All posts in Tendon

Pulsed Electro Magnetic Field Therapy (PEMF)

I call PEMF therapy ‘Magnawaving’. PEMF has beneficial clinical evidence for:

  • The healing of non-union bone fractures (bone growth) (1, 2, 3, 4, 5)
  • Cervical fusion patients that are high risk of non-fusion (1,5)
  • The treatment of depression and anxiety (transcranial magnetic therapy) (10)
  • Urinary incontinence and muscle stimulation. In one study, results were evaluated after 3 months. In 10 patients (7 post prostatectomy, 3 cystourethrocele) which were submitted to 18 sessions, twice a week, an improvement of incontinence in 75% of cases with patient compliance and the quality of life up to 100% also improved (11)

PEMF is gaining significant clinical importance and potential especially to someone like myself who is an ‘off label’ practitioner and ‘biohacker’. I’m able to demonstrate improvements (using a four lead body composition device) to my patient’s for hydration (intracellular and extracellular fluids) and the phase angle, which is a measurement of the body’s overall cell membrane health. Achieving proper hydration especially at the intracellular level is vital to good health especially if you are someone making slow progress.  

Can PEMF provide enhanced musculoskeletal healing and overall health (biohacking)? In my experience the answer is yes. Using high intensity pulsing electromagnetic fields safely passes through a cell membrane and ‘shock’ the structures within. PEMF could accelerate all phases of tissue repair, from initial pain and swelling to blood vessel growth, tissue regeneration, and remodeling. (6) The current thinking is that the primary effect of clinically relevant PEMF signals is to increase the rate of production of Nitric Oxide, which can orchestrate an anti-inflammatory response via increased blood and lymph flow (6, 8).

I can direct the PEMF towards ‘spot’ areas of your body to help resolve injuries or other damage, or I can provide ‘broad’ area treatment to improve self-reported psychometric measures of sleep, mood, and quality of life (life satisfaction) without adverse effects. That’s why PEMF sessions are often called “cellular exercise” and is popular among biohackers.

PEMF therapy translates to speeding up of the healing process. For chronic pain patients such as osteoarthritis PEMF stimulates the microenvironment and the after effects of treatment sessions are increased range of motion and decreased pain. PEMF may help alleviate the pain of arthritis, exert anti-inflammatory action and helps in bone remodeling.

I use PEMF to improve tendon to bone healing in rotator cuff repair, Achilles tendon injuries and gluteal tendon tears because it improves microcirculation. After 8 minutes of low intensity PEMF it improves microcirculation – meaning the RBC’s stop sticking together (3,4). PEMF has been used to effect osteoblast proliferation and is used for fractures. For all the above conditions I can blend PEMF, chiropractic care, nutrition, and topical hemp or BioFreeze. (3,4,7)

I look forward to helping you PEMF for urinary incontinence, brain support, insomnia, and even depressive disorders as well as all of the above.  

1. Aaron RK, Ciombor DM, Simon BJ. Treatment of nonunions with electric and electromagnetic fields. Clin Orthop Relat Res 2004;419:21–29.

2. Akai M, Hayashi K. Effect of electrical stimulation on musculoskeletal systems; a meta-analysis of controlled clinical trials. Bioelectromagnetics 2002;23:132–143.

3. Pilla AA. Mechanisms of electrochemical phenomena in tissue growth and repair. Bioelectrochem Bioenerg 1974;1:227–243.

4. Bassett CA, Pawluk RJ, Pilla AA. Acceleration of fracture repair by electromagnetic fields. A surgically noninvasive method. Ann N Y Acad Sci 1974;238:242–262

5. Mammi GI, Rocchi R, Cadossi R, Massari L, Traina GC. The electrical stimulation of tibial osteotomies double-blind study. Clin Orthop Relat Res 1993;288:246–253.

6. Bruckdorfer R. The basics about nitric oxide. Mol Aspects Med 2008;26:3–31.

7. Diniz P, Soejima K, Ito G. Nitric oxide mediates the effects of pulsed electromagnetic field stimulation on the osteoblast proliferation and differentiation. Nitric Oxide 2002;7:18–23.

8. al-Swayeh OA, Clifford RH, del Soldato P, Moore PK. A comparison of the anti-inflammatory and anti-nociceptive activity of nitroaspirin and aspirin. Br J Pharmacol 2000;129:343–350.

9. Aragona SE, Mereghetti G, Lotti J, Vosa A, Lotti T, Canavesi E. Electromagnetic field in control tissue regeneration, pelvic pain, neuro-inflammation and modulation of non-neuronal cells.J Biol Regul Homeost Agents. 2017 APR-JUN;31(2 Suppl. 2):219-225.

10. van Belkum SM, Bosker FJ, Kortekaas R, Beersma DG, Schoevers RA. Treatment of depression with low-strength transcranial pulsed electromagnetic fields: A mechanistic point of view. Neuropsychopharmacol Biol Psychiatry. 2016 Nov 3;71:137-43.

11. Aragona SE, Mereghetti G, Lotti J, Vosa T,  Canavesi E. Electromagnetic field in control tissue regeneration, pelvic pain, neuro-inflammation and modulation of non-neuronal cells. Biol Regul Homeost Agents. 2017 APR-JUN;31(2 Suppl. 2):219-225.

Dr. Jeffrey Tucker is the current president of the ACA Rehab Council.

Contact Dr. Tucker at 310-444-9393

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Shoulder Adhesive Capsulitis

The goal for patients is to increase movement and pain reduction.
Since ‘no one size fits all’ I offer several forms of treatment that may be helpful. Having the ability to use and combine multiple modalities is providing very positive results in terms of increased movement and pain reduction versus single modalities alone.

An advanced modality that is getting a lot of attention is shockwave. This provides peak pressures that are 1000 times greater than a biphasic ultrasound wave. Shockwave increases local blood flow, increases cellular activity, has an analgesic effect on nerves, and can breakdown calcific deposits (primarily, but not exclusively in tendons).
Laser is another treatment device that can target tissues to impact mitochondrial activity. Laser can be used on nerves, tendons, muscles, ligaments, joint capsules, bone, and wounds.
Pulsed Electromagnetic Field Therapy (PEMF) (MagnaWave) has had FDA approval for muscle stimulation since 1998. PEMF is just gaining popularity as ‘nutritional therapy’ to the cells. It increases nitric oxide levels (same thing Viagra does) and has microcirculation enhancement.

Summary: Combining these 3 modalities along with my hands-on therapy is allowing my patients to feel more supple and experience less pain.

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Pain Relief in Brentwood

I use two different types of shock wave devices for pain relief in my practice. One is a radial pulse wave (EnPuls) and the other is an acoustic wave (PiezoWave). Both carry energy that can be targeted and focused noninvasively to affect a selected region like the shoulder, hip or foot. When these devices are applied to the soft tissues, the impulses or shock waves interact with the targeted tissues and induce a cascade of biological reactions. This results in the release of growth factors, which in turn triggers new blood vessel formation (neovascularization) of the tissue with subsequent improvement of the blood supply and oxygen to the tissues. This helps healing.
Another effect of shock wave therapy is related to the stimulation of cell proliferation, tissue regeneration, and a process through which new blood vessels form from pre-existing vessels called angiogenesis.

The therapeutic effects of shock wave therapy can be used on patients who need pain relief and reduction of inflammation even in cases with diabetes, nerve pain, soft tissue injury, arthritic joint irritation, and healing of bone (2013, Qiu et al; 2013 Liu; 2013 Siegfried).

My practice is located in Brentwood, CA. I can be reached at 310-444-9393.

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Tendinopathy Pain Treatment

Chiropractic care or medication/shots?

Bone marrow stem cell injections vs non-surgical, non-invasive therapy?

DC’s, PT’s and MD’s know that chronic tendon pain is a challenge to treat. Chiropractors and Physical therapists use non-invasive procedures while medical doctors use cortisone shots and now some are using stem cell therapy injections. Research by doctors at the National University of Singapore suggest that bone-marrow derived stem cells accelerate tendon healing.1 Resolving ongoing inflammation is the key to management of these cases.

This is why the great excitement in stem cell therapy, it has the potential to reduce inflammation. BUT, so does TheraLase laser therapy and the use of PiezoWave and EnPuls. These are non-invasive therapies that the general public are not aware of yet.
Even the Center of Translational Regenerative Medicine researchers, in Torino, Italy say: “Tendon injuries represent even today a challenge as repair may be exceedingly slow and incomplete. Regenerative medicine (Tucker’s note – meaning laser and shockwave like the EnPuls & PiezoWave) and stem cell technology have shown to be of great promise.”2

I would much rather have patients try these non-invasive and less expensive therapies before getting a cortisone shot or going through expensive stem cell therapy first.

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