Chronic Ankle Instability and Pain
Jenny had severe ankle pain. She was an avid athlete, playing several sports. After evaluating her, I determined that she was suffering from significant ligaments in her ankles, which was the cause of her pain. Jenny did not know how she injured herself so severely.

Jenny also exhibited tenderness on various parts of her body in addition to her ankles. I surmised this was related to nutritional factors. When delving into her history, I discovered that her ankle pain started a couple of years prior to her visit in our office, just after she had started taking birth control pills because of painful, irregular menstruation. The medication she was taking contained an analogue of estradiol. Her diet consisted of nearly 100 percent carbohydrates, very small amounts of protein, and she was averse to taking vitamins.
 

Jenny was, however, open to receiving Prolotherapy on her ankles, but not to correcting the multiple factors that were related to her systemic connective tissue deficiency problem. She had multiple signs, or symptoms, that confirmed this diagnosis such as non-healing sports injury with no overt trauma causing the original pain; multiple tender points in other parts of her body especially about the knees and hips; dry skin; brittle nails and hair; menstrual problems; improper diet for her metabolism; and finally, her taking synthetic estradiol.
 

In order for the Prolotherapy to be maximally effective, I needed to address Jenny's inability to heal and convince her that she needed to do something about this in order to make the Prolotherapy worth enduring the shots! Reasoning alone would be insufficient.
 

Prolotherapy is a treatment that causes the body to grow strong connective tissue. This connective tissue is primarily collagen, which makes up ligaments and tendons. Thus, Prolotherapy causes the growth and strengthening of ligaments and tendons. When an injury lingers beyond the usual healing time, it typically involves the ligaments and tendons. This weakening of the connective tissue can be graphically represented. Prolotherapy injections, (Watch where do Prolotherapy injections go and do they hurt?)  reverse this by stimulating the connective tissues to heal. As the connective tissue grows and strengthens after Prolotherapy, the athlete reaches the eventual point where the pain has ceased. For the person with a strong immune system, no more treatment or additional medical care is needed. Prolotherapy was indeed a cure for this person.
 

The person with systemic connective tissue deficiency, on the other hand, experiences no specific traumatic event to start the pain because the condition itself is weakening the connective tissues. In such an instance, all (or a majority) of the body's connective tissues are weakening. This process occurs normally with age, but with a systemic connective tissue deficiency (perhaps more appropriately called The Hauser Syndrome) a person experiences an accelerated decline in connective tissue strength. This may result in sagging of the skin, thinning of the hair, and a myriad of other symptoms, the most prominent of which is pain. The first area to become painful will typically be the one that the athlete uses the most. For the pitcher it will be the shoulder, for the runner the knee, for the golfer the back, and so on. If the golfer, in such an instance, just receives Prolotherapy, the pain relief from Prolotherapy will only last a certain amount of time. Once the connective tissue strength decreases below the pain threshold point, the pain will recur. A cure will only be obtained when the athlete receives Prolotherapy along with additional treatments to correct the connective tissue deficiency problem.