Pickle Ball Enthusiast Thrives After Innovative Treatment
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Jill Bowler, mother, grandmother and athlete, became an avid player of pickle ball eight years ago, and was immediately hooked. The racquet sport - a hybrid of tennis and ping-pong – involves strategy Bowler compared to playing chess on a court. Equipment includes a whiffle ball and small paddle that’s larger than a ping pong paddle, but smaller than a tennis racquet. Always physically active and into sports, Bowler said the game changed her life. “It’s a fun way to stay in shape, and it keeps my mind off things that might be stressful in my life. I love it for that.”
Because of the growing popularity of the sport, tournament play takes place across the country. Bowler and a friend paired up, competing in tournaments from Kansas and Arkansas to New Mexico and Montana.
With arthritic knees, Bowler had a history of chronic pain that became problematic two years ago. An MRI revealed a torn meniscus and significant degeneration of the knee joint cartilage. Aware that surgery can worsen arthritis, and hopeful that the pain could be managed, she tried other treatments in an effort to avoid surgery. She used anti-inflammatory medications, heating pads and warm baths, and was treated with repeated injections. These measures were effective for a while, but the pain began to interfere with normal, daily activities. She made an appointment with Douglas Rowles, M.D., OU Health orthopedic and sports medicine specialist.
Dr. Rowles said most people over 50 are typically considered candidates for total knee replacement, based on diagnostic imaging tests, which will clearly show evidence of osteoarthritis. The condition is degenerative, and over time even walking may be painful. The increased risk of injury may make participation in a physically demanding sport ill-advised.
With nearly 20 years of experience, Dr. Rowles recommended an innovative, combined treatment to address Bowler’s condition, citing the probability of more comprehensive, long-term benefits. Bowler said Dr. Rowles was very knowledgeable and addressed every question with confidence and assurance. “My choices were to wear braces and decrease my activity, or try to fix it. Some doctors will just tell you to stop playing, to not work so hard. Dr. Rowles gave me the confidence that we could have a good outcome.” Now more than two months post-surgery, Bowler said her recovery is going well, and she has returned to near-normal levels of physical activity with no discomfort.
“As you age, you begin to think more about the likelihood of injury. Dr. Rowles encouraged me to be realistic, not to overdo it, but he supported my goals to stay physically active and enjoy my sport.” She knows arthritis won’t just go away, but she’s dealing with it, determined to succeed one day at a time. “Right now I’m playing once a day, five days a week.”
Dr. Rowles explained that his goal as a sports medicine specialist is to preserve rather than replace joints, if it is appropriate for the patient. The treatment he recommended for Bowler has been in use for a few years, and is becoming more mainstream, combining traditional arthroscopy with stem cell therapy. The differentiating factor is the stem cell therapy.
Innovations Offer Better Options for Aging Athletes
By extracting bone marrow and dividing it into different layers, the stem cells can be isolated and stimulated to become whatever type of cells are needed to treat an area. “In the past we would perform arthroscopy to remove random loose debris including bone and cartilage fragments as well as address any mechanical sources of pain. That was the best we could offer, and it is often valuable. But it doesn’t address the functional pain associated with arthritis.”
Dr. Rowles has been performing this innovation in treatment for four years. It includes the arthroscopic approach to eliminate those floating fragments that are a source of pain, but also introduces stem cells, which function to provide intense anti-inflammatory treatment and, in certain circumstances, cartilage restoration in order to stimulate healthy tissues worn away by years of use. Now with the experience of nearly 600 procedures, Dr. Rowles has seen excellent results in reduced arthritic pain.
He said it is very challenging to recover, rehabilitate and return pain-free to a sport. “There are differences from person to person, and even from knee to knee in the same person:
- Body type – bone structure, weight, dimensions, muscular strength and flexibility.
- Demands of the sport – tennis and pickle ball, for example, involve sharp or sudden moves, cutting and pivoting.
“Initially during the first week after surgery, we focus on restoring appropriate range of motion, making sure there’s no stiffness or swelling, that walking is normal – without a limp or pain. Then a week or two of low-impact cardio follows – stationary bike, elliptical trainer, or just normal walking. At about three week post-surgery, you can usually gradually resume normal activities.”
Dr. Rowles said it’s never a good idea to “push through” abnormal pain, especially in the knee. “Anything that limits motion – if it’s locking or catching - immediate evaluation is needed. That could be a sign of a loose body floating in the knee, and significant damage can occur in a short time.”
Another indicator is pain that recurs with specific physical activity. Even among very fit and athletic people, the normal wear and tear of aging has a degenerative effect on cartilage. Arthritic conditions are the result of lost cartilage on a bone surface. Typical treatment for arthritic joints in people 50 and older often includes multiple cortisone/steroid injections, with an occasional arthroscopic procedure to remove floating debris in the joint, with no truly long-term benefits. “At the least, the stem cell treatment may delay total knee replacement. At best, we may avoid the need for knee replacement altogether,” said Dr. Rowles.
Dr. Rowles encourages people who have been told they’re likely facing a knee replacement to consider other options. For some, this may be an accurate assessment, but state-of-the-art treatments have opened new doors. In addition to lifestyle considerations – the limitations of using braces, a cane or a walker, for example - some individuals won’t be ideal candidates for a major surgery due to other health concerns. Stem cell therapy may be especially beneficial for these patients.
Stem cell therapy isn’t limited to orthopedics and may be offered by primary care physicians or at specialty clinics. Patients should inquire, however, about the specific type of stem cell therapy being offered. “There are many options, but there are a lot of reasons I prefer to use the person’s own stem cells – a substance from their own body, not processed in any way, moving it from one place in the body to another place where it can help. Routine arthroscopy doesn’t include stem cells, but because of its clear benefits, I’m now incorporating it into almost every procedure I do. The recovery time is reduced by about half – two to three weeks is a dramatic improvement from the standard four to six weeks.”
The pandemic interrupted Bowler’s tournament play and travel, but interest in the sport remains strong and Bowler is eager, confident that competitive opportunities will soon return. She knows each situation is uniquely individual, but encourages people to seek possibilities that enhance their ability to enjoy life. “Don’t push yourself too hard, but the more active you can be, the better off you’ll be. Have a positive attitude, have confidence in yourself and never give up. Dr. Rowles has a great outlook on life and had answers for all my questions. Going forward with surgery was probably the best decision I ever made.”
