Consider the Alternatives: Nonsurgical Options for Pain

From salves to stem cells, what are the nonsurgical options when pain invades our golf games?

Barbara Hey

Above: Aqib Talib receives cryotherapy treatment at Cherry Creek Spine & Sport

Aches, pain, injuries are inevitable in life, more so with each passing decade and even more so for those passionately focused on one particular activity. Golf, for example. Every swing requires the body to move in an unnatural way that tests even the happiest muscles and joints. Without overall strength, flexibility and full range of motion, this repetitive, biomechanical challenge can lead to trouble.

But, there’s plenty to do to keep aches and pain at bay and to heal injuries before resorting to surgery. (Of course, for any extreme pain or injury, you need an orthopedist, pronto.) The most common areas of complaint for golfers are the lower back, shoulder and elbow. A variety of modalities can help.

Timing is critical, so don’t play through pain. The key is to act when you’re in the yellow zone—when you know something’s amiss, but before the pain becomes acute.

That action should encompass reducing inflammation to prevent further tissue damage, getting an assessment of what’s hurting and treating it, and making apporpriate adjustments in body mechanics or exercise regimen to keep it from coming back or becoming chronic. Herewith some healing options.

Reduce inflammation. This is step one when pain kicks in, whether it’s a minor strain or worse. Swelling signals cellular damage and can compound the injury and interfere with healing. Depending on the severity, your physician may prescribe a pain reliever or recommend an OTC nonsteroidal anti-inflammatory medication like ibuprofen or naproxen. Many topical creams also promise relief, among them Aspercreme and Blu Emu creams, and homeopathics like Topricin and Traumeel. Use Biofreeze for a cold effect; Tiger Balm to bring the heat.

TENS up. TENS stands for Transcutaneous Electrical Nerve Stimulation. Sold at drug stores, TENS units (below) gently stimulate the body’s nerves with relaxing pulses to provide temporary relief to aching muscles. The user places electrode pads on the affected areas and uses a control unit to adjust the intensity.

Ice It. Applying cold promptly to the affected area both physically numbs pain and is a powerful counterpoint to inflammation. Cold restricts blood flow and decreases swelling, and can help facilitate healing particularly during the first 48 hours after an injury. This is the DIY icepack route.

Step into the freezer. Another option ups the cold factor considerably. Cherry Creek Spine & Sport Clinic in Denver offers Whole Body Cryotherapy (below), a sort of upright freezer into which you step (wearing undies only) for sessions lasting two to three minutes. This blast of dry cold air cools the skin surface by as much as 50 degrees, walloping muscle soreness, joint pain and whole-body inflammation. “This helps anyone—weekend warriors and pro athletes—ease aches or pain, and with recovery from an acute injury or tough workout,” says Dr. Scott Sheil-Brown, chiropractor and founder of the clinic. The extreme cold stimulates the body’s own anti-inflammatory reaction and also releases endorphins. End result: you feel better.

Warm Up. For chronic pain and arthritis, heat is the way to go. Applying a warm pack to sore shoulders, elbows or back or wherever you hurt—soothes stiff joints, relaxes muscles and help restore mobility. This is particularly important as prep prior to playing, and to lessen the likelihood of tweaking other body parts. Don’t try working around the pain. “You will make adjustments in how you move—even without realizing it,” says Brad Marquez, physical therapist at Select Physical Therapy, Ken Caryl. “Other parts will compensate, and the pain train picks up speed.”

Activate energy. Acupuncture is another option for curbing pain, and reducing inflammation, swelling and muscle tension. At the Boulder Sports Acupuncture Clinic, acupuncture is the first-line treatment for aching athletes, and works its magic by restoring balanced energy flow and activating the body’s ability to heal itself. After assessing the injury and severity of pain, acupuncturist and clinic owner Steven Rizzolo often adds other modalities to accelerate healing.

These include “e-stim,” which sends pulsing current between two acupuncture needles to jumpstart stagnant energy. It’s effective in treating tenacious issues and chronically tight muscles that impinge movement of the shoulder as well as low back pain.

Straighten up. “With most of the golfers I treat, the complaint originates with some kind of postural deficit,” Marquez says. For example, shoulder issues can often be traced to rounded-in posture/shoulder rolling forward/head leaning in. He works to retrain the body to achieve a full upright position, reversing the strain by opening the chest muscles, holding the shoulders and spine in better alignment. Then comes building strength, balanced strength and a strong core, to support proper posture and movement. 

Movement analysis. Another way to stop the pain is to assess movement patterns, stability, motor control, and correct what’s not working. “We look at how a person moves, where the body moves freely or not,” says Eric Dinkins, a physical therapist at Select Physical Therapy in Castle Rock. He also utilizes a laser motion guidance device that can be attached to any body part to provide visual feedback so you can make real-time adjustments. Another technique is mobilization with movement, in which he manually applies pressure to the problem spot—a strained elbow or stuck shoulder—to enable the client to move without pain. 

Increase blood flow. And once the pain is gone, keep it from coming back. Dinkins advises not just going from the car to the course, but spending at least ten minutes getting the heart pumping before playing (a brisk walk, jumping jacks). “One of nature’s best pain remedies is to increase body heat,” he says. “Muscles become more elastic, range of motion gets better, performance improves.”

Stretch and hold. Daily stretching exercises—and holding each stretch a couple of minutes—goes a long way in maintaining spinal mobility and muscle and joint flexibility. 

Hands-on release. After the acute phase or with an injury that recurs, another treatment Dr. Sheil-Brown recommends, in addition to chiropractic care, is Active Release Technique, which manually separates “glued” tissues—scar tissue and adhesions that linger after trauma and result in persistent tightness and limited range of motion. 

Former Bronco and avid golfer Don Horn has benefited from Premier Stem Cell Institute.

Stem cell therapy. This last-resort treatment can help joints in bad shape due to repetitive injury or arthritis and extreme pain. “Most of our clients have exhausted all other treatments and not found relief,” says Kandace Stolz, President of Johnstown-based Premier Stem Cell Institute. “There are not a lot of remedies out there for people who have tried the range of other treatments to get rid of pain and want to avoid or postpone surgical repair or joint replacement.”

With stem cell therapy, a treatment that has been in use for almost a decade, your own stem cells are extracted from bone marrow and injected into the problem area, a peripheral joint (shoulder, knee, hip) or into disc space in the spine. The stem cells then regenerate healthy tissue between bones and restore pain-free movement.

For most issues, this is a same-day procedure. Patients receive a local anesthetic (or conscious sedation, if preferred) while bone marrow is removed from the back of the hip.After a device separates the stem cells from the marrow. a doctor reinjects the cells under precise imagery guidance into degenerated joints and herniated discs, or into a diseased rotator cuff, elbow, ankle or wrist. 

Premier also offers platelet-rich plasma (PRP), in which platelets and plasma, rich in the body’s own growth factors, are separated from a patient’s blood and injected into injured areas to speed healing, often for ailing tendons and ligaments.

“PRP is like giving construction workers espresso shots so they work extra hard and get more done,” explains Dr. Chris Centeno, who founded Broomfield-based Regenexx in 2005. “Stem cell injections are like hiring more workers.”

Barbara Hey is a freelance health writer.

For more information:
Boulder Sports Acupuncture: bouldersportsacupuncture.com
Cherry Creek Spine & Sport: cherrycreekspine.com
Premier Stem Cell Institute: premierstemcellinstitute.com
Regenexx: regenexx.com
Select Physical Therapy: selectphysicaltherapy.com

This article appears in the May 2016 issue of Colorado AvidGolfer.

See more from The 15th Club: Our Annual Health and Fitness Issue:

Cover Story: Going to the MAT with Greg Roskopf

Become Golf Strong: A Strength Program for Golf Fitness

To Repair or Replace? Orthopedic Answers for Golfers

Consider the Alternatives: Nonsurgical Options for Pain

Practice Makes Present: How Yoga Can Improve Your Golf Game

Pelvis Lives! How to Strengthen Your Pelvis for Your Golf Swing

The Skins Game: Protecting Your Skin on the Golf Course

Garden of Gods Club Builds Wellness Center

Colorado AvidGolfer is the state’s leading resource for golf and the lifestyle that surrounds it. It publishes eight issues annually and proudly delivers daily content via www.coloradoavidgolfer.com.