treating sports injuries
TRANSCRIPT
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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
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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
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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
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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.
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)
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.
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)
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
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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
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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.
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)
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
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
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.
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)
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.
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)
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.
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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
(biotherapeutic approach):
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.
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)
P r a c t i c a l P r o t o c o l s
) 13
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
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
(biotherapeutic approach):
• RICE
• Adjunct biotherapeutics(see Table of “Suggested
biotherapeutic medications”)
• Surgical repair may be necessary|
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)
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
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
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.
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A r o u n d t h e G l o b e
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
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
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.
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Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
)
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
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)
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).
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Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
)
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.
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)
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.
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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.
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) 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.
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
)
S p e c i a l i z e d A p p l i c a t i o n s
Fig. 3: Pain in
the right groin
(runner)
Fig. 2: Arthritis
in the right knee
(tennis player)
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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
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
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)
)
S p e c i a l i z e d A p p l i c a t i o n s
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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
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
Fast-acting, Safe, Effective –Study Conrms Traumeel Effective
for Tendinopathies
Dr. Alejandro Orizola
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24/28Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
)
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).
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) 25
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
) 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 . . .
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26
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
)
A r o u n d t h e G l o b e
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
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) 27
Journal of Biomedical Therapy 2007 ) Vol. 1, No. 1
)
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!
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Get your certificate in
applied homotoxicology at
www.iah-online.com
N E W e-learning program
free of charge