of stuff, but that doesn’t necessarily mean that’s the reason you have pain, or dysfunction or whatever. You can go back and listen to that podcast. I won’t reiterate that one now. But it’s a very nuanced thing. We are trying to figure out, what is it that’s really going on? I was not taught, ‘Here is the reason that you have pain.’ I was looking for, ‘Do I need to send this person to an orthopaedic surgeon?’ I don’t think anybody intended, that wasn’t the intent to — They just didn’t know. If your teachers don’t know, then the student, unless they figure it out on their own, doesn’t know.


It wasn’t until I was exposed to Prolotherapy, that my whole paradigm in how I approach athletes changed dramatically. When you consider this concept that I learned was called ‘Tensegrity.’ Tensegrity is the application of the structure as a whole. There’s some pictures out there on the Internet. If you Google tensegrity, T-E-N-S-E-G-R-I-T-Y, I think. Tensegrity. There are some really neat arches and some towers and they are put together with cables and with rods. If you removed one of the cables, the whole thing falls apart. If you remove one of the rods, the whole thing falls apart. The entire structure is contingent upon each little component, and when you have all of that working together as an entire structure, then things function and flow normally.


We don’t tend to think of it that way, at least in my training, that’s not the way we approached musculoskeletal pain in general, much certainly to include knee pain. My evaluations, my exams were looking for those things that may need surgery, looking for a diagnosis, and when I say diagnosis, mainly torn ligaments, those kinds of things. Then, well, you’re injured, your pain. We had things like retro patellar pain syndrome, chondromalacia patella. These terms that it’s like, “What? My knee hurts.” These things, patellofemoral pain syndrome, It’s just this knee pain that we can’t really explain and they just don’t seem to get better. We’ll send them to physical therapy, sometimes they improve, sometimes they don’t, it’s just difficult and it’s frustrating.


I actually had one of these patients and I don’t remember if I’ve talked much about this or not, but when I got into Tulsa Prolotherapy, one of my commanders came to me and said, “I need Prolotherapy for my elbow,” and I was like, “I don’t know what you’re talking about.” I thought I was pretty outside the box and open-minded and all that kind of good stuff, and he says, “I need Prolotherapy.” I’m like, “Dude, I have no idea what you’re saying.” He was a Lieutenant Colonel, I didn’t’ call him “dude”. He says, “I need Prolotherapy.” Of course, in the army when your commander comes to you and says, “I need this,” then your job is to go figure out what it is. My PA at the time went and did the research, found this guy just outside of Nashville, Dr. Mark Johnson. He’s urologist that no longer does urology, all he does is Tulsa Prolotherapy. We sent my commander to him and his elbow got better.


We see stuff like that happen, especially with this kind of outside the box, atypical stuff. Somebody’ll go do something and they get better. That doesn’t mean it’s a slam dunk, it works for everybody, so I dismissed it, “Okay, great, he got better, moving on.” Didn’t put a whole lot of mental thought into it. That guy, Dr. Johnson, he came to us and he said, “Hey, I want to tell you more about Prolotherapy and what it is, and all that kind of good stuff.” We let him come up and do this in-service and he said a couple of things that just were dramatic to me. The first thing he said was, “Don’t use ice after an injury.” I was like, “Come on. This is what we do in sports medicine.”


Marshall: It’s the acronym, right?


Chad: Absolutely. Rest, ice, compress, elevate; RICE. You’re telling me not to do that? All right, well you’ve officially been labelled as a nut job to me. It was big, but then he went on and said, “Not only do you not use ice, but whatever you do don’t ever use anti-inflammatory medications.” I’m like, “Okay, so everything that I was taught about sports medicine, you’re telling me is bunk.” I said, “This guy’s either a genius or an idiot, and I really don’t know which one you are yet.” He quoted not the studies, but he told us about some studies that verified what he was saying. I’m a busy physician in special operations, we’re getting ready to go to Iraq and all that kind of good stuff, and so I was busy. I didn’t have time to look in to all of this stuff so I just put it on the backburner.


Then I slowly started doing some research on it because I was like, “This guy, I don’t know. I’m not going to completely blow it off but how is it that the entire medical world. These are physicians, they’ve been in school for years and years and years, you have to be at least somewhat intelligent to be able to get into medical school and you graduate and you’re a doctor, and my gosh they’re supposed to know what they’re talking about. You’re telling me all of them are wrong?” This guy is saying, “Don’t do what they’re doing.” I got issues with that.


Marshall: Everything that all of your professors in the entire medical community have agreed upon, he’s saying do the opposite of that.


Chad: Exactly. Not everybody can be wrong, you know? It really I don’t want to say caught me off guard, but that was a big cookie to swallow.


Marshall: Was he at the forefront of Prolotherapy or has it been around for a while and just now come into the light?


Chad: Yes, phototherapy’s been around for a long, long, long, long, long time. In its current form, nearly a hundred years. It’s not a new therapy. The first case reports were published in 1950s. Dr. Hackett is the physician that kind of described the term. He published his first book in the 1950s. It’s been around for a long time, it’s just now well known for a number of reasons and we’ll talk about that in a future podcast, about the politics behind Prolotherapy. Basically, you can follow the money trails. There’s just not a lot of money to be made number one, in Prolotherapy because there’s not a pharmaceutical company that’s making the solution. There’s no money to do good quote “high quality, randomized, placebo controlled, double blended studies”.


Secondly, there’s no money to be made in curing people. I hate to say it that way, but it’s true. Even from Prolotherapy. I do Prolotherapy in my clinic and from a business perspective it’s not the smartest thing. Because they come in, they have pain, you make their pain go away, and they don’t come back.


Marshall: Highly effective treatment.


Chad: Yes, exactly. From a business model that’s a bad idea. You want to give them the crack, get them hooked on the crack, so they keep coming back for the crack. That’s good business. That’s not good medicine but it’s good business. The good thing is that when you fix someone’s pain they tell their friends, so we still get new business. I have to sleep at night, the way I sleep at night is by knowing that I did the absolute best I could for the patients. Sometimes you fix them, sometimes you don’t regardless of what they’re coming in for. Sometimes you make them happy, sometimes you don’t. I hate it when we don’t but we do the best we can.


Prolotherapy without question is one of the best things that we do for musculoskeletal pain. In regards to knee pain I think it’s important to understand number one, that concept of Tensegrity. This was a concept that when you think about a knee injury, so you’re a football player and you play basketball.


Marshall: Yes, I play basketball.


Chad: Most common knee injury you saw in your basketball career, what would you say that was?


Marshall: Most common was probably the ACL coming down from a rebound or something like that, or trying to push off and turn really fast dribbling and you see a lot of guards with those knee injuries and have to rehab them.


Chad: Right, and so it’s kind of a plant and twist kind of injury. There’s a lot of meniscal tears that go with that and those kinds of things. Unfortunately we have this reductionist mentality, meaning when you have an injury, we’ll do an exam and we’ll say, “Oh, you tore the ACL.” Then, what I’ve seen, is the surgeons will go in and surgically repair that tendon whether it’s cadaver graft or another ligament or tendon graft, they’ll go in and they’ll fix the ACL and we think we’re done.


Imagine a car going 100 miles an hour down the highway crossing lanes and hitting another car head-on, and the damage sustained to that car. Then someone coming along, the bumper specialist comes along and says, “My gosh, you destroyed your bumper, we need to replace your bumper.” They put a new bumper on the car and then they wash their hands and walk away. There’s a whole lot more damage that goes on and you cannot – because of this I think the concept of Tensegrity helps explain the knee damage, the knee pain, and the comprehensive nature of some of these injuries. That the main thing that may show up on an MRI, the main thing that may show up on an exam is a torn ACL or, “Oh, and you also tore your meniscus.”


There’s this thing called the unhappy triad where the common injury, getting hit from the outside of the knee and it’s ACL mediolateral ligament and medial meniscus. Those three because of their intimately related connections, they’re often damaged together so we get this unhappy triad injury. There’s three things but they’re very distinct. These three issues are damaged. What we look for is this surgically fixable or not? That’s the end. We fix that and then, “Well, you still have pain. Well, you still need physical therapy. Well, here’s your pain meds, here’s your anti-inflammatories.” It’s a broader scope than that. It’s like a nuclear bomb goes off in their knee.


Even if it doesn’t show up on MRI, even if you can’t see it in an arthroscopy when they go in and actually put the poke holes in the knee and look with the camera, and they go in to quote “take a look” and, “We’ll just clean that up,” and they’re cutting away these tissues, it’s just a really common thing. With these knee injuries a lot of these tissues can be damaged. One of the benefits of Prolotherapy is we can go in and address all of them, the vast majority of them. We can help repair damage to an incomplete tear when there’s microscopic damage, which I believe and my experience has shown is a common cause of a lot of these knee pains.


Phototherapy’s just a great option for that, but if you go in with this reductionist mentality that you tore your ACL, we’re going to fix the ACL, and we’re out. You can’t tear the ACL without having some other kind of damage. When you look at the structure of the knee it’s just almost impossible.


Marshall: What makes these knee injuries or the knee as a joint unique to a lot of the different injuries that you’ve seen? Is it the unique relationship between the three ligaments there or is it because it’s weight bearing? What makes the knee unique to some of the other injuries that you’ve see?


Chad: Well, certainly the ligament structure, the knee is a hinged joint, basically what it does is it flexes and extends. There’s a little bit of minimal, but yes, it’s carrying the entire weight of the body. Because of how dynamic we are, we take a 250 pound athlete and send him at 15 miles an hour down the side-line with a football and he’s trying to run as fast as he can. A 300 pound lineman, line back or fill in the blanks is chasing him down like a rhinoceros and drills him. He’s only standing on the one knee. All of those forces can often converge on the knee. Name the athlete, you can see significant knee injuries and I think it’s because of the weight bearing status. The way we transfer, the way we shift our weight during these activities, all of those things I believe contribute to the risk of damaging the knee.


Then if you’ve damaged your knee and had surgery, many times, number one, surgery I believe on some level causes a little bit of damage on its own. It’s why you have a scar, that’s a little bit of damage. That scared tissue is not as strong as what was normally naturally there to begin with. We go in and d surgery and I think this is a theory that I have that the tissue, we have to cut through that joint capsule to get into the ACL. We have to cut into these things and we try and sow those things back together, but you can’t put Humpty Dumpty back together, you can’t. There’s a permanent change in that anatomy and maybe microscopic, and I believe we’ll of ten dismiss that. Say, “Well, it can be that scar.”


The complexities of the pain perception is much greater than you tore your ACL, your knee hurts, fix the ACL, pain goes away. When people have a heart attack, many times that pain radiates, goes down the arm, into the back, into the neck, into the jaw, those kinds of things. The heart has nothing to do with those structures, it’s merely the way the body interprets that pain. We see the same thing with the knee. In fact I saw a guy today, then I guess this is my HIPAA compliant story for the day. This guy comes in and he’s an Airforce guy, he’s 31 years old and he’s got knee pain. He has to take pain medications because of his knee. We started off ding some Prolotherapy and he had some initial response, he had some benefit with the initial injections. The thing about Prolotherapy is, you’ve got to get the right locations, you’ve got to get the right space.


For him, the way his pain was manifesting is like it was in the back of his knee. It was this weird vague pain. Sometimes it’s almost like you’re chasing a chicken, it’s just all over the place and you can’t get it nailed down. One of the many good things about Prolotherapy is that when we do the injections in a comprehensive nature we can identify the actual source of the pain. You inject the area that is uncomfortable, that’s causing the pain and there’s Lidocaine in the solution, so Lidocaine is an anaesthetic. It numbs up those areas. When you numb up the right area and their pain goes away, you know you’ve at least injected the right area. Sometimes that doesn’t have anything to do with where that pain is showing up.


With him, it wasn’t the typical referral pattern, it was this weird. It took a while, it took several rounds for us to identify, “Okay, here’s where the pain is coming from.” Now, we’ve identified, I’m 99% sure we’ve identified where his pain is coming from. He’s been dealing with this for a long time. I believe he’s even had a surgery on his knee, it didn’t help. Again, it’s all about identifying what’s causing the pain. For him, we’re actually beginning to see improvement. I’m quite confident we’re going to fix that and make it go away. It’s just a really fulfilling place to be in where this guy before I knew about Prolotherapy, before I knew how to do Prolotherapy, I wouldn’t have had anything else to offer him. He’s already been to physical therapy, he’s already been to bio-orthopedic surgery, he’s already had surgery. He’s on pain meds and I’m like, “What else do I have to offer you? I don’t have anything”


He’s this 31 year old guy that’s on medications, are we going to commit him to a life of these pain meds? That’s unacceptable to me, it just doesn’t work. That’s one of the ways that we’re different in our clinic at Revolution because we want to identify why someone has pain and try and make that go away. We have pretty good success with it. Sometimes we can’t but when you get the right patient, you find the right injury, you treat it with the right therapy, you take care of it.


Marshall: Talking about this specific case, or there’s a number of other types of cases like that. How successful can Prolotherapy be for a case like that?


Chad: I would say in excess of 90%. I would say that nine out of 10 knees like this guy that come in, we’re going to be able to fix those. Because of the nature of the injury, the nature of the therapy and he’s otherwise healthy. Now, when it comes to something like Osteoarthritis of the knee and we’re really degenerating the cartilage. When I say cartilage, I mean the articular surface where the femur and the tibia, those are the bone above and the bone below where those two contact, there’s some cartilage and of course there’s a meniscus which is also a cartilaginous structure. In between that surface is a cushion and a glide. You could have erosion of those things. We’re talking about a very different injury, pain, disease process and Prolotherapy has had tremendous success with that.


There’s some studies, I believe it’s published in the Journal of the American Osteopathic Association. It’s a couple of a few years ago, I’ll need to get the reference. Showing good improvement with what’s called the WOMAC Score, which is a pain score for knee pain. We saw good improvement with Prolotherapy. Again, it’s yet another study where Prolotherapy has been shown to be beneficial. Again, without really any significant risk, so great procedure but a very different process. With something like that where we’ve got significant damage to some of these tissue inside the knee, non-ligamentous and tenderness in nature then I would really lean more toward stem cell therapy.


Stem cells are these young cells, when a child is conceived and the embryo and you basically start off with one cell. Out of that one cell develops the brain and the spinal cord and the musculoskeletal systems and all of these different things from one cell. As we progress in this development, we begin to make these things that are called stem cells and cool thing about stem cells is, they can become a whole host of other things. Whereas like a chondrocyte is the cartilage cell, the cell that makes new cartilage. That is a chondrocyte, it can only make chondrocytes. Stem cells can become lots of things. When you’re injecting stem cells and provoking the inflammatory response, you’re actually providing a scaffolding of new cells that can become cartilage.


There was a study presented by a physician out of Louisiana and he was doing  stem cell injections, out of his study, one of these patients opted for knee replacement in the middle of the therapy. He called the pathologist, the surgeon in this study. He called the pathologist and he said, “I’m sending down some knee tissue and I want you to take a look at it and tell me what you think.” What they noticed and I’ve actually got the slides. What they noticed was a tremendous amount of new cartilage growth. He said this was so remarkable because we just don’t ever see that in patients needing a knee replacement. Stem cell is something that can dramatically alter the tissues in the knee and we see dramatic improvement in that in addition to improving their pain.


When I do a knee injection with something like stem cell, I recommend incorporating PRP or Platelet Rich Plasma therapy with it. Because then you’re getting these stem cells that will provide the scaffolding in the cells and all of those kinds of things. Plus you’re getting the inflammatory response from these Platelet Rich Plasma because the platelets have growth factors in them. You’re stimulating this healing response with the PRP and you’re providing the scaffolding with the stem cells, and it’s just kind of a one-two punch that we have seen really excellent results with. Of course, you can use Prolotherapy which is when it works it’s definitely the most cost-effective. We could always upgrade to PRP and we can upgrade to stem cell at any time. I mainly use those when the problem is intra-articular, it’s inside knee-joint, cartilage, meniscus those kinds of things.


What I see is so many of my patients they may have something going around inside their knee but they’ve also got damage on some of these structures, the medial collateral ligament. Sometimes it’s just the soft tissue around the knee, almost that joint capsule. We can treat all of that with Prolotherapy, with, number one, excellent results and number two, very little risk for side effects. I’ve never seen a complication from a knee injection and we do a lot, a lot, a lot of injections across the board and we just don’t see complications. Of course, I’m affiliated with the Hackett Hemwall Foundation which is arguably the greatest foundation. The greatest organization teaching and promoting Prolotherapy. We’ve got a worldwide association and they watch and monitor Adverse Events.


There was an Adverse Events in Mexico a couple of years ago. I don’t know exactly what happened. Just to underscore how they followed this stuff and the visibility that they did they put over it and they reported this to us. I don’t know exactly what happened but there was an infection that developed. It was a neck injection, like I said it was in Mexico. We suspect that they were using a standard traditional, would be a very safe dextrose Prolotherapy solution. Prior to that the only complications that were published, happened in 1956, published in 1957. We’re talking it was 50, 60 years ago, 60 plus years ago that had any kind of significant complication. Very low risk of harm, at least decent if not really phenomenal potential benefit and we can fix a lot of stuff with that.


Marshall: What I’m hearing you saying is kind of bringing this full circle is, you were taught a very binary system. It’s either torn and you have to go in and get surgery or, “Stay off it for a little bit, here’s some painkillers.”


Chad: Right.


Marshall: But now you’ve already outlined several different alternatives for that Gap. Now it’s a very less binary system, you can go in there and you can improve somebody’s pain even if they don’t have it torn ACL. Maybe it’s partial or just damaged or something like that.


Chad: Right. Even with an ACL, I’ve heard many I’ve heard many with big surgeons say, “You know you don’t necessarily need to fix that.” I would argue that there is some instability that comes with that and you have to be careful. You certainly couldn’t go play football competitively without an ACL. Your knee, you need that structure. If somebody is running on a straight and level path and you may do okay with a completely disrupted ACL. I’ve heard many times, you don’t necessarily need to repair that thing. If you don’t need to repair it but you have pain why not try Prolotherapy for stem cell or PRP? Very cost effective low risk of harm. We can get a lot of people back to full function without taking time off.


There’s a lot of things that cause knee pain, a lot of things. Knee pain, it’s such a vague generic term. Everything from torn ACL, you could certainly have like bone cancers and things like that which are definitely a little more rare. Then you’ve got some minor soft tissue damage, for example, I was running and in my neighbourhood where I used to live it was very, very hilly, lots of hills and some of them were steep. Running uphill was no problem but running downhill it pounds your knee pretty hard. I did a lot of that and really started getting some knee pain. It was significant knee pain, like I couldn’t run. I couldn’t run across the parking lot. It hurt that bad but my knee exam was “normal”.


I didn’t have laxity on the ligament exams, I didn’t tear my ACL. I didn’t– It was none of those things but it hurt. I didn’t go get an MRI because I wanted to go get surgery, so why get an MRI? Got Prolotherapy and I mean night and day. This was a relatively minor injury that in my opinion without having had an MRI I don’t believe it would have showed up on MRI.


Chad: For listeners like myself or people that are not from the medical field and they’re listening to this and they’re saying, “Well, I’m a runner, I go running every day.” What level of symptoms or pain would you say would qualify them to at least learn more about Prolotherapy or one of these alternative solutions?


Chad: The first thing I would say is, anything that’s causing some discomfort. A lot of times this is a warning that there’s something wrong. God gave us pain for a reason. It’s telling us that something’s not right and I believe we should listen to that. Now, I don’t recommend that everyone that if you tweaked your knee yesterday then you come running in to get Prolotherapy. It’s not what I do. Your body should be able to heal a lot of these stuff on its own, on these lower-level injuries. I usually say give it six to eight weeks and see how it does. Do some therapy related things, do all the normal traditional things other than anti-inflammatories which I still don’t recommend for musculoskeletal problems.


Give it a few weeks and see what happens. If it’s still giving you really any level of pain, I would strongly consider looking into Prolotherapy. Now, let me take one second and — If you’re listening and you’re in Seattle Washington, whatever, you’re know you’re welcome to fly to Tulsa Oklahoma and we’ll be happy to treat your knee.  Find a Prolotherapist in your area and what I would recommend doing because any physician can hang up a shingle and say, “Hey, I do Prolotherapy.” That does not mean that they’ve been trained in the methods that have been used for the last nearly hundred years that are proven to be effective and safe.


Most of the harm that comes with the injections is the ability to use that needle appropriately. Because we’re sticking a needle sometimes way down in the tissues and one of the harms that you can do, although when you’re trained we just don’t really see it. Some will still guard against but sticking a big artery or a nerve or a vein or something like that where if you know you’re doing that’s extremely rare, fairly low risk. Any physician can hang up a shingle and say, “I do Prolotherapy.” My recommendation is that you go to the Hackett Hemwall Foundation website, that’s or I’ll pull it up while we are talking here. It’s H-A-C-K-E-T-T, Hemwall, H-E-M-W-A-L-L, and go to the


On their website on the left hand side there’s a list of Prolotherapists. There are certain criteria that you have to meet. A certain trait levels of training that you have to go through in order to be on the recommended list of Prolotherapists. On this list no one paid a dime to get on that list. You don’t buy your way into this list, you have to have had the training one-on-one with another Prolotherapist, very experienced. This is one of the reasons I recommend this organization. Go on to that website, take a look at that list of Prolotherapists. I know a lot of these guys because it’s a pretty small community and I would get Prolotherapy by any number of these guys. That would be my recommendation.


Certainly if you’re willing to come to Tulsa Oklahoma we would love to treat for your knee pain and obviously we can do a standard Hackett Hemwall Prolotherapy, we can do the stem cell therapy. We can do the platelet rich plasma therapy. Our goal is to get you back on your feet full function with no pain. There’s a really good track record behind Prolotherapy for that. I would say that that’s good for a lot of these tears for this vague knee pain for osteoarthritis, we see benefit. Really if there’s any knee pain, I would strongly recommend Prolotherapy is my primary intervention, unless there’s some emergency reason that we can’t ride. I don’t know that I’ll ever see that.


Marshall: Well, being a former basketball player and 6’7, I know that my time is coming. I know that pain is coming, so when it does, I know that I don’t have to go get operated on to get it fixed at this point.


Chad: That’s exactly right. The thing is like I talked about risks and benefits. If for some reason Prolotherapy didn’t work, you can still go get surgery. Prolotherapy doesn’t mess up the ability to go get surgery. Sometimes surgery messes up the potential for success with Prolotherapy. Surgery is just one of those things that you can’t undo. When you need it, you need it. I’m not anti-surgery. I’m anti-surgery as a first line therapy unless it’s your appendix or a raptured abdominal aortic aneurysm or something.


Marshall: It has its place.


Chad: Absolutely. Absolutely, it has its place but we want to be as cost effective as we can be with the lowest risk, and get people back as quickly as we can. The other thing with Prolotherapy is you really don’t have to take any time off. A lot of my athletes they are still continuing to train, my military guys didn’t have to take any time off and you can stay in the fight so to speak. Great procedure.


Marshall: Cool. I love it. Well I’ve learned a lot today and I know that the rest of the listeners have as well. I know that we have a previous episode on Prolotherapy. Going to do more episodes on the different applications of Prolotherapy, so thank you very much.


Chad: Man, I appreciate your time. Thank you very much for listening. Look forward to seeing you in here next time.


Male: Thanks for listening to this week’s podcast with doctor Chad Edwards. Tune in next week where we’ll be going Against the Grain.


Chad: Upper Cervical Health Centres is not your typical chiropractic office. Different in that they never jerk, twist, snap or crack your spine. They offer a gentle approach to address your health issues naturally. Their patients report an improvement of over 75% in their overall health. They are so much more than a neck and back pain relief clinic. Call them at 9-1-8-7-4-2-2-3-0-0 or visit their website at for a special offer on your first visit. Find your way back to health with Upper Cervical Health Centres.


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