treating sports injuries

8/17/2019 Treating Sports Injuries

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Volume 1, Number 1 ) 2007

Therapy

Biomedical

Treating

Sports Injuries

• Inammation and Immune Regulation

• How Efcient Is Your Practice Marketing?

Integrating Homeopathyand Conventional Medicine

d 2.00 • US $ 2.00 • CAN $ 3.00

Journal of


2/28

In Focu s Treating Sports Injuries – A Functional Approach . . . . . . . . . 4

From t h e P rac t i c e

Muscle Tear in the Lower Leg . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

W hat E l s e I s N e w ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

P r a c t i c a l P r o t o c o l s A Biotherapeutic Approach to Common Sports Injuries . . . . 12

A round t h e Gl ob e “… Hakkin Hill almost killed me!” . . . . . . . . . . . . . . . . . . . . . . 14

Re f r e s h Your Homo t ox i co l ogy

Is Inammation after Injury All Bad? . . . . . . . . . . . . . . . . . . . 16

Mar ke t i ng Yo u r P ra c t i c e How Efcient Is Your Practice Marketing? . . . . . . . . . . . . . . . 18

S p e c i a l i z e d A pp l i c a t i on s Biopuncture and the Treatment of Sports Injuries . . . . . . . . 20

Re s e a r ch High l i gh t s Fast-acting, Safe, Effective –

Study Conrms Traumeel Effective for Tendinopathies . . . . 23

Mak in g o f . . .. . . Traumeel: How Does the Ointment

Get into the Tube? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

A round t h e Gl ob e South Africa: Homotoxicology in the “Rainbow Nation” . . 26

Cro s sword Puzz l e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

)

2

Contents

Published by/Verlegt durch: International Academy for Homotoxicology GmbH, Bahnackerstraße 16,

76532 Baden-Baden, Germany, e-mail: [email protected]

Editor in charge/verantwortlicher Redakteur: Dr. Alta A. Smit

Print/Druck: Konkordia GmbH, Eisenbahnstraße 31, 77815 Bühl, Germany

© 2007 International Academy for Homotoxicology GmbH, Baden-Baden, Germany

Cover photograph

© iStockphoto.com/Ben Blankenburg


3/28Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1

Reference:

1. Sands RR (ed.). Anthropology, Sport, and

Culture. Westport, CT: Bergin and Garvey,

1999.

Welcome to the

New Journal of Biomedical Therapy!

)

Since the fall of 2000, when the Journal of Biomedical Therapywas first published, it has helped

educate many medical practitioners

throughout the world about the po-tential of biological medicine. Now,

some seven years later, we felt it was

time to give the journal a new look.

The redesign, visible at first glance,

is fresh and modern. But that’s not

all! Twelve extra pages make room

for even more information. In addi-

tion to familiar columns such as pro-

tocols, case studies, and medical

summaries, you’ll find new ones in-

cluding In Focus (a keynote articleon cutting-edge medical topics),

Specialized Applications , and Refresh

Your Homotoxicology . Articles on

non-medical topics such as market-

ing your practice, how biological

medications are produced, and news

from around the globe combine in-

formation and entertainment. En-

joy!

This first issue of the new Journal of

Biomedical Therapy is about sports

injuries, an important therapeutic

field for general practitioners and

specialists alike. As evidenced by

ever-increasing interest in the fairly

new discipline of sports anthropol-

ogy, sports have come a long wayfrom being merely a recreational

pastime.1 Historically, people en-

gaged in sports as recreation or play,

in the context of games that differed

from culture to culture and in their

degree of structure and competitive-

ness. After WWII, we saw a shift

from “fun” to “business” in modern

sports, and the world of sports be-

came a very demanding place. Sports

now meet our need for physical ac-tivity, which in the past was served

by activities essential to survival,

such as gathering food or searching

far and wide for other necessities. In

modern culture, sport has become

almost a prerequisite to a successful

corporate career.

Sports medicine today is an inde-

pendent specialty. Physicians and

therapists have to deal with people

who engage in sports on a variety of

levels, from Olympic athletes to cor-

porate executives to “weekend war-

riors.” In the words of Dr. Barkaus-

kas, modern sports physicians must

not only understand the pathologies

they encounter but must also have aholistic grasp of the complexity of

being a healthy sportsperson. Last

but not least, specialists in sports

medicine must understand sports as

a social, economic, and psychologi-

cal phenomenon.

Competitive sports have financial

and professional repercussions. Es-

pecially when the patients are elite

athletes, the practice of sports medi-

cine requires a multidisciplinary ap-proach. Thus biomodulatory thera-

pies offer realistic alternatives, with

the added benefit of not being on

banned lists. That’s why we asked

several experts to write on this im-

portant topic for this issue. Most of

these contributors are directly in-

volved in the care of elite athletes,

some even on the Olympic level.

Alta A. Smit, MD

) 3

Dr. Alta A. Smit



Treating Sports Injuries –A Functional Approach

Understanding sports and sports medicine:

not as simple as you might think!

By Dalius Barkauskas, MD

Head physician of the Lithuanian Olympic team

)

I n F o c u s

4Competitive athletes are extremely

susceptible to injuries, and their

treatment requires a complex approach.

In the extremely demanding world

of top-level sports, every little

detail matters. That’s why the team

approach is so widely used in pro-

fessional sports. In their search for

perfection, athletes and coaches

will consult not only the team’sphysician or physical therapist but

also specialists in nutrition, psy-

chology, sports physiology, and

other related fields.



)

I n F o c u s

Treatment strategies for top ath-letes are very complex. Themain emphasis is on the immune

system (or neuroimmunoendocrinol-

ogy, to use the modern term) ratherthan on the injured area, which sim-

ply reflects the state of the body in

general. Also, professional athletes

are not alone in suffering from inju-

ries and other sports-related prob-

lems. There are millions of amateur

or recreational athletes, and thou-

sands of them deal with injuries

ranging from minor bruises to major

trauma, overexertion, etc. Estab-

lished and aspiring experts in thefield of sports medicine must be pre-

pared to meet the needs and expec-

tations of very specific and very dif-

ferent groups of individuals.

When dealing with athletes, the

medical profession must confront

multiple issues simultaneously. Not

only can sports injuries and related

pathologies cause permanent health

problems, they may also have seri-

ous professional and financial con-

sequences. Immediate first aid and

correct diagnosis often determine

the gravity and duration of the in-

jury. People who are active in sports

are often also very active in their so-

cial and business lives. In these cases,

the physician’s situation becomes

tricky due to a number of factors:

1. Such individuals have no time

for full treatment. There is no place

for the treatment strategy known in

the medical profession as ex juvanti-

bus – meaning that what works tellsyou what’s wrong. Especially during

the competition season, there is no

time for second attempts. If your ini-

tial treatment fails, these patients

will never approach you again.

2. Sensitivity to aggressive medica-

tion. The need for aggressive treat-

ment strategy increases the possibil-

ity of iatrogenic disease.

3. In addition to their acute symp-

toms, these patients often presentwith muscular imbalances, micro-in-

juries, and problems that have al-

ready become chronic.

4. The psychological factor: Will I

be able to continue to play or com-

pete?

5. Altered movement patterns due

to injury affect performance.

6. Most importantly, the doctor or

other medical professional must

have a full and compassionate un-

derstanding of what sports mean to

those involved.

These factors put considerable pres-

sure on the medical practitioner. In

addition, while “soft” techniques –

body-friendly methods and medica-

tions – are important, any interven-

tion must produce rapid, reliable

results.

Homotoxicology in sports

medicine: why and how?

For the physician or other profes-

sional in the field, biological medi-cine offers unique approaches and

treatment modalities. The possibili-

ties include:

• Drainage therapy

• Stimulation of

enzymatic systems

• Treating acute and

chronic injuries

• Immunomodulation in

cases of immunodeficiency

• Treating viral infectionsSafety is the main feature of bio-

logical approaches, along with the

possibility of combining different

techniques. Antihomotoxic medicine

is a regulatory therapy. In addition

to syndromes related to overexten-

sion and overtraining, sports physi-

cians frequently see cases of dysbio-

sis. Biological medicine in general

and homotoxicology in particular

are very effective in such cases. An-

other factor to consider is tissue aci-

dosis, which is very important in

sports not only because of anaerobic

activity but also because of unre-

stricted use of sports supplements,

many of which have not been deter-

mined to be safe for long-term use.

Even the common supplement glu-

cosamine, for example, may cause

allergic skin reactions or gastroin-testinal disturbances and is not rec-

ommended for use during pregnan-

cy.

) 5

A sports physician’s job is full of

responsibility: Appropriate rst aid

and correct diagnosis signicantly

determine the gravity and duration

of an injury.



)

I n F o c u s

Clearly, biological approaches have

distinct advantages. They can be

highly effective yet minimally inva-

sive. In my experience and opinion,

both physicians and athletes comeout ahead when the treatment stim-

ulates natural, physiological healing

reactions in the body. As I men-

tioned above, we need to be able to

control what we are doing: Our

treatment must be aggressive and

have predictable positive effects and

minimal or no side effects. Total

suppression of the pain reaction is

not our goal, however, because pain

is the crucial factor in limiting ag-gressive movements.

It is interesting to note that specific

types of homotoxicological medica-

tions correlate with levels of inter-

vention:

• Catalysts act on

the cellular level.

• Suis-organ preparations work

on individual organs.

• Combination medications work

throughout the body.

For maximum effectiveness of

course, understanding Reckeweg’s

philosophy of antihomotoxic medi-

cine and the Disease Evolution Table

as the basis of treatment is of para-

mount importance, but these topics

are beyond the scope of this article.

See Figure 1 for a simplified dia-

gram of the modes of action of bio-

therapeutics.

Clearly, the mechanism of action is

modulated by the immune system,

so understanding the immunologi-

cal bystander reaction will be help-

ful, as will a general knowledge ofmatrix physiology and pathophysi-

ology.

Treatment strategies

for sports injuries

First of all, I would like to empha-

size that therapy for acute injuries is

relatively straightforward. The well-

known RICE acronym applies,

along with other treatment tech-niques. It is important to follow the

general principles of diagnosis, treat-

ment, and re-evaluation. It is impor-

tant to remember that inflammation

means healing. If we analyze the

phases of inflammatory response

(acute, repair, maturation), it be-

comes obvious that inflammation

needs to be controlled but not en-

tirely suppressed. During treatment,

we are also dealing with reflex ac-

tions of the nervous system, since

any nociceptive stimulus will cause

the nervous system to react. Again,

it is important to permit adequate

response. Thus indiscriminative use

of drugs that suppress inflammation

(NSAIDs, steroids) may produce di-

rect as well as remote side effects.

From the point of view of antiho-

motoxic medicine, the product ofchoice here is Traumeel. Figure 2

shows its (simplified) mode of ac-

tion. Traumeel is a very complex

product, and all of its ingredients act

synergistically on inflammatory re-

sponses:

• Aconitum napellus, Hamamelisvirginiana, Millefolium, Bellis

perennis, Belladonna, Arnica

montana: stabilise vascular

permeability, prevent venous

stasis

• Aconitum napellus, Arnica

montana, Chamomilla,

Hypericum perforatum:

analgesic effects

• Echinacea purpurea and

angustifolia, Hepar sulfuris:antisuppurative effects

• Calendula ofcinalis, Arnica

montana, Symphytum officinale,

Echinacea purpurea: promote

healing and callus formation

In acute injuries, Traumeel is best

combined with Spascupreel (for

muscle strains) and Lymphomyosot

(for tissue swelling).

In an attempt to show that they are

open-minded, some doctors add

Traumeel to an injection cocktail of

anti-inflammatory steroids. Figure 2

makes it clear that there is no advan-

tage to such an approach because

the steroid drug blocks all the in-

flammatory reaction pathways. Fur-

thermore, the side effects of cortico-

steroids on connective tissue are

well-known and have been thor-

oughly described, so their use intreating sporting injuries is becom-

ing very controversial. 6

Highpotency

Antihomotoxic medication

Low/mediumpotency

Biophysicalaction

Biochemicalaction

Informationtransfer

Immunomodulatingaction

Matr ix drainage Radical trapping

Immunologicalbystander reaction

Enzymeactivation

Fig. 1:

Modes of action

of biotherapeutic

medications



Example

Infiltration of 2 ampoules of Traumeel

and 3 ampoules of Lymphomyosot in

the area of the lig. talofibulare anterius

after acute ankle sprain in a basketball

player; needles 27G-3/4 inch. Dramatic

improvement in walking ability wasevident the next day.

)

I n F o c u s

Traumeel is an Inflammation-

Regulating Drug (IRD)

When dealing with sports injuries, itis advisable to monitor other factors

that contribute to successful perfor-

mance: sound nutrition, wise use of

supplementation (sometimes the sci-

entific evidence does not confirm

the theory), flexibility, and sleep,

the main aid in recovery (the physi-

ological peak in growth hormone

occurs between 10pm and 1am).

Before coming to a final diagnostic

conclusion, it is important to stressthat because the site of the injury is

often not where the pain is, treating

the painful location may not treat

the injury. Careful functional evalu-

ation is needed. Moreover, there are

usually no objective signs in such

injuries, and making conclusive

statements purely on the basis of in-

strumental data can be misleading.It is not uncommon to see “awful”

changes on X-rays but no clinical

symptoms or vice versa.

Before deciding on a course of treat-

ment, therefore, the doctor needs to

answer the following questions:

• Is this an instance of local

or referred pain?

• Is the structure involved inert

or contractile?

• Is the pattern capsularor non-capsular?

• What does palpation reveal?

Alternatively, diagnosis can be made

on the basis of functional tests.

When dealing with micro-injuries

and chronic problems in the muscu-

loskeletal system, it is important to

realize that any disturbance of func-

tion in a single motor segment willhave repercussions and require com-

pensation throughout the body. In

other words, we will see chain reac-

tions in the locomotor apparatus.

Consequently, localized treatment is

impossible or even nonsensical. The

nervous system is what determines

whether functional disturbance will

manifest clinically. Neurological

control has several aspects: It sup-

ports functioning by maintainingcorrect motor patterns and compen-

sating for disturbed function. On

the other hand, a chronic nocicep-

tive stimulus may disrupt normal

) 7

Fig. 2:

Mode of action of Traumeel AntigenAntigen

Th 1 Th2IL

Interleukin

B lymphocyte

Plasma cell

TGF-β

Th3

Traumeel®

Phospholipids

Arachidonic acid

Pain

ProstaglandinsLeukotrienes

Inammation

CyclooxygenaseLipoxygenase

HistamineHeparin

+

Phospholipase

MAST CELLlg


8/28

function and cause pathological mo-

tor patterns to become fixed. There-

fore, we see more musculoskeletal

problems in psychologically labile

athletes. The main changes may begrouped into three categories:

• Changes in stereotyped

movements

• Upper and lower cross

syndromes

• Myofascial trigger points

With regard to injecting trigger

points, it is always important to real-

ize that there are both silent trigger

points (usually the main ones, at the

core of the problem) and active (usu-ally satellite) ones. Therefore, the

use of this technique requires skill-

ful palpation and the ability to in-

corporate muscular chain reactions

and interrelationships into the clini-

cal picture. (In treating problems of

the biceps, for example, it may be

necessary to inject the peroneus ter-

tius.) The products of choice here

are Traumeel and Spascupreel. For

very persistent problems, Coenzyme

compositum is helpful because it

stimulates aerobic tissue metabolism.

For long-term results, prophylactic

measures such as matrix detoxifica-

tion (the most familiar prescriptions

for this purpose are Detox-Kit, Thy-

reoidea compositum, and Galium-

Heel) and corrective exercises are

essential.

Conclusion

For sports physicians, antihomotox-

ic medicine offers a very safe and yet

very powerful approach to the hu-man body, permitting treatment

strategies that are simultaneously

gentle and aggressive. From the per-

spective of functional medicine, pre-

dictability of any intervention is a

paramount requirement. In conclu-

sion, I would like to stress a few

points:

• Not all techniques from profes-

sional body building are suitable

for health-club clients. This is amajor problem in modern fitness.

Being able to control your body

and its movements is important;

mountains of muscle are not.

• Don’t disregard the genetic

factor.

• Use food supplements intelli-

gently.

• Be prepared for intensive

training.

• The main factors in tness

are the brain, the will, and

knowledge.

• Do not compare yourself

with others.|

Further reading:

1. Lewit K. Manipulative therapy

in rehabilitation of the locomo-

tor system. Oxford, Boston: But-

terworth-Heinemann, 1999.

2. Kibler WB, ed. ACSM’s hand-

book for the team physi-

cian. Champaign: Williams &

Wilkins, 1996.

3. Brukner P, Khan K. Clinical

sports medicine. Sydney: Mc-

Graw-Hill, 2003.

4. Kreider RB, Fry AC, O’TooleML, eds. Overtraining in sport.

Champaign: Human Kinetics,

1998.

5. Denegar C, Saliba E, Saliba

S. Therapeutic modalities for

musculoskeletal injuries. Cham-

paign: Human Kinetics, 2006.

6. De Coninck, S. Basic course in

OM Cyriax: Generalities. De-

Haan, Belgium: ETGOM.

7. Biotherapeutic Index. Ordinatio

Antihomotoxica et Materia Me-

dica. Baden-Baden: BiologischeHeilmittel Heel GmbH, 2006.

)

I n F o c u s

8

Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1

Relaxation and

sleep are impor-

tant factors in the

healing process.


9/28

)

F r o m t h e P r a c t i c e

The patient:

42-year-old male, 178 cm and 82

kg. Active in sports since adoles-

cence; former soccer player in the2nd National League. Has played

tennis for years at the club level;

usually plays 8 hours per week.

The incident:

On Sunday, the patient experienced

acute pain in the left calf after reach-

ing vigorously for the ball during an

exhibition match. Two minutes later,

the pain forced him to drop out ofthe game. The patient elevated his

leg, took an NSAID (75 mg diclof-

enac), and applied cold compresses.

The next morning, approximately

20 hours after the incident, he limp-

ed into my office.

The findings:

Obvious livid discoloration of the

left lower leg, with a tender “gap” in

the lateral musculature of the lower

leg. Pulse intact, no pathological

neurological findings and no indica-

tion of fracture. No antibiotic use

(ciprofloxacin) in the patient’s medi-

cal history.

The diagnosis:

Lateral muscle tear in the left lowerleg.

The treatment:

With the patient in the face-down

position, the lower leg was disin-

fected. An injection containing 5 mlprocaine 2%, 5 ml Actovegin (a com-

bination of glucose and a hemodial-

isate), 1 ampoule of Traumeel, 1 am-

poule of Zeel, and 5 ml glucose 10%

was administered. Approximately 8

ml of the solution was injected into

the “gap” and 5 ml each distal and

proximal to the gap.

In addition, a compression bandage

with Traumeel ointment was ap-

plied. The patient was advised tokeep the bandage moist for the rest

of the day and overnight by apply-

ing Retterspitz (a liquid topical medi-

cation containing citric acid, tartaric

acid, alumen, rosemary oil, arnica

tincture, and thymol), to take one

tablet of Traumeel sublingually ev-

ery hour, to take it easy, and to keep

his leg elevated.

The next day, he returned to the of-

fice. He could not yet put weight on

his leg, but the swelling was defi-

nitely receding although the discol-

oration was more apparent. Another

injection of the same solution was

administered and a new bandage

applied, with instructions to replace

it periodically. The patient’s oral

Traumeel dosage was reduced to

2 tablets 4 times a day.

At his next appointment two dayslater, he moved almost normally as

he walked into the office. The site of

the injury was still pressure-sensitiveand extending the leg still caused

pain, but the patient was able to re-

sume his work in outside sales. The

injection was repeated, and he was

allowed to do a little light walking

and swimming over the weekend.

Three days later, he was almost

symptom-free. He was still taking

2 Traumeel tablets 4 times a day and

applying Traumeel ointment to his

calf, which was still sensitive topressure where the gap had been.

The injection “cocktail” was admin-

istered once more, and he was al-

lowed to resume tennis practice

wearing an elastic bandage.

Two weeks after the injury, he was

playing with almost no pain; after

four weeks, he was symptom-free

and fully active in sports again. At

this point, the Traumeel tablets were

discontinued.

Conclusion

Sports medicine practitioners are all

too familiar with patients who pres-

ent with muscle tears. The “cocktail”

of injectables described above, in

combination with oral and topical

Traumeel, significantly accelerates

the healing process and gets aspir-ing athletes back to their recreation-

al sports in a hurry.| ) 9


Muscle Tearin the Lower Leg

By Johann A. W. Kees, MD

Head physician of the German volleyball team VfB Friedrichshafen

(German Champion, German Cup winner, and

European Champions’ League winner 2007)

A “cocktail” of biological medications

plus a local anesthetic is injected into

the injured spot on the calf.



)

W h a t E l s e I s N e w ?

10

Hormone deficiency

increases risk of falling

Low testosterone levels in elderly

men may be one of the causes of in-creased risk of falling. A US research

team studied more than 2500 men

between the ages of 65 and 99,

measuring their androgen and estro-

gen levels. Subjects reported the fre-

quency of falls every four months

for four years. During the study pe-

riod, 56 percent of participants ex-

perienced one or more falls. The

men with low testosterone levels

had a 40 percent greater chance offalling. This phenomenon was espe-

cially pronounced in “younger” men

(under age 70). In men over 80, hor-

mone levels no longer had any influ-

ence on the frequency of falls. Inci-

dents of falling were independent of

the men’s fitness levels.

Arch Intern Med 2006;166:2124-31

Counting calories is all

that really helps

Which diet is best for losing excess

pounds? That’s a matter of fashionand a subject of constant debate.

Studies to date have been inconclu-

sive, mostly because the subjects

stopped following the dietary guide-

lines after a short time. That’s why

Boston scientists, in a recent study

of a group of overweight subjects,

not only compared different diets

but also provided the subjects’ food

for six months.1 One of the two

diets tested emphasized foods withhigh glycemic index values, the oth-

er foods with lower glycemic loads.

Both diets reduced calorie intake by

30 percent. After six months, each

group was supposed to continue on

the assigned diet independently for

another six months. Isotope tech-

nology was used to measure unre-

ported calorie intake. In the first six

months, participants lost an average

of 10.4 kg and 9.1 kg on the lowand high glycemic diets, respective-

ly. After twelve months, the differ-

ence had vanished, and the average

weight loss for both groups was 8

kg. The study concludes that the

number of calories ingested is all

that counts, not their sources. In

addition, a second study demon-

strated that sensations of hunger and

how much food is eaten are inde-

pendent of foods’ glycemic indexratings, thus disproving the conten-

tion that high-glycemic foods make

people feel hungrier due to insulin

spikes.2

1. Am J Clin Nutr 2007;85:1023

2. Diabetes Care 2005;28:2123

F O R P R O F E S S I O N A L U S E O N L Y

The information contained in this journal is meant for professional use only, is meant to convey general and/or specific worldwide scientific information relating to the

products or ingredients referred to for informational purposes only, is not intended to be a recommendation with respect to the use of or benefits derived from the

products and/or ingredients (which may be different depending on the regulatory environment in your country), and is not intended to diagnose any illness, nor is it

intended to replace competent medical advice and practice. IAH or anyone connected to, or participating in this publication does not accept nor will it be liable

for any medical or legal responsibility for the reliance upon or the misinterpretation or misuse of the scientific, informational and educational content of the

articles in this journal.

The purpose of the Journal of Biomedical Therapy is to share worldwide scientific information about successful protocols from orthodox and complementary practi-

tioners. The intent of the scientific information contained in this journal is not to “dispense recipes” but to provide practitioners with “practice information” for a better

understanding of the possibilities and limits of complementary and integrative therapies.

Some of the products referred to in articles may not be available in all countries in which the journal i s made available, with the formulation described in any article or

available for sale with the conditions of use and/or claims indicated in the articles. It is the practitioner’s responsibility to use this information as applicableand in a manner that is permitted in his or her respective jurisdiction based on the applicable regulatory environment. We encourage our readers to share

their complementary therapies, as the purpose of the Journal of Biomedical Therapy is to join together like-minded practitioners from around the globe.

Written permission is required to reproduce any of the enclosed material. The articles contained herein are not independently verified for accuracy or truth. They have

been provided to the Journal of Biomedical Therapy by the author and represent the thoughts, views and opinions of the article ’s author.

Left: Lower testosterone levels increase

the risk of falling in elderly men. The

age group of 65- to 70-year-olds is most

affected.

Right: Pasta or salad? For losing weight,

only the number of calories counts,

not their source.



)

W h a t E l s e I s N e w ?

Chocolate diet

for hypertension?

If you must eat sugary treats, make it

dark chocolate. A meta-analysis con-ducted by a Cologne research group

concludes that dark chocolate has

positive effects on high blood pres-

sure. The 173 study participants,

one-third of whom had hyperten-

sion, each ate a 100 g bar of dark

chocolate daily for two weeks. In

comparison to a control group, their

diastolic blood pressure decreased

by an average of 2.8 mm Hg, sys-

tolic by 4.7 mm Hg. This effect isdue to the high concentration of fla-

vonoids in dark chocolate (a 100 g

bar contains 500 mg). Flavonoids

support formation of NO, which di-

lates blood vessels.

Because of chocolate’s high sugar

and fat content, the “chocolate diet”

is definitely not the hypertension

therapy of the future. Nonetheless,

chocolate is a “healthier” alternative

to other sweets.

Arch Intern Med 2007;167:626

Breastfeeding has no effect

on later weight

Until recently, the assumption has

been that babies breastfed for a min-imum of 6 months are less likely to

be overweight as adults, but a re-

view of relevant studies was incon-

clusive, with different studies re-

porting different conclusions. An

analysis of the “Nurses Health

Study,” in which over 35,000 nurses

participated, was designed to pro-

vide more conclusive information.

The women’s weight and height

were documented and their motherswere interviewed about their nutri-

tion as infants. This analysis, the

most detailed and comprehensive

on the subject to date, showed no

relationship between breastfeeding/

bottlefeeding in infancy and body

weight in adulthood.

Int J Obesity advance online publication

24 April 2007; doi: 10.1038/sj.

ijo.0803622

IAH course

on homotoxicology

As of July 1, 2007, the International

Academy for Homotoxicology(IAH), a provider of educational pro-

grams on homotoxicology, is offer-

ing an e-learning course on basic

homotoxicology and antihomotoxic

therapy. This abbreviated course is

open to MDs and licensed practitio-

ners worldwide. Upon completing

the course and passing an online ex-

amination, participants are issued an

IAH certificate in Basic Homotoxi-

cology and Antihomotoxic Therapy.The course is offered free of charge,

and students can prepare for the

exam at their own pace. The text-

book for the course comprises twen-

ty complete lectures in PDF format,

which can be downloaded and prin-

ted. Diagrams and illustrations are

clear and informative, and the con-

tent – compiled by the world’s fore-

most experts in homotoxicology – is

presented in basic medical terminol-

ogy that is easy to understand.

IAH’s abbreviated course is the op-

portunity to discover the science be-

hind homotoxicology and to learn

to use antihomotoxic therapy effec-

tively in your practice. The course is

available on the Internet at www.

iah-online.com|

) 11

Dark chocolate reduces high blood pres-

sure but is not recommended for long-

term treatment due to its high sugar

and fat content.

Contrary to popular opinion, breast-

feeding does not reduce an infant’s riskof becoming obese in adulthood.



A Biotherapeutic Approachto Common Sports Injuries

By Dalius Barkauskas, MD

Head physician of the Lithuanian Olympic team

1 Anterior Knee Pain

Syndrome

This syndrome includes a number of

conditions that can cause aches andpains related to the kneecap (patel-

lo-femoral pain syndrome). These

conditions are common among ath-

letes, especially runners (probably

because running is the most frequent

form of exercise for the majority of

people). Over 40% of injuries relat-

ed to running involve the knee, and

for this reason the syndrome is

sometimes referred to as “runner’s

knee.”Clinical manifestations include pain

and sometimes swelling, especially

during running and especially on

the under-surface of the kneecap.

Fluid may accumulate, causing swell-

ing of the knee. If the kneecap is out

of alignment, any vigorous activity

can cause excessive stress with wear

and tear on both the cartilage of the

patella and the underlying bone,

along with irritation of the joint lin-

ing. At first only downhill running

is painful, but later all running and

eventually even other leg move-

ments, like walking down steps, will

cause pain. Ultimately, pain is pres-

ent even at rest.

Diagnosis:

Medical history, physical examina-tion, and diagnostic tests (X-ray, CT,

MRI, or blood tests) may be neces-

sary to make a final diagnosis.

Treatment

(biotherapeutic approach):

• RICE (Rest – Ice –

Compression – Elevation)

• Biotherapeutics (please refer

to the Table of “Suggested

biotherapeutic medications”)

2 Epicondylitis

(lateral epicondylitis or tennis elbow ;

medial epicondylitis or golfer’s elbow )

Epicondylitis is a painful inflamma-tory condition of the muscles and

tendons of the forearm that attach to

the elbow (epicondyle). It is termed

lateral epicondylitis (tennis elbow )

if it involves the lateral muscles/

tendons (extensors) and medial

epicondylitis ( golfer’s elbow ) if the

inflammation involves the flexor

muscles and their tendons.

Etiopathogenesis: In epicondylitis,inflammation of the extensor or

flexor muscle/tendon is secondary

to overuse or overstressing from ath-

letic or professional activities that

require repetitive, forceful forearm

supination and/or pronation of the

muscles and tendons that originate

at the epicondyle.

In time, if the situation is not cor-

rected, the condition will result in

sub-periosteal hemorrhages, calcifi-

cations, spur formation, and – ulti-

mately – tendon degeneration.

Treatment


see Table of “Suggested biothera-

peutic medications”

)

P r a c t i c a l P r o t o c o l s

12

More than 40 percent of injuriesrelated to running involve the knee

joint.


13/28

)

P r a c t i c a l P r o t o c o l s

) 13


Anterior Knee Epicondylitis Shoulder Injuries

Pain Syndrome

Primary tissues Cartilage Tendons Ligaments

Involved tissues Synovial lining Tendons/muscles

Biotherapeutic Traumeel Traumeel Traumeel

medications + + +

Choose from drops, Zeel Coenzyme Kalmia

tablets, ointments, + compositum compositum

or injection solu- Cartilago + +

tions according to suis-Injeel Kalmia Ferrum-

clinical conditions & compositum Homaccord

patient compliance. + +

(More than one form Ferrum- Lymphomyosot

may be used if avail- Homaccord

able – e.g., Traumeel + +

may be administered For chronic In cases of chronic

both topically and conditions with weakness of

via biopuncture.) scar formation, connective tissue,

add: add:

Graphites- Silicea-Injeel

Homaccord or

Thyreoidea

compositum

Table: Suggested biotherapeutic medications

The shoulder is a very complicated joint,

and the treatment of shoulder injuries

is equally complex.

3 Common Shoulder Injuries

Because the shoulder has the great-

est range of motion of any joint in

the body, it must balance strength,flexibility, and stability. This balance

can be maintained through exercises

aimed at stretching and strengthen-

ing the supporting structures to

avoid pain and injuries during spe-

cific activities. Problems are gener-

ally due to overuse, which loosens

the rotator cuff – the group of mus-

cles and ligaments/tendons that sur-

round the shoulder joint. About

20% of sports injuries involve theshoulder.

Many sports entail the risk of inju-

ries to the structures forming the

pectoral girdle (the three shoulder

bones – clavicle, scapula, and hu-

merus – along with their respective

supporting ligaments and tendons).

Shoulder injuries include rotator

cuff injuries, subluxation/dislo-

cation, acromion-clavicular sep-

aration, clavicle fractures, etc.

Diagnosis: Proper medical evalua-

tion must be performed by qualified

health care professionals, with refer-

rals if necessary.

Treatment


• RICE

• Adjunct biotherapeutics(see Table of “Suggested

biotherapeutic medications”)

• Surgical repair may be necessary|


14/28

)

A r o u n d t h e G l o b e

“… Hakkin Hill almost killed me!”

A report on the 2007

Traumeel Wally Hayward Marathon By Fanie Blignaut

During that same year in Europe,

a young, newly qualified doc-

tor – Hans-Heinrich Reckeweg –started his medical career in the

Harburg district of Hamburg, Ger-

many. In 1932 he moved to Berlin,

where he worked in a “Wohlfahrts-

praxis” ( pro bono practice) for the

poorest of the poor.

From such humble beginnings, these

two individuals would continue

their different paths into life to be-

come legends in the true sense of

the word:

• Wally Hayward as “the greatest

long-distance runner of all times,” as

he was hailed by Fleet Street jour-

nalists in 1953, when he broke ev-

ery world record for events above

the marathon distance. He repre-

sented South Africa in the Olympic

Games and became a Championshipmedalist and an inspiration to many

thousands of road runners in South

Africa. Wally Hayward passed away

on April 28, 2006, at the age of

97.

• Hans-Heinrich Reckeweg as the

“father of homotoxicology,” a lead-

ing researcher in the field of antiho-

motoxic medicine and the founder

of Heel GmbH. He is remembered

by thousands of medical practitio-

ners for his stated life’s dream –

“One day I will build a bridge be-

tween homeopathy and conventional

medicine.” Hans-Heinrich Recke-

weg passed away in 1985.

Even though these two legends nev-

er had the opportunity to meet each

other, their worlds finally came to-

gether on May 1, 2007. At exactly

6:30 that morning, a single shotfrom the starter’s gun heralded the

start of the “First Memorial Trau-

meel Wally Hayward Marathon,”

and 7000 athletes entered a new era

in road running in South Africa.

Top marathon event

in South Africa

The Wally Hayward Marathon has

been run for the last 30 years and iswidely regarded as one of the top

three marathon events in South Af-

rica. The great Wally personally at-

tended the race every year until his

death in 2006. The year 2007 saw

two major changes in the event:

From now on, it will be billed as a

“memorial race,” and it will be

known as the “Traumeel Wally Hay-

ward Marathon.”

The route follows the tree lined

streets of Centurion, a municipality

just outside Pretoria. Centurion has

often been called “a park within a

city” because of its beautiful natural

14


This year, one of South Africa’s most

popular road races was renamed the“Traumeel Wally Hayward Marathon.”

In 1930, a 21-year-old South African athlete – Wallace

(“Wally”) Henry Hayward – won his first Comrades Marathon,

a race run over a distance of 96 km between the two cities

of Durban and Pietermaritzburg in South Africa. He wore

“takkies” (shoes used for playing tennis in the 1930’s) stuffed

with pages from an old telephone directory because they were

too big for him and he could not afford new ones.


15/28

)


environment. The course is fairly flat

with a few mild hills – that is till the

tired runners reach “Hakkin Hill”

during the last kilometer of the race.

This hill is a real “killer” and has be-come quite notorious among partic-

ipants. Asked what they think of the

race, most runners will comment,

“Water points were excellent, orga-

nization was good, beautiful route

– but Hakkin Hill almost killed

me!”

This year also saw the introduction

of the Traumeel Wally Hayward

Championship Blazer. It has been

decided that the male and femalechampions would receive a champi-

onship blazer (as in most major golf

events, such as the American Mas-

ters) with a gold embroidered “Trau-

meel Wally Hayward” badge. This

tradition will continue in the years

to come and will commemorate

Wally Hayward’s life and his contri-

bution to road running in South Af-

rica.

People from all walks of life

The 2007 race was run in pleasant,

sunny conditions. First place win-

ners were Joseph Mphuthi in the

men’s division with a relatively slow

time of 2:29:02 and Judy Bird in the

women’s division with 3:00:21. Al-

though the race is primarily a 42.2

km marathon, it also offers 21.1,10, and 5 km races and a 1 km fun

run for children. This year, the par-

ticipants ranged in age from 3 years

(1 km fun run) to 83 years. The race

is designed as a community event

that draws the citizens of Centurion

to the Zwartkop Hoërskool, where

the race starts and finishes. There are

stalls selling traditional South Afri-

can food – boerewors rolls and jaf-

fles – as well as all the more familiardelicacies such as hotdogs and ham-

burgers. All in all, it ’s a festive gath-

ering of people from all walks of life

– runners, spectators, and visitors.

Face to face with

the medical experts

The Traumeel Wally Hayward Mar-

athon also has a serious side. The

importance of “sensible participa-

tion in sport” is emphasized by in-

volving health practitioners (ho-

meopaths), chiropractors, and

physiotherapists on the race day.

Athletes are informed about the

dangers of popular pain killers used

on long runs, the need for good

stretching programs, and the advan-

tages of using Traumeel regularly

during training. Physiotherapistsand chiropractors use Traumeel ex-

clusively at their treatment stations.

The First Memorial Traumeel Wally

Hayward Marathon was a great suc-

cess. Participant feedback – as re-

corded by the SA Runner Magazine

– clearly indicates that it will remain

one of the most popular marathon

and social events of the running

community in South Africa. As one

athlete explained, “If you don’t runthe Wally, you don’t run at all!”|

Although the Traumeel Wally Hayward Marathon of 2007 already attracted some international athletes (mostly from

neighboring African countries), the organizers plan to launch a marketing drive to attract more athletes from otherparts of the world. Runners from Germany have already expressed interest in participating in the 2008 event. For

more information about the race, e-mail Fanie Blignaut at [email protected]. ) 15


Winners of the

42.2 km run

received gold-

embroidered

championship

blazers.

Physical therapists

and chiropractors

cared for the

runners before,

during, and after

the race.


16/28

16


)

Re f r e s h Y o u r H o m o t o x i c o l o g y

Is Inammation after Injury All Bad?

By Alta A. Smit, MD

Tissue healing after injury is acomplex process that aims toreplace damaged tissues and return

them to a pre-injured state. Acute

inflammatory reactions are charac-terized by rapidly resolving vascular

permeability, edema, neutrophil and

macrophage infiltration and T lym-

phocyte migration, and – ultimately

– resolution into healthy tissue. In

contrast, when an inflammatory pro-

cess becomes chronic, we see a pic-

ture of chronic tissue destruction

and fibrosis.1

The modern view of inflammation,

therefore, is that acute inflammation(if not too robust) is beneficial,

whereas chronic inflammation is

detrimental.2 This is in keeping with

the concept of disease evolution as

postulated by Reckeweg and seen in

the Disease Evolution Table (six-

phase table). We find acute inflam-

mation in the 2nd phase of the table

and degeneration in the 5th phase.

Most 5th phase degenerative dis-

eases have a common denominator,

namely, chronic inflammation that

leads to tissue destruction and fibro-

sis.3 The result is organ damage and

sometimes death.

Typically, inflammation is a Th1 re-

sponse driven by pro-inflammatory

cytokines such as IL-1, TNF-α, and

IL-6. Although other mechanismsare also involved, fibrosis is primar-

ily a Th2 response.4 It is therefore

important to restore the normal

physiological balance between these

two processes.

The aim of any therapy for injury

should thus be to “subdue” inflam-

mation to a level adequate to pro-

duce degeneration of damaged tis-

sue yet permitting normal tissue

remodelling. Especially in athletes,

it is important to achieve normal re-

pair of connective tissue, as fibrotic

tissue is less elastic and is thus sus-

ceptible to re-injury and tends to

impair performance.

Furthermore, chronic recurrent in-flammation has been implicated in

the development of overtraining

syndrome in elite athletes, due to

the neurological effects of pro-

inflammatory cytokines.5, 6 Conse-

quently, total suppression of inflam-

mation after injury is not the best

strategy.

Although not proven in clinical tri-

als, NSAIDs have long been suspect-

ed of interfering with tissue healingif administered after injuries such as

fractures, and many authors urge

caution, especially in certain patient

groups.7 Corticosteroids, which are

known to interfere with the remod-

elling process, should be used spar-

ingly, if at all, in the acute phase of

injury and should actually also be

avoided in chronic inflammation.4

Key words:

Acute inflammation, repair,

chronic inflammation,

fibrosis, immune regulation,Traumeel


17/28

) 17


)

Re f r e s h Y o u r H o m o t o x i c o l o g y

Immune regulation

How, then, can a balance between

inflammation and repair be achieved

in acute injury? As always in com-plex systems, interfering with just

one aspect is unwise because it may

negate normal feedback mechanisms

and interactions, as is the case

with nonsteroidal anti-inflammatory

agents. Apart from increasing the

risk of adverse events, full suppres-

sion of inflammation is not desirable

because a certain level of inflamma-

tion (as we saw above) is needed to

eliminate degraded tissue.This delicate balance can be achieved

through immune regulation. The

hallmark of any biological regula-

tion therapy is that it acts on multi-

ple points in the process and sup-

ports the body’s own mechanisms

for achieving resolution. The com-

bination product Traumeel is one

such inflammation-regulating medi-

cation.

Traumeel has a long history of use,

and a great deal of empirical evi-

dence attests to its effectiveness and

tolerability. Increasingly, however,

research is discovering a mosaic of

therapeutic effects for this product.

Basic research has already indicatedtwo or three possible mechanisms of

action:

• Induction of T regulatory cells

via the low concentration of

plant materials in the product8

• Down-regulation of pro-inam-

matory cytokines such as IL-1,

TNF-α and IL-89

• Perhaps also the action of helen-

alin (a sesquiterpene lactone gly-

coside contained in arnica),which has been shown to modu-

late NF-κB, a nuclear transcrip-

tion factor in the inflammatory

cascade

There is also an increasingly strong

clinical evidence base for Traumeel,

especially in sports injury and or-

thopedic surgery.10-13 This product

should be considered for its im-

mune-regulating properties, which

permit some degree of inflammation

while simultaneously promoting re-

pair.|

References:

1. Wynn TA. Common and unique mechanisms

regulate fibrosis in various fibroproliferative

diseases. J Clin Invest 2007;117(3):524-9.

2. Stramer BM, Mori R, Martin P. The inflam-

mation-fibrosis link? A Jekyll and Hyde rolefor blood cells during wound repair. J Invest

Dermatol 2007;127(5):1009-17.

3. Van Brandt B. The Disease Evolution Table.

Journal of Biomedical Therapy 2007;

Spring:13-5.

4. Meneghin A, Hogaboam CM. Infectious dis-

ease, the innate immune response, and fibro-

sis. J Clin Invest 2007;117(3):530-8.

5. Smith LL. Tissue trauma: the underlying

cause of overtraining syndrome? J Strength

Cond Res 2004;18(1):185-93.

6. Suzuki K, Nakaji S, Yamada M, Totsuka M,

Sato K, Sugawara K. Systemic inflammatory

response to exhaustive exercise. Cytokine ki-

netics. Exerc Immunol Rev 2002;8:6-48.7. Clarke S, Lecky F. Do non-steroidal anti-in-

flammatory drugs cause a delay in fracture

healing? Emerg Med J 2005;22:652-3.

8. Heine H, Schmolz M. Induction of the im-

munological bystander reaction by plant ex-

tracts. Biomedical Therapy 1998;16(3):224-

6.

9. Porozov S, Cahalon L, Weiser M, Branski D,

Lider O, Oberbaum M. Inhibition of IL-1β

and TNF-α secretion from resting and acti-

vated human immunocytes by the homeo-

pathic medication Traumeel® S. Clin Dev

Immunol 2004;11(2):143-9.

10. Zell J, Connert W-D, Mau J et al. Treatment

of acute sprains of the ankle. BiologicalTherapy 1989;7(1):1-6.

11. Singer SR, Amit-Kohn M, Weiss S, Rosen-

blum J, Lukasiewicz E, Itzchaki M, Ober-

baum M. Efficacy of a homeopathic prepara-

tion in control of post-operative pain – A

pilot clinical trial. Acute Pain 2007;9(1):7-

12.

12. Birnesser H, Oberbaum M, Klein P, Weiser

M. The homeopathic preparation Traumeel S

compared with NSAIDs for symptomatic

treatment of epicondylitis. Journal of Muscu-

loskeletal Research 2004;8(2-3):119-28.

13. Schneider C, Klein P, Stolt P, Oberbaum M.

A homeopathic ointment preparation com-

pared with 1% diclofenac gel for acute symp-

tomatic treatment of tendinopathy. Explore

2005;1(6):446-52.

Disease Evolution Table: Acute

inammation occurs in the 2nd phase of Dr. Reckeweg’s concept of

disease evolution; chronic inamma-

tion belongs to the 5th phase

(degeneration).


18/28

18


)

M a r k e t i n g Yo u r P r a c t i c e

How Efcient IsYour Practice Marketing?

Successful strategies for healthcare practitioners

By Marc Deschler

Marketing specialist

The Test

Managing a business or a practice

isn’t difficult if you factor in a few

basic principles such as: common

sense; setting long-term goals and

sticking to them; patience, consis-

tency, and perseverance; recogniz-

ing connections; self-motivated in-

novation; good planning and

implementation; and – last but not

least – enjoying your work. Often,

however, we fail to consider these

things because they’re too simple

and basic. Put yourself to the test by

checking the statements that best

apply to you.

1. Defining goals

(2) I make short-term plans be-

cause the healthcare market is so

fluid. I want to avoid pinning myself

down and becoming unable to re-

spond rapidly to changing situations

in public health policy.

(4) I plan for the medium term. I

always leave the door open by try-

ing to anticipate new developments

(e.g., an employee leaving or a com-

peting practice opening) and to re-

spond adequately.

(6) I plan for the long term.

Short-term and long-term goals

must be related. One crucial ques-

tion, “Where will this practice be in

five years?” is always part of my stra-

tegic planning. I observe policy de-

velopments closely, and I consider

how my position in the market may

change: Will a new, competing prac-

tice appear in town? Does a newbusiness nearby mean an opportu-

nity for more patients?

Marketing is certainly a subject many of us don’t view as essential. For you as a therapist,

marketing could be defined as organizing your practice in ways that bring in more patients,

either through advertising or by being more focused in your efforts. This sounds complicated,

but it simply means building patient loyalty and improving your outreach and/or the organiza-

tion of your practice. Many practitioners are already effectively marketing their practices on a

purely intuitive level. With this column, however, we hope to stimulate your thinking in ways

that may help you improve your everyday work and increase your success. We’ll start the series

with a brief test of your own marketing status.


19/28

) 19


)

M a r k e t i n g Yo u r P r a c t i c e

2. Marketing to patients

(2) It is very difficult for health-

care practices to influence patients

or to attract new patients in the waysthat other businesses use to draw in

customers. Especially in tough eco-

nomic times, we need to be able to

rely on our regular patients and try

to limit our losses.

(4) Marketing to patients is

somewhat important to me. I try to

provide what my patients want, and

friendly interactions with them are

my top priority.

(6) I am intent on providing thegreatest possible benefits to my pa-

tients, including intangible benefits.

Human relationships, credibility, en-

thusiasm, image, service, and enthu-

siastic customers are top priorities in

my practice. Sound marketing is one

of the few areas we still have any

control over. When planning mar-

keting events such as patient semi-

nars, I factor in all the information

(age distribution, catchment area,

etc.) I have in my database, and I

seek competent advice if I need it.

3. Reorganizing and implement-

ing new strategies

(2) I respond meticulously to

changing situations (decreasing

numbers of patients, an employee’s

resignation). Of course it’s difficultto be active on multiple fronts at the

same time, but the complexity of my

practice demands it.

(4) I am receptive to innovations

(e.g., new trends in therapy, new di-

agnostic procedures) and glad to

implement them in my practice. For

me, organizing my practice meansdeveloping detailed plans so I can

achieve all my long-term goals.

(6) Doing nothing means falling

behind. In my practice, I encourage

both internal and external innova-

tion. When reorientation is needed

(for example, adding targeted coun-

seling to increase the efficacy of

treatment), I prefer to tackle a few

objectives thoroughly and monitor

the results (“What has this accom-plished?”) before taking other ac-

tions. I have patience when imple-

menting such plans.

Scoring

Add up the number of points you

checked and compare them to this

scale:

6-10 points: In changing situations

(policy shifts, more stringent legisla-

tion, more demanding patients),

clinging to old habits is not desir-

able. If you continue to “shoot from

the hip,” you’ll lose track of your

truly important goals. You’ll proba-

bly give up on good solutions pre-

maturely because you can’t wait for

them to be effective. Be patient!

12-14 points: Planning for the

medium term and focusing on mar-

keting and innovations are definitely

the right way to go, but long-term

goals are essential to long-term suc-cess. Look for simple steps you can

actually take toward these goals.

Don’t assume that your problems

have complex causes and require

equally complicated solutions.

16-18 points: Your practice is

guided by commonsense and you

establish long-term goals for your-

self. Instead of wasting your pa-

tience and perseverance on attemptsto treat the symptoms of an ailing

healthcare system, you focus on your

own innovations and progress. Your

efforts to provide maximum benefits

for your patients have taught you

that an average plan, well imple-

mented, is worth more than a poorly

implemented masterpiece.

A concluding comment

I find it important to do just a few

things right rather than attempting

to do everything at once. In the end,

the most important thing is the en-

joyment and satisfaction you find in

your work, although sometimes that

too is hard to achieve. You may not

have been dealt the hand you’d like,

but you can make the best of what

you have.|

Evaluating your marketing activities will

help you provide better service to your

patients and ultimately increase the

success of your enterprise.


20/28

)

S p e c i a l i z e d A p p l i c a t i o n s

In general, Traumeel is injected for

acute inflammation and Zeel forchronic joint pain. Spascupreel is

used in muscle spasms and Lympho-

myosot for swelling and inflamma-

tion. Several of these products may

be combined in a cocktail, and a lo-

cal anesthetic such as procaine 1%

or lidocaine 0.5% can also be add-

ed.

Subcutaneous injections

Subcutaneous (s.c.) injections are ad-

ministered when deeper injections

are impossible for technical or prac-

tical reasons. For example, instead

of injecting medication into small

joints such as the temporomandibu-

lar joint or finger joints, biopunctur-

ists first start with subcutaneous

injections into the pain zone. Subcu-

taneous injections may also be

administered for sports injuries

– for example, when cutaneo-

muscular reflexes are used to

influence deeper layers.

Biopuncture and the Treatmentof Sports Injuries

By Jan Kersschot, MD

“Biopuncture” is the term used to describe the injection of

biotherapeutics in specific spots or areas. Biotherapeutics such

as Traumeel, Lymphomyosot, Spascupreel, and Zeel contain

low doses of natural ingredients, and the ampoule forms are

specially designed for injection. In general, these products are

injected either subcutaneously or into muscles, tendons, or

ligaments.

20

Journal of Biomedical

Fig. 1: Lateral band injury in

the right ankle (basketball player)

Case study:

A basketball player (age 25) hadbeen in pain for three days after in-

juring her right ankle during a club

competition. She had difficulty

walking and the ankle was swollen,

especially laterally. An ultrasound

showed signs of swelling and lateral

band injury.

I suggested using local subcutane-

ous injections to stimulate healing.

In each session, about 1.5 ml of a

mixture of Traumeel (2 ml), Lym-

phomyosot (1 ml), and lidocaine

0.5% (3 ml) was administered by s.c.

injection into each of four spots

(Figure 1). She also applied Trau-

meel ointment to the ankle and took

Traumeel tablets. After two sessions

(one week apart), she noted about

80 percent improvement. She had

no further trouble playing basket-

ball.


21/28

) 21

Intramuscular injections

When treating athletes with minor

orthopedic complaints, biopunctur-

ists focus heavily on the muscular

system. Patients may suffer from

pain in affected muscles and com-

plain about weakness in those mus-

cles. During examination, certain

areas or spots may be very tender on

palpation. Such points are called

myofascial pain points (MPPs). Some

of these points (called myofascial trig-

ger points , or MTPs, in biopuncture)

also trigger pain elsewhere in the

body. For example, a patient pre-

senting with heel pain may be expe-

riencing pain referred from MTPs in

the calf muscle, so the injection will

be administered into the calf muscle.

Referred pain on the side of the leg

may be due to MTPs in the gluteus

minimus muscle. In biopuncture,these MPPs and MTPs are injected

with Spascupreel, Traumeel, or

Zeel.

Case study:

A tennis player (age 53) had pain in

the right knee for six months. It was

worse after playing tennis. X-rays

revealed arthritis in both knees, es-pecially on the right side; ultra-

sounds were normal. An NSAID

prescribed by his doctor gave quick

relief but had to be discontinued

due to gastric pain.

During his initial visit, the patient

pointed out the painful area (the

right patellar region). On clinical

examination, however, I discovered

several trigger points in the right

quadriceps muscle (above the area ofpain) and injected a mixture of Zeel

(2 ml), Spascupreel (1 ml), and pro-

caine 1% (2 ml) into those MTPs at

a depth of 1 to 2 cm. The patient

received three injections at each of

the weekly sessions (Figure 2). After

the first session, he complained

about increased pain and discom-

fort. I explained that this was simply

a reaction phase; it meant that the

medications had started to work. He

experienced great improvement af-

ter three sessions and achieved com-

plete and lasting relief after seven

sessions.

Case study:

A woman (age 30) had experienced

pain in the right groin for three

months, especially while running

(800 m). When NSAIDs didn’t help,she decided to try biopuncture. Ini-

tially, I injected Traumeel (s.c.) into

the pain zone on a weekly basis.

When these local subcutaneous in-

jections failed to produce results, I

looked for myofascial trigger points

(MTPs) and found several in the ad-

ductor longus muscle. These spots

were injected with Traumeel at a

depth of about 2 to 3 cm (Figure 3).

The patient experienced more than50 percent improvement after the

first set of injections into the MTPs

(without injecting the groin) and

achieved permanent relief after three

weekly sessions of injections into

the same trigger points.


)


Fig. 3: Pain in

the right groin

(runner)

Fig. 2: Arthritis

in the right knee

(tennis player)


22/28

Injections into ligaments

Ligaments are often injured by trau-

ma, especially when no bones are

broken. Because the blood supply toligaments is limited, recovery is usu-

ally slow; incomplete healing is not

uncommon. Moreover, due to the

fact that ligaments have many nerve

endings, especially at their points of

attachment to the periosteum, liga-

ment damage is quite painful, and

the damaged areas, called ligamen-

tous pain points (LPPs), are tender

when palpated. Again, referred pain

may occur farther from the injurydue to ligamentous trigger points

(LTPs).

Local injections are administered

into the painful spots, close to the

attachment to the bone. Traumeel is

the medication of choice; local anes-

thetics and hypertonic sugar water

(glucose 20%) may be added.

22


Case study:

A 29-year-old professional football

(soccer) player was experiencing

chronic neck pain that had begun

two years earlier when he collidedwith another player on the field. X-

rays and CT scan were normal, but

on clinical examination, palpation

caused significant tenderness along

the nuchal ligament on the midline

of the neck. I injected four pain

points (LPPs) with a mixture of

Traumeel (2 ml), hypertonic sugar

(2 ml of glucose 20%), and 2 ml

lidocaine 1% on a weekly basis (Fig-

ure 4). After five weekly sessions,the patient was symptom-free.

Conclusion

Increasingly, sports medicine spe-

cialists are seeking alternatives to

cortisone injections. Athletes arealso becoming interested in medica-

tions that are safe and not on any

banned substance lists. The time is

right for physicians to discover the

benefits of biopuncture, and work-

shops that include demonstrations

of injection techniques on actual pa-

tients are a good introduction. Inter-

ested physicians are usually sur-

prised and pleased to discover how

easy and accessible this approach isand how safe and beneficial it can

be for their athletes.|

For more information,

please visit

www.kersschot.com

Fig. 4: Chronic neck pain after

collision with another player

(football/soccer player)

)



23/28

Reference:

Alejandro Orizola, MD

Oral Presentation: The efficacy of Traumeel ver-

sus diclofenac and placebo ointment in tendinous

pain in elite athletes: a double-blind randomized

controlled trial.

World Congress 2007

Society for Tennis Medicine

and Science

16 & 17 February 2007

Antwerp, Belgium

Antwerp, February 16, 2007.

The homeopathic combination pro-

duct Traumeel is an effective alter-

native to diclofenac ointment for

topical therapy of acute, non-trau-matic tendinopathies, according to a

recent three-armed, placebo-control-

led, double-blind, and randomized

study of 252 competitive athletes.

The study was conducted from De-

cember 2005 to September 2006

by Dr. Alejandro Orizola, an ortho-

pedist at the University of Chile

Clinic in Santiago de Chile. The

findings of the study were recently

presented at the World Congress ofthe Society for Tennis Medicine and

Science in Antwerp, Belgium, with

more than 200 participants from all

over the world.

Tendon inflammation

due to repetitive stress

The athletes recruited included

members of the Chilean Davis Cup

team and professional soccer league,

who were suffering from various

tendinopathies. 89 of the athletes

were treated with Traumeel oint-

ment and 87 with diclofenac oint-

ment, while the rest received a pla-

cebo. In each group, the ointment

was applied three times a day; in ad-

dition, an ointment dressing was ap-

plied overnight. Sonograms taken at

commencement of therapy and after

21 days of treatment revealed chan-

ges in tendon diameter and edema

in the affected areas. In addition, theathletes were questioned about their

subjective perception of symptoms.

More effective than diclofenac

Significantly greater improvement

in sonographic findings and subjec-

tive symptoms was noted under

therapy with either diclofenac or

Traumeel than in the placebo group.

The homeopathic combinationproved superior to the allopathic

product in all parameters surveyed.

As a result, the athletes treated with

Traumeel were able to resume train-

ing after an average of 20.3 days, in

comparison to 24.6 days for the di-

clofenac group and 30.6 days for

the placebo group. The homeopath-

ic product also performed very well

with regard to tolerability. No ad-

verse effects appeared in the Trau-

meel group, but allergic skin reac-

tions forced four of the athletes

treated with diclofenac to terminate

therapy. In conclusion, Orizola de-

scribes the homeopathic combina-

tion Traumeel as a safe and effective

alternative to diclofenac in treating

non-traumatic tendinopathies.|

)

R e s e a r c h H i g h l i g h t s

) 23


Fast-acting, Safe, Effective –Study Conrms Traumeel Effective

for Tendinopathies

Dr. Alejandro Orizola



)

M a k i n g o f . . .

. . . Traumeel: How Does the OintmentGet into the Tube?

By Sven Schäffer, PhD

24

It’s a familiar scenario for every active person: You overdo it

and end up with sore muscles, or a hard hit produces a painful

bruise. Perhaps you apply Traumeel ointment to the affected

area to aid and accelerate healing. But have you ever won-

dered how that ointment gets into the tube?

The active ingredients are rst diluted

and succussed (right); the Becomix

mixer then incorporates them intothe ointment base (left).


25/28

) 25


) 25

First of all, the ointment containsfourteen active ingredients.Twelve are extracts of well-known

medicinal plants such as arnica, ca-

lendula, and chamomile. They comein liquid form, as so-called mother

tinctures. The remaining two ingre-

dients are mineral salts, supplied in

powder form.

When an order for Traumeel oint-

ment is received, those twelve moth-

er tinctures and two mineral salts

are transferred from the warehouse

to the production facilities, where

each liquid ingredient is diluted and

succussed (shaken) separately to therequired dilution or “potency.” The

two solid ingredients are first triturat-

ed (pulverized) with lactose and then

diluted and succussed with ethanol.

Collectively, these processes are

known as “potentization.” Once the

potentization process is completed,

the ingredients are mixed together

in specific proportions to produce

a complete solution containing the

right dilutions of all fourteen ingre-

dients. It goes without saying that

all of these steps are implemented

and documented in accordance with

GMP (“Good Manufacturing Prac-

tice”) principles.

Meanwhile, the ointment base is be-

ing prepared in a huge stirring vat.

(A typical production run is 500

kg, 17 kg of which are active in-

gredients.) A small window in thevat allows workers to check on the

progress of the mixing process. To

produce a consistently emulsified

ointment base, the fatty ingredients

(petroleum jelly and paraffin) and

the water phase must be heated sep-

arately to about 80°C before being

introduced into the vat for mixing.

Once the mixture is fully emulsified,

it is cooled to 58°C before ethanol

and the active ingredients are addedto complete the formula. The final

product is then cooled to room tem-

perature and transferred to a large

storage vessel, where it is monitored

by Quality Control before packag-

ing. All this takes about three days.

Once Quality Control has released

the ointment for packaging, the next

step is filling the tubes. The con-

tainer of ointment attaches directly

to the filling machine, which does

all the rest automatically: the open

lower end of each tube is inserted

into the machine, which has a fill-

ing rate of 50-60 tubes per minute.

After filling, each tube is crimped,

sealed, and imprinted with the lot

number and the expiration date for

post-production tracking.

Next, the package inserts are folded,

and one insert is placed alongside

each tube for insertion into the box.Optical scanning confirms the pres-

ence of the insert in each unit, and

the packages are weighed to ensure

all parts have been included. Finally,

the packages are inserted into car-

tons in bundles of five. Here, too,

each tube that has been produced is

documented to allow tracking. Now

the Traumeel ointment is ready to

be delivered to wholesalers and

pharmacies in more than 60 coun-

tries throughout the world, where

patients can purchase it to treat their

injuries.

This is how more than 2 million

tubes of Traumeel ointment are

produced in Baden-Baden each

year.|

Empty tubes

approach the lling

machine (top),

where they are …

… lled (middle) …

and inserted into

cartons along with

package inserts

(bottom).

Most of the active

ingredients in

Traumeel ointment

are derived from

medicinal herbs

such as Arnica

montana.

)

M a k i n g o f . . .


26/28

26


)


South Africa:Homotoxicology in the

“Rainbow Nation”By Rüdiger Schneider, PhD

What do we associate withSouth Africa? Table Moun-tain, Kruger National Park, the “Big

Five,” the Cape of Good Hope, and

Cape L’Agulhas, the southernmostpoint on the African continent. Yet,

South Africa is not a typically Afri-

can country. The ambiance of its

major cities and the lifestyle of ur-

ban South Africans feel distinctly

European – a fact that can be attrib-

uted to the strong influence Euro-

pean nations (Dutch, French, Ger-

man, Portuguese, and English) had

on the early history of South Africa.

The mixture of European and richindigenous cultures has resulted in

some interesting situations in this

country, affectionately known as the

“Rainbow Nation” among its citi-

zens. For example, South Africa has

no fewer than eleven official lan-

guages, which include nine tribal

languages, English, and Afrikaans –a language spoken in no other part

of the world but South Africa.

Commitment in education

and sports

Homotoxicology found its way into

South Africa as early as 1986, when

Heel was represented by a local dis-

tributor; six years later, Heel South

Africa was founded. Since that time,countless seminars and continuing

medical education programs have

been offered to support physicians

and pharmacists in treating their pa-

tients with homotoxicology. Heel

South Africa – along with Traumeel,

of course – has also been a constant

presence at major sporting events.

For the first time this year, the com-

pany is the main sponsor of the

Traumeel Wally Hayward Marathon,

historically one of the most popular

standard marathon road races in

South Africa (see the article on page

14). Another important event is the

Comrades Marathon, an annual 90

km ultra-marathon between Pieter-

maritzburg (the capital of Kwazulu-

Natal province) and the coastal city

of Durban.

Heel South Africa was one of thefirst international companies to of-

fer alternative and complementary

medicine in a country where veryfew practitioners – locally known as

“homeopaths” – specialize in home-

opathy. Tribal medicine is the most

prominent form of alternative medi-

cine and is mainly practiced by an es-

timated 400,000 traditional healers

known as “sangomas.” As education

becomes accessible to all citizens of

South Africa, health practitioners

are emerging from previously dis-

advantaged groups. This new groupof medical doctors is showing great

interest in homotoxicology.

In this vast country of roughly 46

million people, there is a critical

shortage of qualified health practi-

tioners. As a result, South African

pharmacists play a unique role in the

healthcare system: They often func-

tion as a “first-line consultant” for

conditions such as colds and flu or

minor injuries, but they also moni-

tor their patients’ blood pressure and

provide diabetic care. Antihomotox-

ic medications are often part of their

treatment protocols.

Twenty years after its introduction,

homotoxicology is firmly estab-

lished in the South African health-

care system and enjoying great pop-

ularity with patients and practitioners

alike.|

Cape Town and the famous

Table Mountain

One of the “Big Five”: elephants

in the savanna


27/28

) 27


)

C r o s s w o r d P u z z l e

Solve the puzzle and win!

Here’s how it works: Complete the

crossword puzzle and enter the let-

ters from the numbered boxes in the

blanks to make a word. Then e-mail

your solution to:

[email protected] to enter it

in our drawing before October 26,

2007. Ten lucky winners will re-

ceive copies of the book “Biological

Medicine in Orthopedics, Trauma-

tology, and Rheumatology” (Hein-

rich Hess, ed.). Please remember toinclude your complete mailing ad-

dress. Results of the drawing are fi-

nal. Good luck!


28/28

Get your certificate in

applied homotoxicology at

www.iah-online.com

N E W e-learning program

free of charge

treating sports injuries

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