Tendonitis

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    Tendonitis

    I am sure this has been talked about before, but I need advice. I have really bad tendinitis in both of my elbow areas. If I go to the doctor, I know what they are going to say. Rest, rest, rest. I get that and I know that is what I need to do, but it is so hard to not workout. Any ideas or suggestions
    No pain no gain right?





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    rest, ice, ibuprofen.





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    i swear to god, i have been battling debilitating tendonitis in my wrists and elbows forever. for me, i have found that 2500mg of glucosamine per day, skeletal balm and ice is magical. i totally feel like a new man. i still have some pain (i guess i always will) and i have to be particular with my movements, but i feel soooooo much better. my orthopaedist had me on mobic, which is very harsh on the liver and didn't work nearly as well as my system now does,
    Cutting Hurts, But I Want To Be Hard ! ! !

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    Rest, ice, NO IBUPROFEN! NSAIDS interfere with healing; as your body lays down new tissue, inflammation helps it lay down in an organized matrix. NSAIDS interrupt this; you will tend to re-injure the area because it will never quite heal properly.

    You could try running a little bit of NPP while you do physio on the area. Also, while you train, you must not re-irritate it. I'm going through this with my left hip right now - when I squat anything heavier than 95 lbs my psoas gets annoyed; the only way to heal this is to do my physio and basically not squat until I can do so with no pain at all.

    Gena, there's always something else you can train. Train lats; train your hams. Build up your calves and your quads. Work on your abs. Build up your endurance base. Do more of everything you can, while you completely stop doing ANYTHING that irritates the tendinitis AT ALL or it will never get better.

    </tough love>





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    Thanks for the advice. I well rest. I know I need to.






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    Quote Originally Posted by Prince View Post
    rest, ice, ibuprofen.
    This.

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    I've been dealing with same thing. Lot's of icing, stretching and massaging the elbows. I took 6weeks of all pressing, and when I finally reintroduced presses, I used very light weight and very controlled eccentrics.

    I still have to avoid certain movements, and I will probably avoid all triceps isolation that's not rehabilitory for a long time yet, but the pain has vastly improved and really only occurs now with the first couple of warm-up sets for any overhead work.

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    You are all so wonderful. I have wraps on them now, I hope this helps. I have a great massage therapist that have given me may ideas. I have stopped working upper body for a while. I am sure that will help. Yes tough love
    I think I was working my muscles harder then I should have far to soon. Backing off now. Life will be good again soon





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    Quote Originally Posted by Built View Post
    Rest, ice, NO IBUPROFEN! NSAIDS interfere with healing; as your body lays down new tissue, inflammation helps it lay down in an organized matrix. NSAIDS interrupt this; you will tend to re-injure the area because it will never quite heal properly.
    The effects of common anti-inflammatory drugs on the healing rat patellar tendon.

    Ferry ST, Dahners LE, Afshari HM, Weinhold PS.
    Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA.

    Abstract

    BACKGROUND: Tendon injuries that occur at the osteotendinous junction are commonly seen in clinical practice and range from acute strain to rupture. Nonsteroidal anti-inflammatory drugs are often prescribed in the treatment of these conditions, but the effect that these agents may have on the healing response at the bone-tendon junction is unclear.

    HYPOTHESIS: In response to an acute injury at the osteotendinous junction, the healing patellar tendon will have inferior biomechanical properties with administration of anti-inflammatory drugs as compared with acetaminophen and control.

    STUDY DESIGN: Controlled laboratory study.

    METHODS: A total of 215 Sprague-Dawley rats underwent transection of the patellar tendon at the inferior pole of the patella, which was subsequently stabilized with a cerclage suture. The animals were then randomized into 7 groups and administered 1 of the following analgesics for 14 days: ibuprofen, acetaminophen, naproxen, piroxicam, celecoxib, valdecoxib, or control. At 14 days, all animals were sacrificed, and the extensor mechanism was isolated and loaded to failure. Biochemical analysis of the repair site tissue was performed. Animal activity throughout the study was monitored using a photoelectric sensor system.

    ESULTS: The control group demonstrated greater maximum load compared with the celecoxib, valdecoxib, and piroxicam groups (P < .05). The acetaminophen and ibuprofen groups were also significantly stronger than the celecoxib group (P < .05) but not statistically different than the control group. A total of 23 specimens had failure of the cerclage suture with the following distribution: control (0/23), ibuprofen (0/23), acetaminophen (0/24), naproxen (3/24), piroxicam (4/24), celecoxib (6/22), and valdecoxib (10/24). The difference in distribution of the failures was significant (P < .001).

    CONCLUSIONS: Anti-inflammatory drugs, with the exception of ibuprofen, had a detrimental effect on healing strength at the bone-tendon junction as demonstrated by decreased failure loads and increased failures of the cerclage suture. Acetaminophen had no effect on healing strength. The biomechanical properties paralleled closely with the total collagen content at the injury site, suggesting that these agents may alter healing strength by decreasing collagen content.

    CLINICAL RELEVANCE: Selective and nonselective cyclooxygenase (COX) inhibitors should be used judiciously in the acute period after injury or surgical repair at the bone-tendon junction.

    PMID: 17452512 [PubMed - indexed for MEDLINE]

    The effects of common anti-inflammatory drugs on t... [Am J Sports Med. 2007] - PubMed result





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    Baby I have been with you for so long, how could I ever listen to anyone but you. You have always been right on every thing you have ever told me. You are such the MAN. Sorry ladies, he is all mine and I will fight til the end
    I have never meet a man a wonderful as you xoxo





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    Anything studied on humans? We aren't always all that rat-like.





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    The study posted did not prove that ibuprofen does not interfere with healing. What it did was to demonstrate that of the NSAIDs administered to rats with knee injuries, all but one - ibuprofen - caused problems. We don't know if a higher dose would have caused problems for the little rats, or if ibuprofen is universally safe for all tendinopathies. This study, for instance, is more recent than the one Prince posted:

    Ibuprofen upregulates expressions of matrix metall... [J Orthop Res. 2010] - PubMed result
    "In conclusion, ibuprofen upregulates the expressions of collagenases including MMP-1, -8, -9, and -13 without affecting the expressions of types I and III collagen. These findings suggest a molecular mechanism potentially accounting for the inhibition of tendon healing by ibuprofen." Note that the researchers do not doubt ibuprofen's inhibition of tendon healing - in fact, they are postulating the mechanism.

    We have had strong evidence for many years now that ibuprofen causes problems for tendinopathies in primates, which are much closer to humans and thus for whom results are more generalizable:
    Oral ibuprofen: evaluation of its effect on perite... [J Hand Surg Am. 1986] - PubMed result
    Oral ibuprofen: evaluation of its effect on peritendinous adhesions and the breaking strength of a tenorrhaphy.

    Kulick MI, Smith S, Hadler K.
    Abstract

    In a study of 21 primates, treatment with oral ibuprofen significantly reduced the force required for tendon gliding following flexor tendon injury in zone II. Tendons that were partially lacerated but not repaired required less force for tendon motion than those repaired. Ibuprofen also reduced the breaking strength of completely divided and repaired extensor tendons. The addition of a piece of chromic suture buried across the extensor tenorrhaphy site significantly increased the breaking strength of the repair in control and treated animals alike. These findings were observed at 4 and 6 weeks after tendon injury and repair. No adverse reactions to the medication were observed.


    There has been surprising little research done on humans using ibuprofen, but one recent study showed that it interferes with bone healing:
    Effect of acetaminophen, ibuprofen and methylpredn... [Arch Oral Biol. 2010] - PubMed result
    "CONCLUSION: These results suggest that ibuprofen, acetaminophen and methylprednisolone at therapeutic doses reduce osteoblast growth without affecting other cell parameters, such as antigenic profile or cell cycle. Use of these drugs should be reconsidered in clinical situations that require a rapid healing of bone defects."

    So, depending upon your particular persuasion you may choose to identify with the lucky rats in one study, or the unfortunate humans, rats and primates in other studies. NSAIDS interfere with healing because they interfere with inflammation. Sometimes this is helpful. Usually it is not. A notworthy exception is in cases where healing is not desirable (adhesions). If you must take an NSAID, ibuprofen is the one you probably want as it seems to cause the least problems of them all. But I would stop short of recommending it during the acute healing phase of an injury.





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    nice studies done on monkeys, any on humans?





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    Read my post again. The 2010 study I posted was on human osteoblasts.





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    Quote Originally Posted by Built View Post
    So, depending upon your particular persuasion you may choose to identify with the lucky rats in one study, or the unfortunate humans, rats and primates in other studies. NSAIDS interfere with healing because they interfere with inflammation. Sometimes this is helpful. Usually it is not. A notworthy exception is in cases where healing is not desirable (adhesions). If you must take an NSAID, ibuprofen is the one you probably want as it seems to cause the least problems of them all. But I would stop short of recommending it during the acute healing phase of an injury.
    Fine, but nothing you posted is any more conclusive than what I posted.





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