A tennis player on the Senior Circuit in the Los Angeles metropolitan area, with shoulder pain, consulted Dennis Lox M.D., for shoulder Regenerative Medicine and Stem Cell Therapy Options at his Beverly Hills, California office.
Shoulder Problems in Tennis Players
A few common shoulder problems that occur in tennis players are:
Tennis players are clustered in warm weather states such as Florida and California to take advantage of year long playing capability. Both Florida and Southern California be it the major metropolitan or areas of San Diego or LA (Los Angeles), or South Florida, Tampa Bay, Sarasota, or Orlando, all have great tennis and golf weather. Whether the Tennis player serves right or left has some importance to their pain complaint. Dominant arms serve overhead placing great stress on the rotator cuff tendons, specifically the supraspinatus. The supraspinatus muscle is responsible for initiating arm elevation, and is at its weakest point with the arm elevated to 90 degrees (shoulder height), and external rotated above the head. This places the supraspinatus tendon (one of the four rotator cuff muscles), against the overlying acromio–clavicluclar (AC) joint. This is know frequently as a cause of shoulder pain. The AC joint often downslopes or points down from genetics or bone spurs of overuse. This leads to the development of impingement syndrome from repetitive overhead shoulder work such as serving or smashing the ball. Impingement of the rotator cuff, scarring known as tendinosis, or overt rotator cuff tears can occur. Lastly, the underlying the rotator cuff is the glenoid labrum, a cartilagagenous covering of the humeral head. Damage or wear to the rotator cuff can lead to wear of the glenoid labrum or frank labral tears. When all surfaces have been involved the bones show wear the glenoid rim and humerus head, known as gleno-humeral arthritis.
Dennis M.Lox MD. An expert in Sports and Regenerative Medicine practices in the Tampa Bay, Florida area, and in Beverly Hills, California.
Metropolitan Area, Florida (727) 462-5582
Metropolitan Area, Beverly Hills, California (310) 975-7033
Knee AVN or Avascular Necrosis from Lupus is less common than AVN of the hip, however patients do consult and discuss Regenerative Medicine and Stem Cell Therapy for Knee AVN with Dennis M. Lox M.D. This patient had Lupus for years, and then developed knee pain of unknown origin. It took many specialists to finally diagnose knee AVN. By this time no one had any ideas for her expect when her knee wore out to get a knee joint replacement surgery. She was in her late 20 years of age, hardly what any 20 year old wants to hear. For this reason she sought out Dr. Lox, after much research on alternatives to knee replacement surgery in Knee AVN. She found Regenerative Medicine and Stem Cell Therapy as a good option to further explore with Dr. Lox. This is how many patients from around the world have found and went for consultation with Dr. Lox. Dr. Dennis Lox has offices in the Tampa Bay, Florida area, and in Beverly Hills, California. This has allowed patients from the North Pole to India and Australia to travel to see Dr. Lox for treatment.
What is AVN?
Avascular Necrosis is often also called Osteonecrosis. They both refer and mean the same basic concept. Lack of blood flow (Avascular) results in bone cell death (necrosis). Thus the names Avascular Necrosis (AVN) and Osteonecrosis are most frequently used to name this disorder. Other terms are used less often, such as aseptic necrosis, bone infarction and other names for AVN of specific bones or areas have been used as well.
What Causes AVN?
Trauma is the frequent cause of AVN. Sports injuries, or traumatic injuries are the most frequently seen reason in younger patients with AVN to consult with Dr. Lox. Even great athletes like the legendary professional football and Baseball player Bo Jackson, developed AVN of the hip as the result of traumatic tackle and fall causes his hip to be injured where the blood vessels to the hip joint were damaged. This lead to bone cell death or necrosis. It was only months later that Bo Jackson was diagnosed with AVN of the hip. Pain and injury are common in football. AVN is relatively rare, however it is so devastating that it was always be kept on the experts sports physicians radar as a possible cause for unresolved pain. Next to trauma, idiopathic or unknown causes is most frequently seen in AVN. This is disturbing to patients, because everyone wants to know why? If there are no answers it is unsettling. Naturally, before one states it is idiopathic or of unknown cause, all known possible reasonable causes must be excluded.
Lupus, Autoimmune Disorders and AVN Knee or Hip
There are many systemic causes for the development of AVN. Of these diseases and systemic causes of AVN is the group of autoimmune disorders of which Lupus is one. Autoimmune disorders or diseases, are characterized by the body’s immune system to attack the patients own body creating great harm. The nature and way it evolves or manifests itself compromises the field of Rheumatology. Rheumatoid Arthritis is one of the autoimmune disorders. Various lab tests and physical examination findings characterizes each different autoimmune disorder. The hip is the most frequently involved joint often both hips in autoimmune disorders. This is followed by the shoulder then the knee.
Excessive Cortisone or Corticosteroids and AVN
Excessive high levels of cortisone known as corticosteroids has been associated with the development of AVN. Unfortunately, many diseases known to cause AVN are treated with cortisone. This compounds and complicates matters. Which caused which is often asked. In the end caution with high doses of cortisone or corticosteroids is prudent. It may also be seen in many other non autoimmune disorders such as steroid dependent asthma or Emphysema. Lung ailments are often given high levels of cortisone over longer periods which increase the risk of the development of AVN.
Multiple Joint AVN
AVN of non traumatic origins such as Lupus, autoimmune diseases, and excessive cortisone can appear in more than one joint. Such as both hips, a hip and a knee, or even a hip, knee, and ankle. Anything is possible with diffuse disease processes. This is why consulting an expert such as Dr. Lox is necessary for early accurate diagnosis and treatment recommendations. ***Video pic multi joint AVN
Regenerative Medicine and Stem Cell Therapy Options for AVN
Regenerative Medicine and Stem Cell Therapy have shown increasing promise, interest, and treatment in the last decade for AVN of all causes. Dr. Lox has seen nearly every cause of AVN in all age groups, all types of athletes from teens to professional. This has given Dr. Lox vast experience over the last decade in treating all types of AVN in nearly every situation, and joint. Experience and expertise is important. Dr. Lox is an expert in Sports and Regenerative Medicine. His expertise has led him to lecture on a variety of topics around the world to University Professors and Regenerative Medicine experts. Dr. Lox has lectured on AVN in the setting of Regenerative Medicine and Stem Cell Therapy as well. This has led to great discussions with colleagues around the globe to help patients in need. Dr. Lox has helped multiple teenagers with AVN go on to continue to play their chosen sport and get college scholarships. There can be light at the end of the tunnel, and this is truly rewarding indeed.
Tampa Bay Metropolitan Area, Florida (727) 462-5582
Beverly Hills, Los Angeles Metropolitan Area, California (310) 975-7033
Dr. Lox has treated many patients who engage in Hiking and complain of bad knee pain. What is really meant by hiking, and what effect does it have on your knees? A leisurely stroll should not be included. A patient once stated he was walking the beach in Malibu, but it was not difficult enough, so he wanted to go straight up the Santa Monica mountains. Not the same activity at all, and clearly that would be hiking. The incline, and often the decline places stress on the knee. Normal knees are unaffected. Injured or arthritic knee will experience pain. The same with climbing stairs is frequently cited. Another patient was traveling in India and Tibet. He had trouble getting to Mount Everest’s basecamp. Not your typical hiker statement. We conversed on all the great Mountain climbing films, neither of us wishes to expose our knees or other body parts to The Summit or K2. He was considering Mount Kilimanjaro. However, a good Sports and Regenerative Medicine specialist should be prepared for all patients desires and goals. Including, discussions about what is reasonable or not. Thus his appointment with Dr. Dennis Lox was timely.
Knee Pain with Walking Uphill
Not all knee pain is the same. Different people will experience different knee pain dependent on a variety of factors. Walking uphill may be just one of many factors that trigger knee pain. The load of uphill walking may be transferred to the kneecap, throughout the three knee compartments, place undue stress on torn ligaments, or may be lateral to the iliotibial band. Common types of Knee Pain with Walking uphill. Knee ArthritisPatellofemoral PainIliotibial Band SyndromeTorn Ligaments
The knee is a complex joint. It is often referred to as a tri-compartment. The medial, lateral compartment and the undersurface of the knee cap or patella comprise the 3 knee compartments. This is misleading, as the knee is really one open compartment allowing free communication of cell signal, and fluids to flow between all 3 compartments. Patellofemoral Pain may be associated with knee cap or patellar arthritis. This is referred to as chondromalacia patella. This can be made worse going uphill, on an incline, or even with high heels. Knee arthritis is not stagnant. Knee arthritis is progressive over time. Understanding this concept helps to make informed decisions.The iliotibial band may be an isolated finding or present with other knee pain symptoms. The iliotibial band syndrome is an overuse injury of the connective tissues that lie on the outside of the knee and thigh, running from the pelvis to the tibia bone in that crosses the knee joint. The iliotibial band can become inflamed or develop irritation as the result of rubbing across the femoral condyle above the knee joint. The iliotibial band is an important knee stabilizer. Overuse can occur in repetitive sports such as running or cycling as the iliotibial band continues to rub with repetitive motion of the knee joint. Specific iliotibial band exercises may help.
Knee Pain with Walking Downhill
Downhill walking may be the predominant factor in knee pain, or just another symptom of many. It is non-specific, however, it may indicate several areas of more stress in the knee.Knee ArthritisRunners Knee is a nonspecific term. It may be referred to the knee cap or patellofemoral syndrome, however, as it is sometimes used as a catch all term specific should be used instead. If it is patellofemoral the strength of the surrounding muscles may be an important variable that can be addressed. Arthritis of the underside of the kneecap, the patella is important to understand. If it is severe chronic friction cannot be overcome by strength it of the surrounding muscle groups. Iliotibial Band Syndrome
Regenerative Medicine Treatments
Often patients have already had knee surgery or are looking to avoid it, especially knee replacement surgery. This has often led to researching Regenerative Medicine treatments. Knee stem cell therapy and Platelet Rich Plasma (PRP), are Regenerative Medicine treatment options that can be discussed with your physician when appropriate. An experienced Sports and Regenerative Medicine specialist such as Dennis Lox M.D. is capable of guiding patients through the various disorders and treatment with specific goals.
Platelet Rich Plasma (PRP)
PRP is a Regenerative Medicine option that utilizes concentrated blood platelets collecting from the patients own blood. Using a simple technique peripheral blood is collected and concentrated to give a platelet enriched concentration of plasma. Thus the term Platelet Rich Plasma or PRP as an abbreviation. The platelets are a rich source of growth factors which have healing properties, and can counter the bad effects of inflammatory cytokines. PRP contains no stem cells, therefore the response is limited in healing capacity. Many factors go into deciding if PRP is the first or right choice for a patients condition. There are many ways PRP can be derived, and scientifically not all PRP is the same. An experienced Regenerative Medicine specialist can answer your questions.
Stem Cell Therapy
No other topic has become more confusing for patients than this. There are so many different answers from so many people who give non-scientific statements, and often contradictory merely to push their agenda. Patients need to be aware there are many new clinics stating various things often incorrect. Stem cell therapy by virtue of the name implies there are stem cells. Platelets and Plasma are not stem cells. Perinatal tissues are tissue products. They are derived from newborn tissue. These include amniotic fluid, placenta and cord blood. Tissue products contain many things. They may or may not have stem cells. In the United States stem cells must come from the patients own body and be used the same day or it falls into the category of drug therapy, and it is not FDA approved for this. To get around this perinatal tissue of amniotic, placental or cord blood is a tissue therapy and considered a medical device, not a drug. Most have no stem cells that are left or viable. That is why the FDA has made a crackdown on the manufacturers making claims it is a stem cell product. Careful examination will see it listed as an acellular product. Acellular=NO Cells. Yet many clinics continue to claim it is a stem cell product when it is not. The FDA has announced it is going to further enforce inaccurate statements in this regards. The future is clear FDA approved stem cell therapies derived from anything not the own patients will be a drug.It can be confusing, but not to the doctors who truly understand this. The doctors who do understand this fully, are the ones typically willing to take the time to explain everything.
Patient Centered Treatment
Treat the patient in front of you. Listen to the patient. Question the patient. Examine the patient. Discuss goals, expectations and outcomes. This patient-specific approach allows for the best outcome. There is no cookie cutter template for everyone. Be wary of one size fits all treatment approaches. This Patient had Specific Hiking Goals
This Patient had Specific Hiking Goals
Basecamp Everest, Mount Kilimanjaro, Nepal, and Africa. These goals are kept in mind when treating the patient. He has vivid memories of each place and his desire to achieve his goals are understandably important to him. Not everyone has such lofty goals. Dennis M. Lox M.D. is an expert in Sports and Regenerative Medicine. No matter what the goal, Dr. Lox will give personalized medicine and a personalized approach to each patient.
A patient consulted Dr. Lox for knee stem cell for knee arthritis that developed after childhood polio. He developed a leg length discrepancy (unequal leg length) as the result of the polio. His opposite leg developed knee arthritis as a result of walking unevenly over time. Dr. Lox is an expert in Sports and Regenerative Medicine with a special expertise in degenerative arthritis. You don’t see Polio much anymore. Many years ago it was a dreaded disease . Thankfully, the polio vaccine almost eradicated it worldwide. This was an unusual case, however the basic knee problem was not. Knee arthritis is a common reason patients request Regenerative Medicine and Stem Cell treatment.
Leg Length Discrepancies and Knee Arthritis
Leg length discrepancy or leg length inequality can occur for many reasons. It may be idiopathic or some are born this way. Usually this is minor. Genetic or bone diseases may result in significant differences in leg length. The most common reason is trauma. Fractures of the leg that result in multiple fractures and require extensive surgery may often lead to this. A severe motorcycle accident is an example. Knee or hip replacement surgery may lead to this as well. Over time if not corrected for, an uneven wear pattern often develops in the opposite leg. This can affect commonly the knee or hip. Leading to degenerative knee and hip arthritis. The spine may also develop arthritis as well.
Knee Arthritis is not Static: It Gets Worse
Degenerative knee arthritis does not stay the same over time. It is not static. It progresses. If you look at knee arthritis x-rays over a 5 year period, it will shown changes of arthritis progression. How much may be determined by many factors. That is where an expert like Dr. Lox comes in. He understands the science and has the experience to know all the things that make up these differences. The good news is Dr. Lox also knows how to alter the modify these progressive knee arthritis problems in addition to knee Regenerative Medicine and Stem Cell Therapy. It is not uncommon to see the progression halt or actually reverse with Regenerative Medicine.
Stem Cells and Regenerative Medicine Options For Knee Arthritis
The truly exciting part of stem cells and Regenerative Medicine is the ability to modify knee arthritis progression, halt it or in some cases reveres it. No two patients are alike, so there are many factors which may affect outcome. Again, this is why having an expert like Dr. Lox is so important to fully help each patient achieve their goals.
Dennis M. Lox is a Sports and Regenerative Medicine expert with offices in the Tampa Bay, Florida area, and in Beverly Hills, California. Dr. Lox treats all types of sports, orthopedic and arthritis problems from professional athletes to older patients who just want to enjoy the quality of their life.
The popular Ron and JP sports radio show on iheart featured MLB hall of fame pitcher Denny McLain and Dennis M. Lox on a interesting topic of stem cell treatments, sports medicine, and how the sport of baseball has changed.
The Expendable Athlete
Sports has changes. Competition is stiff to make it to Major League Baseball. Salaries are exorbitant compared to yesteryear. This has led teens to pitch more at a younger age, throw more, leading to more injuries, more shoulder and Tommy John elbow surgery. No one will ever pitch enough with current rotations to rest major league pitchers to match Denny McLain’s 1968 30 win season. Many pitchers who have surgery never make it back after shoulder and elbow surgery. Some have stellar careers, while others never get back to top form. The average length of pitching after returning to the professional pitching after shoulder or elbow Tommy John surgery is 100 innings. Therefore, even those that make it back to the major leagues, don’t last long typically.
Sports Medicine and Stem Cell Treatment
For a while it seems only the athletes were getting Regenerative Therapies such as Platelet Rich Plasma and Stem Cell treatments to not just their shoulders, for rotator cuff tears, impingement syndrome, and glenoid labral tears they were in the news. Kobe Bryant or Peyton Maning in Germany. Then more reports other other elite athletes Tiger Woods, and Rafael Nadal had knee stem cell treatment. It may have seemed liked just athletes were getting stem cells and Regenerative Medicine, but every day people from all walks of life were getting in the United States. It just didn’t make the news the way the top elites did. Stem cell treatments for variety of sports and musculoskeletal orthopedic conditions were being treated in the Inited States for over a decade. Dennis M. Lox M.D., an early pioneer in the field has been treating sports and orthopedic conditions for decades. Dr. Lox began using Regenerative Medicine and stem cell treatments about 10 years ago. He has amassed great knowledge treating athletes from a variety of sports from a Ballerina’s toe to a, neck of a weightlifter. Top to bottom. Not only this, athletes and patients alike are all different. They come in different sizes shapes and have different needs and goals that are all important to understanding how to individualize treatment to that patient. There is no cookie cutter approach to humans. They are diverse and must be treated according to what is best for that patient. Only with such an approach can the best care be provided. Dr. Lox is passionate about his and strives for this with every patient.
Getting an Expert is Important
The need for a well trained experienced medical doctor who is a specialist in Regenerative Medicine is very important. Many people are claiming they are stem cell doctors now that the public has heard about it. The problem is some have little training, and some are chiropractors hiring nurse practitioners, and physicians assistants to do the procedures for them, as chiropractors do not have a license to inject a patient or perform medical procedures. Chiropractors are great at what they went to school for, and I have great respect for the many good ones who help patients with what they were trained to do.
Beverly Hills, California
450 N Roxbury Drive, Suite 602
Beverly Hills, CA 90210 Call: 310-975-7033 Get Driving Directions
*DISCLAIMER: Like all medical procedures, Dr. Dennis Lox Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.