The Pain & Injury Doctor ONLINE Newsletter

Here is your latest pain relief tip. If it doesn’t apply to you, still take note because life is full of surprises. If you know someone who is dealing with this type of pain, please forward this email to that person– thanks!

Chronic Ligament Pain – What to Do When a Joint Seems to Take Forever to Heal

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What is Happening:

Sometimes when you injure your ankle, wrist, knee, finger or other joint, the pain doesn’t go away entirely. A nagging soreness remains, even months later, and your joint is not fully “100%.”

The main reason why ligaments and tendon injuries take a long time to heal compared to muscle and skin injuries is that they don’t have a direct blood supply. They are comprised of a collagenous matrix secreted by special cells called fibroblasts and chondroblasts, and it takes a relatively long time to make this matrix.  This is why often when a professional athlete injures a ligament, it is usually a “season ending” injury due to the long time it takes to heal.

Sprains and strains are graded I-IV. Grade I is a minor sprain-strain, where just a few fibers are torn. Grade II sprains and strains are partial tears, where the tear doesn’t go all the way through the ligament or tendon. Grade III is a complete tear, where it separates, and Grade IV is when it comes off a bone.

If you injured a joint and it is still painful after a month, and you notice instability (the joint moves more than it should) then you likely sustained a Grade III or IV sprain-strain. It is the instability that continually stresses the rest of the joint’s ligaments and tendons and prevents complete healing. Most people get the ligament/tendon reattached surgically; some leave it alone which is not a good idea because the instability will accelerate joint degeneration (arthritis) resulting in more pain and more loss of function down the road.

If you sustained a Grade I or II strain but still feel pain, it could be that you are continually aggravating it, or on the opposite end, keeping it too immobile (bracing) causing it to atrophy and delay healing.

Another possibility of chronic ligament and tendon pain is scar tissue adhesions. When ligaments, tendons, muscle and fascia (thin covering of muscle) are injured, the body lays down scar tissue, which is less organized than normal collagen fibers and tends to bunch up and calcify. It can also stick to adjacent tendons and interfere with their movement, causing pain.

Recommended Home Therapy Products Covered in Today’s Newsletter:

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Self-Treating Chronic Ligament & Tendon Pain

If you have a severe sprain/strain causing instability (Grade III or IV) you will most likely need surgery to reconnect the torn ligament or tendon.

For the more common Grade I and II sprain/strains, (upon initial injury) rest it, ice it (20 minutes every 2 waking hours for a few days), compress/support it with tape or a brace, and try to keep it elevated to reduce edema.

For chronic sprains/strains (lasting greater than three months), do the following:

Apply a comfrey root-based ointment to your ligament daily, such as Dr. Theiss Comfrey Root Ointment, Kytta Salbe or Dr. Christopher’s Tissue and Bone Ointment:

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Dr. Theiss Comfrey Root Salve

Dr. Theiss comfrey root ointment gives remarkable results for minor sprains and strains. Comfrey root extract contains a natural substance called allantoin, which hydrates cells, helps remove dead cells and facilitates cellular regeneration in injured tissue. Good for ligament, tendon and muscle sprains and strains. Do not take internally or on open wounds, as high concentrations are toxic to the liver.

More Information

Apply red-light therapy to your ligament three times a day:

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TendLite Personal Red Light Therapy Device

Studies show that red light has therapeutic effects on human tissue, similar to how sunlight stimulates plants to produce energy (sugar) in their leaves. It stimulates cells to increase ATP (energy) production, which enhances tissue repair and regeneration and reduces inflammation.

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The TendLite device is a simple to use tool effective for common strains, sprains, joint pain and any soft tissue condition involving inflammation. It works great in conjunction with myofascial therapy and topical anti-inflammatory agents.

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Do myofascial therapy using a Myobar, before or after red light therapy:

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MyoBar Myofascial Therapy Tool

Therapists use this instrument to treat ligaments and tendons that have scar tissue adhesions, which usually develop after soft tissues experience injury. The action of this tool breaks apart scar tissue and increases blood flow, improving ligament and tendon mobility. Use right after red light therapy for best results.

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Using long strokes along the length of the tendon, press down firmly but not too hard. When you feel the small bumps of scar tissue, use shorter, quicker, firmer strokes to soften them up.

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Do resistance exercises to put a controlled load on the affected tendon. Doing this stimulates the fibroblast and chondroblast cells to make more collagen matrix in the ligament, effectively thickening and strengthening it. A 5 lb. dumbbell is good for wrist and shoulder problems; if it’s your knee or ankle ligament, use an ankle weight. Move your joint in all directions with the weight.

Alternatively, use Theraband Resistance Tubing:

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TheraBand Exercise Tubing

Theraband is what professionals use to help their patients rehabilitate joints after injury. Simply cut a 2′ section and make loops on each end. Secure one loop to an immobile object and grip the other end to exercise your joint in multiple planes.

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More Information

Take supplements for joint health. Dr. Williams Joint Advantage Gold gets my highest recommendation:

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Dr. Williams Joint Advantage Gold 5x

  • Relieves every day joint aches and pains
  • Supports healthy cartilage
  • Improves mobility and flexibility
  • Reduces inflammation

This supplement features NEM– natural eggshell membrane, which is packed with joint-supporting nutrients including glucosamine, collagen, chondroitin sulfate and hyaluronic acid. It includes research doses of bromelain and boswellia, both shown to help improve joint function and reduce stiffness, as well as other potent herbs.

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Lastly, magnetic therapy may be helpful in enhancing tissue healing. While the mechanism isn’t entirely clear, the belief is that by applying a weak magnetic field over an injured area, it balances the “disruption” in the body’s electrical field that is emanated by injured cells, enabling faster healing.

Since it can do no harm, there is no harm in giving it a try.  I have had patients use magnetic bracelets and beads who reported a noticeable difference in their pain (although admittedly, it could be a placebo effect).

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Magnetic Therapy Set

  • Magnet therapy wraps for key areas of the body: wrist, elbow, neck, knee, ankle, back and head.
  • Contains a total of 28 magnets for deep penetrating magnet therapy.
  • Size Large/X-Large fits waist up to 50″(127 cm)

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More Information

Other Helpful Tips:

1. Avoid smoking (if you do). Smoking interferes with healing of any kind.

2. Eat bone broth soup weekly, made with animal joints, and eat all the cartilage and tendons as well. This provides building blocks for connective tissue.

3. Make sure to include onions, garlic and shallots in your diet. Alliums are high in sulfur, which is needed for protein (collagen) synthesis.

BOTTOM LINE:  It is not uncommon for joint sprain/strain injuries to linger for months. This includes ankle, knee, shoulder, elbow and wrist and finger injuries. The key is to “re-ignite” your body’s healing mechanisms using the techniques mentioned so that your body can finish the job.

These are some of the products I recommend to patients complaining of chronic, lingering joint sprains/strains. Most patients report good to great results; therefore, you have a very good chance of experiencing the same! ~Dr. Perez

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For more detailed, step-by-step guidance on permanently resolving chronic muscle and joint pain, visit

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The information contained in this email and on www.PainandInjuryDoctor.com is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as a medical directive. It is provided as a sharing of knowledge and information from the research and experience of Dan Perez, D.C. Every person is unique, and individual cases of pain are therefore unique. Dr. Perez encourages readers of PainandInjuryDoctor.com to use available sources of information to help them make a more educated and informed decision regarding their health, in partnership with one or more qualified health care professionals.

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