Tendinitis
DEFINITION AND CAUSE OF ACUTE TENDINITIS
When someone does a physical activity to excess they strain the muscle that was overused. This can happen to a well-trained athlete who is striving to excel or a retired person who overdoes it working in their garden. This scenario is often seen in the "weekend warrior" athlete who sits at a desk all week and then plays softball or tennis all day on the weekend. The resultant muscle strain (mild tear) creates inflammation and pain. This strain usually occurs near the end of the muscle where it attaches to a bone or blends into its tendon. This creates a condition known as acute tendinitis. This condition could also be created if the muscle is strained from trauma such as a fall.
The usual treatment for acute tendinitis is to rest the area, apply ice for 10-20 minutes at a time for at least 3 times a day. This procedure is done to the injured area for the first 24 - 72hours. Moist heat may be used after the acute swelling is improved. Rest prevents further muscle injury, the ice reduces the initial inflammation and swelling and the moist heat circulates blood through the area to speed the healing process. Now, if you added gentle mobilization and progressive movement therapy to this treatment plan the muscle would probably heal totally back to normal.
However, this is not what the average person usually does. They may ice once or twice and rest a bit, but most often just take an over-the-counter pain medication and continue on with their normal activities. If the strain was minor, their body may be able to heal the muscle fibers normally. Unfortunately, this is not the usual result because the injured muscle is being used instead of rested. Because of the stress on the muscle, their body heals the injured muscle fibers by binding them together with fibrotic adhesions or scar tissue. This is done in an attempt to prevent further damage to the injured area. It is a normal protective response of their body.
This scar tissue formation results in the injured muscle becoming shorter and tighter than normal. The increased tension and stress on the muscle makes it more susceptible to strain during future physical work, recreational activities or even activities of daily living. If the muscle is over-stressed or reinjured further, eventually enough scar tissue will form to cause a chronic tendinitis or other more serious condition to develop.
TREATMENT FOR ACUTE TENDINITIS
- Rest the injured area as much as possible for 3-5 days. (e.g., Do not walk on your injured ankle.) Since muscles are more easily injured then ligaments, what is usually referred to as a sprain (ligament injury) is most often just a strain (muscle injury). Sometimes there is some ligament injury as well as muscle strain.
- Ice the area frequently to reduce inflammation and pain. Just prior to going to sleep is the best time because fluid accumulates in your tissues while sleeping. This leads to increased pressure and pain to the injured area. Apply the ice for 10-20 minutes at a time with at least 30 minutes between applications. Always place a paper towel between your skin and the ice pack. Going to sleep with a reusable blue ice pack applied is safe because it warms up in about 20 minutes. Never go to sleep with a regular ice pack applied.
- Use a vibrating massager often to reduce inflammation and increase blood flow.
- Lightly massage the muscle 2 or 3 times a day for a few minutes each time. Apply a good body lotion and massage along the muscle fibers, moving toward the muscle's attachment. No more than a mild amount of pain should be felt.
- Gently stretch the injured muscle. Slowly stretch and hold for 30-60 seconds. Do not use any fast or jerky movement. Stretching can be done 5-10 times daily but do not overdo it.
- If desired, moist heat can be used 48-72 hours after the injury. If soaking in a warm bath, Epsom salt or another product developed for treating muscle strains could be added to the water.
Following these guidelines should prevent fibrotic adhesions from forming. If you often experience an acute strain to the same area, the muscle probably already has a lot of adhesions. In this case, follow the upcoming instructions included in treatment for chronic tendinitis.
DEFINITION AND CAUSE OF CHRONIC TENDINITIS
When a muscle develops a certain degree of scar tissue, it becomes tight enough to pull the bone it is attached to out of normal alignment. This causes the joint directly related to that bone to become misaligned. A joint misalignment often creates a situation where the muscle tendon receives excess pressure and irritation. This irritation comes from either the tendon receiving abnormally high pressure from a bony structure or simply from the tight muscle putting increased stress on the tendon. Often, it is a combination of the two. For this reason, the painful tendon may be the one attached to the tight damaged muscle or could be receiving stress from a joint misalignment caused by another tight muscle.
This continual excessive stress to the tendon causes inflammation, swelling and pain. The pain is usually increased with use of the involved muscle or joint.
This creates a chronic tendinitis condition that will not heal with rest. A problem like this could last a lifetime if not properly treated and will usually worsen as the joint misalignment becomes greater.
A chronic joint misalignment could also result in bursitis, osteoarthritis or neuritis depending on which part of the joint is receiving the abnormal stress.
FACTORS AFFECTING TENDINITIS SEVERITY
You now know the cause of tendinitis, but there are five primary factors that determine the severity of the condition. The first is simply the degree of misalignment in the joint. Obviously, the worse the misalignment the greater the stress on the tendon and the more inflammation and pain normally created.
The second factor is time. Usually, the longer a misalignment is present the more stress and increased scar tissue the muscle and tendon accumulates. This is why tendinitis will often get progressively worse. As people live, work and play they accumulate muscle damage leading to joint misalignments. As time passes, more damage accumulates. Since many of these imbalances are minor the person may not notice a problem until they are 40 or 50 years old. At that time, they begin to have inflammation and pain in whatever joints have been misaligned. Most just assume that it's a natural part of aging and are unaware that a successful treatment exists, so they just live with the pain or use drugs or other treatments that just cover up their symptoms. Unfortunately, as the condition progressively worsens, stronger drugs and more radical treatments are required to deal with the pain.
A third factor influencing the severity of tendinitis is the amount of use the affected joint receives. If someone is physically active in their job, sports, exercising or other activities, more inflammation and pain in the tendon will be created than if they are physically inactive.
The fourth factor is weight. It should be easy to see that weight-bearing joints such as feet, ankles, knees, hips and spine are going to receive more stress in a 250 pound person than in a 125 pound person. Reducing and maintaining a more normal body weight will usually reduce the pain of many tendinitis conditions.
The fifth factor comes from the bodies power of adaptation. When a joint is imbalanced the body actually creates other joint imbalances to compensate and reduce stress to the original imbalanced joint. This can often result in pain relief in the original injured area and explains why a lot of therapies appear to have resolved a problem when they really haven't. Unfortunately, the compensating area will usually develop a problem of its own after a period of time because of the excessive stress it then receives.
TREATMENT FOR CHRONIC TENDINITIS
If you have a chronic tendinitis condition, learning how to do PROGRESSIVE BODY MOVEMENT can help you. The misaligned joint directly causing the tendinitis must be aligned properly and any other joint imbalances which could cause the problem to return must also be aligned. Then we must determine what caused the muscle damage which lead to the joint imbalance. If it is an activity that you are doing incorrectly then you must be educated in how to do it without over-stressing your muscles.
SYMPTOMATIC RELIEF
The symptoms of tendinitis can be treated in various ways. Some relieve the pressure on a tendon temporarily while others help reduce the inflammation caused by the joint imbalance. In my experience, none of these treatments remove the primary cause as PROGRESSIVE BODY MOVEMENTS treatments do, but they are helpful to varying degrees.
Exercise to strengthen certain muscles can sometimes create a counter pull against the tight, damaged muscle. This can help realign the joint in some cases, thereby relieving some of the stress on the inflamed tendon. However, if not done properly it could cause increased pressure on the tendon instead. Unfortunately, since most joint imbalances vary, a generic exercise program can't be designed for most tendinitis conditions. Specific exercises would be designed for someone who received treatments but could not stay long enough to get their joint totally realigned. Those who get their joints realigned totally would be taught exercises to keep their muscles strong and more resistant to over-stress. This helps prevent the problem from returning once the muscles have healed from the treatments.
A lot of tendinitis therapies use heat in some form. Applying heat to short, damaged muscles causes them to lengthen temporarily, thereby relieving some of the pressure on the tendon. This provides some relief, however heat also increases inflammation and makes the problem worse. Using heat to treat tendinitis is a two-edged sword. It helps a little in one way but hurts in another. Whatever you do, never apply dry heat to your muscles. Since muscles are around 70 percent water, the dry heat dehydrates them causing them to become shorter. This creates a greater imbalance in the joint making your problem worse. I believe that massaging and stretching your tight muscles will relieve the pressure and pain as much as moist heat without the negative effect of increasing the inflammation.
A number of nutritional supplements have an anti-inflammatory effect. I recommed KAPREX and ULTRA INFLAMMX. Both can be ordered from the NUTRITION section on this site.
PREVENTION OF TENDINITIS
You now know that the cause of tendinitis is a joint misalignment placing excessive stress on the affected tendon. You also know that scar tissue that has formed to heal an injured muscle is what causes the muscle to shorten and pull the joint out of alignment. Knowing this you should now have an idea about how to prevent tendinitis. It is actually quite simple. Any time you have muscle damage from a trauma, if you treat the injured muscle correctly, very little, if any, scar tissue will form.
You must also learn how to do repetitive activities in such a way that you will not over-stress your muscles and gradually accumulate scar tissue over a long period of time. You should also learn how to avoid poor postural and body usage habits that can cause muscle damage to slowly accumulate. Learning PROGRESSIVE BODY MOVEMENT as taught by Dr. Tucker is one of the best ways to learn how to use your body without over-stressing your muscles. This is very important because many problems are created by the slow accumulation of muscle damage rather than from a trauma of some kind.
Another way to prevent muscle damage is to warm up properly before sports participation or other physical stress. Also, cycling your work, recreational activities or physical training allows your body time to properly heal any areas that have been stressed. For example, if you are training for baseball, don't run three or four days in a row and then throw three or four days in a row. Doing this could easily cause some muscle damage and scar tissue buildup. Instead, alternate running and throwing every other day. This way the muscles around your knees and shoulders will have time to recuperate properly after each training session.
Everyone will benefit from a regular strength-building exercise program for their entire body. This will make all of their muscles more resistant to muscle damage and help prevent not only tendinitis, but also arthritis, bursitis and neuritis. When done efficiently it only takes a few hours each week. If you are a weekend athlete it is especially important to do a regular exercise program during the week. This way you will be less likely to strain a muscle on the weekend while doing a sport you enjoy. Keeping in shape will also make you better at your activity or sport and provide many other health benefits.
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