Plagued by tendon injuries in the past two years.

[Michael Gorsky]

Hello,

My story is far from original but my situation has had many Physical Therapists scratching their head.  I'm a life long athlete, I've trained in everything from Martial Arts, Basketball, Football, Body weight Training, Powerlifting, Cycling Racing (bicycle), and other sports.  I'm 29 years old and the lack of knowledge and respect for the biology and science behind the human physiology has left my body crippled for the past two years.  I've always been the young bull, typical "no pain no gain" and I never had the necessary respect for "easing" into training, I went full gas and expected positive results.

Throughout 2016 I battled with tendinitis in both of my knees, it came in waves, some days I couldn't walk, then I would be fine for months until again I'd be crippled for 2-3 days not being able to get out of bed. The end result was arthroscopic surgery on both knees last summer to repair meniscus damage that was causing locking in my left knee and extreme pain in the right.  Fast forward to Oct. of 2016 when I made near full recovery from the two surgeries only to be brought down with an extreme case of tendinitis in both knees as well as tennis elbow (tendons) in both elbows.  I basically wasn't able to activate my quadriceps muscles between Nov. 2016 and Feb. 2017 because of the sheer pain it placed on the patella tendon.  As you'd imagine this caused extreme atrophy on both of my legs.  I was stuck in my house not able to leave because the stair case outside was too challenging, dealing with any day-to-day activities at home was a nightmare.  I wasn't able to bend my knees for months while in bed.  My doctor told me "it'll take about 6 months for it to heal, nothing else can be done beside physical therapy".  

Since I was unable to train my body for those 6 months because of the tendon injuries, I focused instead on educating myself on the topic of Physical Therapy, mobility, strength training, proper biomechanial movements, healthy dieting to alleviate inflammation, etc.  I made myself the promise that I never want to deal with that kind of pain again and I'll do everything in my power to rebuild my body and transform myself into a healthier athlete.  I've had pretty incredible progress since Feb. because of that commitment but walking down the stairs is still a challenge and I'm still dealing with pain whenever I make unstable movements or go to extreme loads because the muscles are still in a weakened/damaged state.  I'm extremely optimistic about my healing long term, with that said, I know that I have many tendons in my body that are compromised: knees, elbows, hands, wrists, forearms, and possibly in my back.  Some have improved, like the elbows, and others have been flaring up, like my hands and wrists.  I've been on disability since October, the story is much more complicated and deeper but I'd hate to make you guys read a wall of text.
 

My question is: Any there ANYTHING you can recommend for me to continue moving in the right direction and also would sighning up for the Fundamentals & Foundation 1 courses accelerate my healing as well as helping keeping them from flaring up again or would I need to first figure out a solution that works and then return to your courses when my body is fulled healed?

I really need to figure this out, I can't live the rest of my life in this state.
Thank you in advance,
-Mike

[Darin Phoenix]

Hi Michael, 

Sorry to hear that you have been having such a rough time of it over the last two years. It is impossible for any of our coach's on the forum to recommend a training program when you are in such a physically compromised state. 

The physical therapy that your Doctor recommends will be your best course of action, they are in a far more qualified state to make recommendations on your recovery. 

Once your body is healed then our beginner course is Fundamentals. This is a gentle introduction to GST and is a great way to assess your body and discover weaknesses and imbalances before moving onto the other courses.  

Good luck with the rest of your rehabilitation.

[Coach Sommer]

Hello Michael,

Sorry to hear about your present unfortunate circumstance.  However this can also be viewed as an opportunity to finally move forward and stop your seemingly perpetual cycle of injury/recovery/injury/recovery.

First and foremost you MUST stop the obsessive compulsive behavior in your physical training.  Otherwise this will simply turn out to be another brief pit stop of recovery before you once more begin racing towards your next injury.

Embrace the fact that you are not superman.  That there are no magic bullets.  And that time is the one adversary that you are never going to be able to defeat.  

You are in your present situation because over the years you have consistently ignored the multitude of warning signs from your body that you were working far too hard and doing far too much.  You continually abused your body.  And then abused it again.

My recommendations:

1) First, heal.  This is your main priority.  With the degree of damage you have incurred, this is going to be a long, annoying, drawn out process.  When you can tolerate it, began high level bodywork (A.R.T., medical massage etc) with a qualified professional.

Do not attempt to be macho with the bodywork.  Only allow the therapist to work as hard and deeply as you can tolerate while still being able to force yourself to completely relax the muscle being worked upon.  If you find yourself unable to avoid tensing your muscles in a fight or flight response to the pressure, simply ask the therapist to lighten up a bit.  

2) Begin identifying and correcting your mobility deficits.  This will be enormously valuable in increasing your daily quality of life.

3) Learn to train with moderation.  Realize that 'no pain, no gain' is at best a short term game for young adults who still mistakenly believe they are immortal.  As we begin getting older, nature forces us to embrace the notion of 'no brain, no gain'.  As you have discovered first hand, this is a hard dose of reality from which there is no escape.

Best of luck to you and remember that we are here to help as you begin navigating your way out of this labyrinth of injuries back to health.

Yours in Fitness,

Coach Sommer

[Michael Gorsky]

Thank you so much for your response, Coach Sommer.  I listened to your podcast with Tim many times over the the past year to ingrain the information into part of my routines, unfortunately the damage was already done.  If I can ask you this question: If I can do good form, full range, push ups and pull ups pain free (and also while using a "SlingShot" for support) can I do low volume, "Greasing the Grove" kind of training to at least maintain my fitness?  I was thinking 3-5 push ups a few times a day.  I've realized that when a tendon is inflamed, allowing the connecting muscle to hit atrophy only makes the tendon suffer more because its forced to take on extra load that the muscle is no longer able to handle.  

I've been working on mobility every single day, my ROM in my shoulders has increased and with it so has my strength and stability.

Are there any techniques for healing and/or strength gaining you can recommend, specifically for dealing with tendon injuries, that from your experience work best?

Thank you again, it really means a lot.
Michael

 

Edited April 22, 2017 by Michael Gorsky

[Benjamin Renaud]

Hi Michael, I can relate to a much lesser extent, having had tendonitis in both knees that took almost 2 years to rehab and in both elbows in he last year. The only thing I can suggest for recovery is to look at Original Strength book (or the newer one Pressing Reset) to help with recovering mobility with very gentle and manageable exercises. It got me a long way when trying to recover range of motion in my knees and generally moving more and better.

[Michael Gorsky]

4 hours ago, Benjamin Renaud said:

Hi Michael, I can relate to a much lesser extent, having had tendonitis in both knees that took almost 2 years to rehab and in both elbows in he last year. The only thing I can suggest for recovery is to look at Original Strength book (or the newer one Pressing Reset) to help with recovering mobility with very gentle and manageable exercises. It got me a long way when trying to recover range of motion in my knees and generally moving more and better.

Thank you for the suggestion, I just ordered "Press Reset".  I completely agree with his philosophy, sounds like this book goes over a lot of his theories.  

 

Would still appreciate if anyone can recommend anything that would help rebuilding from "crippling" tendinitis. 

 

Thank you again, everyone.

Mike

[Coach Sommer]

Michael,

No.  Let me repeat that again as it appears you did not hear me the first time ... NO!

No, you may not attempt to maintain your fitness while you heal.  

No, you may not attempt another short cut to shorten the healing time.

Stop.  Accept the fact that you are broken.  If you continue, broken is going to transition to crippled.  

Yours in Fitness,

Coach Sommer

[Benjamin Renaud]

@Michael Gorsky you need to find a physical therapist to rebuild from tendonitis. Usually eccentric protocols are what seem to work best. But do find professional help. The best you can do is light activity if you can handle it, like walking and swimming. And like coach said ART or other modalities may help. I had ART done for my knees and it helped a lot.

[Jonas Winback]

Sorry to necromance a semi-old thread, but I thought I'd post some tendon related research here instead of creating a new thread.

A researcher named Keith Baar hade made some pretty interesting research lately regarding tendons, injuries and injury prevention. He makes his own tendons and ligaments in a lab and does research on that, among other things.

In one fairly recent article he summarizes some key points he finds relevant to injury prevention, aimed at both training and nutrition:

From the background provided above, a series of recommendations can be developed to maximize performance, decrease the risk of tendon/ligament injury, and/or accelerate return to play.

Consider incorporating a connective tissue health session into training. This type of session would involve <10 min of activity targeted to a tendon/ligament that is prone to injury. For example, runners would do a session to target the hamstrings and patellar and Achilles tendons, whereas baseball players would target the throwing arm. These exercises could be performed with a light weight and using a limited range of motion if necessary. The connective tissue health session should be performed either 6 h before or after any other training.

Following injury, athletes should begin training as soon as possible. Training can consist of simple range-of-motion and limited weight supported exercises because the amplitude of the load is not important for stimulating collagen production [25]. The training should again consist of <10 min of activity followed by 6 h of rest. Reasonably, this means that the athlete will train for three short periods each day.

Consume leucine-rich protein as part of training. Beyond the direct effects this will have on muscle [47], tendons will also benefit from the added muscle mass and strength and possibly a greater mTORC1 activation [15].

Glucose uptake into tendons increases during exercise [48]. However, because blood flow to inactive tendons is limited, nutrient delivery to tendons following exercise is believed to be relatively low. This suggests that any nutritional intervention that is designed to directly target a specific tendon/ligament needs to be in place prior to exercise.

Thirty to sixty minutes before training, athletes should be encouraged to consume 15 g of gelatin in either a liquid or gel form [46]. The exact amount of gelatin and whether this will vary with body weight is currently being determined.

Also, recently he was featured in a podcast and discusses some things in detail. Really good stuff for learning more about how tendons work.

[Alessandro Mainente]

The truth is that the only one medicine against connective tissue injuries it is the prevention. period.

wrong training exercises, wrong intensity, wrong frequency, wrong volume, bad estimation of personal possibilities, super big ego are the biggest enemies of the prevention.

[Oscar Riaño]

54 minutes ago, Alessandro Mainente said:

The truth is that the only one medicine against connective tissue injuries it is the prevention. period.

wrong training exercises, wrong intensity, wrong frequency, wrong volume, bad estimation of personal possibilities, super big ego are the biggest enemies of the prevention.

Perfect answer! Put an emphasis on ego

[Jonas Winback]

True enough. But if everybody had knowledge of the proper way to do all these things and perfect knowledge of their own physical possibilities and limitations then people wouldn't be struggling so much with injuries in general. Getting one or several overuse injuries or something similar and trying to find a correct way back from that through limiting their activities, a proper progression of the dosage and exercises etc can be a puzzle. If anything can improve and increase the chances of things turning out the right way, then that might be something worth learning about.

[Alessandro Mainente]

4 hours ago, Jonas Winback said:

True enough. But if everybody had knowledge of the proper way to do all these things and perfect knowledge of their own physical possibilities and limitations then people wouldn't be struggling so much with injuries in general. Getting one or several overuse injuries or something similar and trying to find a correct way back from that through limiting their activities, a proper progression of the dosage and exercises etc can be a puzzle. If anything can improve and increase the chances of things turning out the right way, then that might be something worth learning about.

 

"perfect knowledge of their own physical possibilities and limitations" this is the problem. people overestimate their possibilities.