Sprains and Strains 4
Tendonitis is a common problem with athletes, especially athletes that have had a lot of injuries. It is characterized by a sharp stabbing or burning pain, in close proximity to a joint during a muscle contraction. This pain is specific to the contraction of a muscle and is not related with the movement of the joint. Often after rest or sleep, this area will stiffen up and be very painful, but will slowly loosen up and feel better as one moves around. Often tendonitis lingers for weeks or months and sometimes years. It can be very disruptive to your training schedule and your performance potential. The older you get the more likely you will develop it in one form or another.
Tendonitis is a typically a state of inflammation and irritation that exists in the tendon of a muscle. The tendon has a poor blood supply in comparison to the muscle, so it receives less supply of oxygen and nutrients. When a tendon becomes injured, because it heals slowly, over time it will also become inflamed. The severity of the inflammation correlates with the amount of pain one experiences. Often one can pinpoint the area of pain and while pushing on it with a thumb or finger feel a ropey or nodular sensation in the tendon or the musculo-tendon transition. In addition, it is characteristic to hear a crackling or popping noise during movement.
Traditional therapies such as rest, ice, non-steroidal anti-inflammatories, ultra sound even cortisone shots help in the short term, but are not very successful for long term correction. In my office I have used these therapies with sporadic success. Over the past few years I have experimented with some non-traditional forms of therapy and have had much better results for both short and long term correction. .
Most trainers and researchers agree that prevention is the best measure of treatment an athlete can practice. The foundation of prevention is to take proper care of yourself. Proper care consists of many components. The components we will explore are eating properly, being smart about how you utilize your weight training, rehabilitating injuries correctly, maintaining proper bio-mechanics, and practicing proper post exercise recovery.
Theoretically nutrition is the easiest place to make changes. There are many nutrition plans available, and if your looking at controlling inflammation, utilizing a Ph balancing diet is the best. Optimally we want our bodies Ph to be neutral(6.8 to 7.0) to alkaline (7.1 to 7.6). Inflammation thrives in an acid environment (6.7 or less). Making things simple, the best way to control Ph is to eliminate acid producing foods. Coffee, refined sugar, processed foods, excessive red meat are the most common and make up at least 75% of the average diet. Start looking at labels and you will be surprised how much sugar you are actually eating on a daily basis.
Here is an easy rule of thumb to follow if you want to start changing Ph. Vegetables (preferably raw or as close to raw as possible), green leafy lettuce, fruits, white meats like fish, lamb and poultry, red meats in moderation, eggs, good fats like olive oil, flax seed oil, sesame seed oil, apple cider vinegar, water, green and black teas. Sounds pretty boring doesn't it? But, consider this, just about every thing else is processed, pasteurized, refined, packaged, frozen or synthesized. The more refined a food is from its natural state usually the more acid forming it becomes.
When weight training it is very important to maintain a stable posture. You want to have a straight (neutral) low back and limit body movement to the muscle/s you are trying to develop. Ideally your body should be stabilized in an isometric contraction while functionally moving the limb that you are trying to strengthen. This allows you to strengthen core muscles every time you lift a weight. You get much more bang for your buck. In addition, you want to replicate the type of movement you utilize while competing. This way you are strengthening the ligaments, tendons and muscles with dynamics similar to how they are used.
My favorite example of improper use of weight training is the common "Lat Pull" exercise. Ninety nine percent of the people I watch in the gym pull the bar down and behind their head. This isn't how the Latisimus Dorsi is designed to be used. Plus by bringing the bar behind the head people drop their heads forward. This puts unnecessary strain on the neck and upper shoulder muscles including the ligaments and tendons. It makes much more bio-mechanical sense to bring the bar down in front of you and touch it to your belly button.
Current research suggests that eccentric weight training can help improve the healing rate of tendonitis. Eccentric means elongating the muscle while maintaining resistance. Using the bicepts as an example, bending your elbows bringing your wrists up to your shoulders against weight is a concentric contraction. Then lowering your wrists against weight until the arm is straight is an eccentric contraction. The best way to do eccentric contraction work is with a machine. Find a comfortable weight using one arm or leg where you can do 15 to 20 reps. Then using both limbs concentrically move the muscle through its full range of motion. You are now in the starting position for an eccentric contraction. Next, use only one limb resisting against the weight through the eccentric motion as you return to the original starting position. Do this slowly for 3 sets of 15 reps. Increase the weight with in pain tolerance every few work outs. Try to work out like this every day and expect 10 to 12 weeks to reduce the pain and crackling sound to a minimal range.
In my office I have had great results combining non-traditional therapies. One of which is nutrition based. I find that combining an herbal anti-inflammatory with tissue specific nutrition helps support healing of the tendon from the inside out. Since the blood supply to the tendons is limited it makes sense to provide an increased amount of tissue specific building blocks & healing factors. This tissue specific nutrition is know as a protomorphogen. It consists of specific tissue components including DNA and amino acids that improve cellular metabolism and growth rate of that tissue. This protocol also works as a great preventative measure and can be applied to any tissue, organ or gland.
A second non-traditional therapy I have had great success with is an ionizing machine that supports the natural cleansing mechanisms of the body. It works great on any inflammatory condition by supporting the lymph system. It removes inflammation, metabolites and heavy metals from the body via osmosis. This extra support helps the lymph system become uncongested, freeing it up to work more efficiently. Another therapy I use is known as a Cold Laser. This laser induces and calibrates local tissues into a healing frequency. This in turn, speeds up the local cellular metabolism and helps speed up the natural healing cycle.
Maintaining proper bio-mechanics is another great preventative measure. Ask any serious runner what his most important investments are and he will tell you good shoes and custom orthotics. For runners this maintains proper motion and function of the feet, ankles and knees. By supporting the body this way a runner can be assured of proper spinal balance, efficient muscle use and reduced stress to tendons, ligaments and joints.
To make a basic bio-mechanical assessment of your self, look in a mirror and take notice of your body positioning. Your head should be straight and your shoulders should look balanced. When exercising take notice if your body works smoothly or if you favor a certain leg, arm or muscle. Take notice how your body functions, if it feels like a joint is jamming or you notice a limp, then these are signs that you have bad bio-mechanics.
Last but not least is proper post exercise care. After strenuous exercise icing down sore muscles and tendons is important to reducing inflammation. Stretching out after exercise is just as important as stretching out prior. When you get home take half an hour for a session of contrast therapy. Contrast therapy is 15 minutes of heat followed by 15 minutes of ice. This brings in a fresh supply of blood then helps reduce inflammation. Use herbal anti-inflammatories like Boswella Serrata, Bromelain, Echinacea or Black Current Seed Oil. Herbals have minimal side effects and are much safer than the standard ibuprofen.
If you are an athlete chances are at one point in your career you are going get tendonitis. If it gets bad enough it can be career ending. So learn to spend the extra time and take good care of your body, especially if you have had serious injuries. Like the old saying, "An once of prevention is worth a pound of cure".
Dr. Mark utilizes the highest quality supplements and products available. For more information:
drmark@proactivehealthcare.net or 408-294-4074
Copywrite 2007 Dr. Mark Lucas, D.C.