About Tendonitis

[Banzas]

I was looking at Powerball's official forum and found this topic, maybe you'll find it helpful (maybe you don't have a powerball but the theory is interesting).

http://www.powerballs.com/forum/showthr ... -explained

Tendonitis

Tendons are, effectively, bits a string tying the muscles to the bone. As the muscle moves, so the tendon transmits that movement to the bone and joint movement occurs.

In an ideal world the strength of the tendon would be more than the strength of the muscle. That way the muscle could never inadvertently damage the tendon.

Tendonitis occurs when the tendon becomes inflamed. This can happen because of constant rubbing across the tendon such as when wearing a pair of boots that cut into the achilles tendon at the back of the ankle. It can also occur because of a direct injury to the tendon that fails to heal properly.

But mostly it occurs for no apparent reason, and the diagnosis is usually "overuse" or "repetitive strain injury".

So what happens?

Basically, (and we are talking "overuse" injuries here - although the theory will work with all tendonitis) the muscle applies the force to the tendon, over and over again until the tendon becomes sore.

Now, and heres the interesting bit, lets go backwards and discuss how the human body gets stronger. Everytime you exercise anything your cells undergo stress. Those that are strong enough will absorb it no problem. Those that aren't strong enough will "self distruct".

Literally.

The cells are all full of little bubbles of acid called lysosomes. When they become over stressed the bubbles burst and the cell is destroyed by the lysosomes. This rather brutal way of destroying things paves the way for new and stronger cells to replace them.

So we have a system where old, or weak cells are constantly replaced by new stronger ones.

Very clever.

You know this feeling. Exercise hard and the next day everything feels stiff and sore. Thats your body destroying old cells ready for stronger ones to be put down.

So, in a normal body, if you exercise, you notice the muscles sore the next day, because the muscles were the "weak link".

The same exact thing happens in tendons too. You exercise, they destroy the weak and replace with the strong. You just don't feel it as much because the tendons don't have as good a nerve supply.

They also don't have as good a blood supply so it takes them longer to heal.

Now, what happens if your muscles become stronger than your tendons?

Basically, you don't notice yourself become tired and achey until your tendons start hurting :- Tendonitis.

Add in the slower healing and if you do the same activity everyday you are destroying faster than your healing - not good.

Typical tendonitis culprits:

Typing - The muscles to your fingers get worked over and over. Everyday you are back typing without giving your tendons time to recover.

Tennis - Well not really, rarely have I ever seen a tennis player with tennis elbow, but the theory is that the muscles are the wrist are super strong and its the tendons that get damaged.

So next question is what can we do?

Well, if we can increase the blood supply, give the tendon enough time to heal and make sure the tendon strength stays ahead of the muscle strength then we will overthrow the tendonitis.

Next bit of science---->

The eccentric phase of loading.

Medical speak for putting a weight down rather than picking it up.

Imagine, if you will, a tennis ball on a string. Lift the string and the ball will come with it.

Its not difficult, the ball is quite light. Then having lifted the string and ball, drop your hand quickly and then stop suddenly.

The ball will briefly be in freefall before the string stops it suddenly.

The weight of the ball hasn't changed, but the pressure in the string was higher stopping it going down than when lifting it up.

Transpose that to muscle and tendon, and the tendon works harder when putting something down that when lifting it up.

So if we concentrate on the lowering phase (the eccentric phase), we will strengthen tendon. And thats one third of the battle.

Now for best results we want to work on eccentric training until we feel the "burn", like you would if strengthening muscle. We then leave it for 24 hours to heal before attempting anything else.

In the legs, easy - Patella Tendonitis, drop into a little squat and repeat until it starts aching.

Achilles tendonitis, stand on a step and drop your heels over the end, repeat until you feel the ache.

With both, try again tommorow and you will get there eventually.

With the arms? Hard.

Until now.

The powerball, during its slowing down stage especially, but all the time you are in control of it (and its not in control of you), you are working eccentrically.

Spin once a day, until you feel an ache (and this will be a different speed and duration for everyone).

Over weeks you will improve your tendon strength.

As a side note, the longer you powerball for the more bloodflow will increase. So its better to spin for slightly longer, at a lower speed than short but fast.

Aim for 3-5 mins or there abouts.

May I finally say that not all pains are tendonitis, other conditions such as tenovaginitis and bursitis can immitate a tendonitis, but may not respond in the same way.

So its still worth asking for help!

This looked interesting to me because I feel some pain on my left elbow (not intense, not sure if it is tendonitis because it doesn't hurt when I exercise, just after) and I have a powerball so maybe I can use it for some rehab and to gain strength on my elbow.

Banzas

[AlexX]

The Steady State Cycle is a good way to ensure that your tendons stay on par with muscle strength growth. It has helped me greatly in reducing injuries, especially now that my job has become more manual labor intensive.

[Khassera]

Raising this topic just to ask around:

Anyone have any experience in rehabbing tendonitis with a powerball?

I have been spinning my powerball for the past week now, and I feel my arm's getting exponentially better every day. I think Slizzardman said at some point that tendonitis rehab is about increasing bloodflow to the tendons which in turn carries away broken and dead tissue and replaces it with new tissue. If you're immobile, there's virtually no bloodflow, thus no recovery. If you rehab and mobilize the joint every day, there's a steady stream of bloodflow to the tendon which speeds up the recovery. This is my logic at work, not a scientific statement, so please, if I'm wrong feel free to correct me.

My golfer's/climber's elbow rehab looks like this:

Before my workout of the day:

- 5-10mins of low-intensity spinning

- Stretching

Workout (squat power cycle + abdominals, I do heavy dips with pbars once a week to hit the upper body, other than that it's off limits)

after workout:

- 5-10mins of low intensity spinning

- Stretching

- Vibration treatment with a car polisher (Yep! Works like a charm!) to the tendons and forearm

- ice pack cooldown 1-3 times after workout each spaced about 2h apart

I received my Glucosamine and vit C supplements today, started to take em. High doses of vit C, normal dose of Glucosamine and a high dose of omega 3 is also in my regimen.

[Khassera]

Anyone have any input on this?

I'm pretty desperate. My arm's a lot better now, but I still have pain very, very locally (an area on the medial epicondyle on the proximal end of ulna about the size of a fingertip) when I turn the arm into an armwrestling position, that is 90' angle + false grip flexor and humeral supination. This sucks!

Next week I'll go get an ultrasound to check what's going on. I'd love to know if this thing's gonna stay with me 'til the end of time, am I doomed to never do another chinup?

And I'd also love to know if Ido or Slizz have experienced tendonitis during their training careers and how they coped with it.

[anhkun]

when slight symptoms of tendonitis occurs, what should i stop doing? e.g handstands. back lever, planches? or just take a week off?

[Blairbob]

A week? At least 2-3 days, I'd say.

[anhkun]

A week? At least 2-3 days, I'd say.

so lets say i get some pains in my left elbow, avoid all exercises that might put stress on it? e.g handstands, back levers, planches, chinups etc?

[Nic Branson]

Tendonitis...what a pain this is and very very easy to prolong.

Does performing the movement bother it? If yes, do not do it.

Does it bother it afterwards? If yes, if the pain is minor then scale back is severe do not do it.

If it comes on bad then I would take a week and do light work, higher reps to move some blood and fresh nutrients around the body the extra recovery time should help get it down some.

Things that have worked for me to deal with somewhat chronic issues (mostly R bicep tendonitis proximally located)from old injuries. Manual massage, liniment prior to training (only used when the tendonitis is flaring up) and compression sleeves AFTER training. I do not advocate them for use during as you do not want to mask any of the symptoms.

It might take some time for the pain to go completely away, learn to manage the volume and don't push it while it is healing. I'm not an ice fan personally, really only if the pain and swelling is severe.

[Joshua Naterman]

Anyone have any input on this?

I'm pretty desperate. My arm's a lot better now, but I still have pain very, very locally (an area on the medial epicondyle on the proximal end of ulna about the size of a fingertip) when I turn the arm into an armwrestling position, that is 90' angle + false grip flexor and humeral supination. This sucks!

Next week I'll go get an ultrasound to check what's going on. I'd love to know if this thing's gonna stay with me 'til the end of time, am I doomed to never do another chinup?

And I'd also love to know if Ido or Slizz have experienced tendonitis during their training careers and how they coped with it.

Sounds like you may have problems with pronator teres. Look up that muscle and work on it specifically and see if that helps. Go light and don't dig too hard with manual techniques. Little by little is the way to go.

Part of that originally quoted post is bunk, but that's not an issue I want to tackle. Eccentric exercise seems to be an important part of healing the tendons, that is true. NEVER go past a 5 out of 10 on a pain scale when performing rehab exercises, and that pain should only register to that point during the eccentric and NOT get worse with each rep.

Statics allow you to exert a relatively constant force on the tendons and control it, which makes slow strengthening of the tendon attachments (both to the bone and to the muscle) easy to do without damaging anything. The tendon itself is stronger than the muscle in nearly all cases aside from steroid abuse, it is the junction with the muscle that gets damaged most often. It is generally excessive passive tension (muscle tone) that causes the tendinopathies to appear, though the mentioned rubbing can also cause the problems. Usually it is the excess tension that leads to the rubbing but there are some areas inherently vulnerable to this.

Compression sleeves during training can be great because they help keep everything warm and can help distribute the tension in the tendon, but like it has been said you have to be careful not to use them as an excuse to work harder. You should use them as a tool to let you stay comfortable while you perform your normal work. If this may be a problem for you, like canthar said you shouldn't use them until after.

There is a LOT of misinformation out there regarding full healing time. Even for minor injuries rehab is not 100% complete for 6-12 months. Try to remember that.

Finally, controlled elastic forces help immensely with rehabbing tendon injuries when they can be used appropriately.

[Andrew Komarnyckyj]

I've personally found the Tyler Twist very effective as a cure for chronic tendonitis. Apparently there is some clinical evidence (as well as my own experience) supporting the view that it works.

http://www.hygenicblog.com/2009/08/26/t ... ork-times/

[Joshua Naterman]

I've personally found the Tyler Twist very effective as a cure for chronic tendonitis. Apparently there is some clinical evidence (as well as my own experience) supporting the view that it works.

http://www.hygenicblog.com/2009/08/26/t ... ork-times/

Loaded pronation and supination will always help when appropriate resistance is used, and this particular type of loaded pronation/supination is excellent because it causes ALL the muscles to work together which keeps them all appropriately strengthened.

The bottom line is that in the elbow tendinopathies tend to come from chronic over-exertion. In other words, doing significantly more work than the muscles can actually handle on a regular basis. This causes them to get tight and put extra stress on the tendons, which are designed to be relaxed when not in use. This extra stress due to tightness (hypertonicity, too much muscle tone) causes quite a number of issues.

There is technically no such thing as chronic tendonitis. Tendonitis is, by nature, an acute injury. Once you're past 2-3 weeks you are technically developing tendonosis, which is a degenerative condition and not an inflammatory one. That's important because using the right words allows you to get the correct advice when trying to rehab yourself!

[Andrew Komarnyckyj]

OK - thanks for that! I must admit that the statement about excess muscle tone stacks up for me. I was always able to get temporary relief by thorough static stretching of the arms and shoulders.