Tendonitis - Any Suggestions

[nueces5]

I have been fighting tendonitis in my shoulder/elbow for the last two years and haven't been able to shake it. I got from playing too much softball and now it is affecting my ability to shoot and practice. The last two years I have been been a drain on shooting without being able to practice or maintain any consistancy.

I have tried everything that has been suggested to me so far, anyone have any ideas to get rid of tendonitis?

Hi, I am a general surgeon.

I was a rock climber, had tendinitis.

I did a treatment that today I it recommend to my patients.

Voltaren (not other one) 50mg every 12 hs + omeprazolel 40 mg every day.

The most important: absolute rest for 3 months The ice works better when it is ACUTE (in two weeks from start pain) someone kind of kinesiology, heat, laser, etc...

Any ask, just do it

Edited December 3, 2009 by nueces5

[Godzilla]

Thanks for the MD's chipping in. I did seek professional medical advice but I was very disappointed in the direction that I given. That is why I started the post to see what the scope of cures or remedies were available out there from first hand experience.

After 6-8 visits with the doctor (over a 18 month period) all I got was a shot, 2 visits to the rehab clinic/a couple of rubber bands and a little arm compression band. I was told to lay off from doing anything that hurt it (originally baseball and softball) and it might get better. I have done everything that I was advised to do but no results.

Jerry told me that he had a surgery several years ago that removed a bit of material under the muscles in his forearm and that cured his issues.

I tried to get a referral to specialist and she (my doctor) said it wasn't necessary although she has not been able to help me get better over the last two years. I guess some of the doctors don’t take it as a serious aliment.

I have been taking fish oil, laying off all of the fun activities and even the not so fun ones. I wear an arm support (even at night) and take anti inflammatories. I am trying to incorporate the wrist curls as much as possible but back off if the pain comes back. I also have been montoring my diet but I normally do that anyway.

All in all I feel a little better but don’t think that I am any closer to getting rid of the problem.

[Woody Allen]

Tendonitis vs. tendonosis: It’s all in tendons

http://www.leaderherald.com/page/content.d...7.html?nav=5004

If you treat tendonosis as you would treat tendonitis-it will never ever go away. Treating tendonosis as you would tendonitis often makes it worse.

You need to see someone who knows the difference. Your best bet is a physical therapist/doctor who treats college or professional athletes on a regular basis.

Edited December 3, 2009 by Woody Allen

[nueces5]

Thanks for the MD's chipping in. I did seek professional medical advice but I was very disappointed in the direction that I given. That is why I started the post to see what the scope of cures or remedies were available out there from first hand experience.

After 6-8 visits with the doctor (over a 18 month period) all I got was a shot, 2 visits to the rehab clinic/a couple of rubber bands and a little arm compression band. I was told to lay off from doing anything that hurt it (originally baseball and softball) and it might get better. I have done everything that I was advised to do but no results.

Jerry told me that he had a surgery several years ago that removed a bit of material under the muscles in his forearm and that cured his issues.

I tried to get a referral to specialist and she (my doctor) said it wasn't necessary although she has not been able to help me get better over the last two years. I guess some of the doctors don’t take it as a serious aliment.

I have been taking fish oil, laying off all of the fun activities and even the not so fun ones. I wear an arm support (even at night) and take anti inflammatories. I am trying to incorporate the wrist curls as much as possible but back off if the pain comes back. I also have been montoring my diet but I normally do that anyway.

All in all I feel a little better but don’t think that I am any closer to getting rid of the problem.

two years is too much time.

ibuprofen is very good for fever, not for your problem.

Buy some diclofenac, I use voltaren, some omeprazole (protect your stomac ), try 3 weeks, If you do not feel better, maybe you need a MRI ...You cannot live with pain

[Bear23]

"

I tried to get a referral to specialist and she (my doctor) said it wasn't necessary although she has not been able to help me get better over the last two years. I guess some of the doctors don’t take it as a serious aliment.

"

there is the source of your problem. get to a shoulder specialist, ortho or physiatrist.. You obviously have a an impingement syndrome and most likely a partial tear of the supraspinatus tendon (I am assuming this as you mentioned a surgery which would decompress the area).

[Jake Di Vita]

take anti inflammatories. I am trying to incorporate the wrist curls as much as possible but back off if the pain comes back.

Do NOT self medicate with NSAIDS (yes that means ibuprofen).

Also you are trying to control inflammation and then stressing an obviously injured part of the body causing inflammation. Knock off the wrist curls.

Ice massage. Twice a day gets you a "C". It is passing, but barely. How many Omega 3's are you ingesting daily? Are you eating bread, pasta, starches? All three of those greatly promote inflammation.

[eric nielsen]

PM sent.

I would very much like to see the moderators close this topic ASAP.

[Singlestack]

PM sent.

I would very much like to see the moderators close this topic ASAP.

Why?

[JeffCSR]

PM sent.

I would very much like to see the moderators close this topic ASAP.

Why?

Good Question, my tendinitis has been affecting my shooting, what's wrong with the topic?

I saw a Surgeon in July, went thru therapy and problem returned. I'm unable to take ibuprofen etc due to heart meds, any tips I find I think are helpful. Would be nice to home remedy if possible.

[eric nielsen]

I let the 1st poster know that inflammation is an incredibly complex subject and that he needs a very good specialist to nail down both the cause and treatment of his individual case. A doctor's group of orthopedists and pain specialists, with their own practice location and their own x-ray facilities, would be a great choice.

In this thread there are a few good suggestions that would likely not hurt anyone if they were followed. There is also a ton of well-meaning but inaccurate or non-applicable information: the majority of the posts. I've been taught enough so far to realize that I'm not qualified to diagnose or recommend treatment for Mike's condition. Also learned enough to be disturbed by some of the info here.

Usually this forum is a great place to learn but not so much this one thread. I think a better angle for Brian's forum to tackle would be along the lines of which gun - Open, Limited, Production - or which technique, which repetitive motion, has led to pain/inflammation. Did a switch to a different ______ [division, ammo, training regimen, etc] help. That sort of thing.

A better place to get free, forum-type advice on medical matters would be a medical forum. One in which practicing doctors check in frequently.

Inflammation is one of the most frustrating disorders of the human body. The way the body creates and then clears inflammation - or doesn't clear it - is so crazy in its complexity and contradictions that I wanted several times to give up the task of learning it. If it helps you visualize the scope of the inflammation problem, here are three links. They should be good for the next 7 days. Please don't repost their contents:

DiPiro text

Williams text

G&G text

[Woody Allen]

I suggest that you skip the pain specialists, orthopetics, xrays, MRIs. Find a physical therapist (find one with their own shop if possible) near a large University who regularly treats atheletes. Make an appointment. Your insurance most likely won't pay. Pay the $ 50-$100 out of your pocket. They see many many injuries from repetitive motion (sports). If you have a history of repeated bouts of tendonitis, it can be as simple as a few exercises to straighten the collagan fibers as they regenerate over a period of months, use of ice (how to use the ice), and how to resume your shooting often in a matter of weeks (within limits), and how to prevent it in the future.

KEY-THEY know who to refer you to if they suspect it is not run of the mill tendonitis or tendonosis and they know the difference between tendonitis and tendonosis. If you try to copy the exercises from this forum or the net, and/or swallow gallons of fish oil, you may have to take up another sport. These PTs make their living getting atheletes back playing. They know which doctors to avoid.

[Paul Burtchell]

http://www.activerelease.com/what_patients.asp

One more time.....

[Woody Allen]

http://www.activerelease.com/what_patients.asp

One more time.....

http://www.tendinosis.org/index.html

Eric is right-close the thread.

Edited December 5, 2009 by Woody Allen

[Singlestack]

Just so y'all know. We don't close threads because someone disagrees with its content.

As with anything on the internet, it is up to the reader to decide what is useful and what is not.

[eric nielsen]

Evidence-based medicine is the foundation of all licensed, clinical care by doctors and pharmacists in this country. Long-term studies are done with single-blind and especially double-blind trials that are peer-reviewed and repeated by 2nd parties, usually many times over. Meta-studies are done after the fact to look for statistically and clinically significant correlations between treatment and effects, good and bad.

There are literally hundreds of medical procedures and medicine therapies done every day that do not have a solid chain of theory and science to rationally explain why they work but are done because they have shown - in the process described above - that they DO work. There is also a giant scrap-heap of medicines and procedures that have been rejected by the health care community because, even with volumes of solid science and accepted theory behind them, time has shown that they do NOT work. The evidence shows no proven benefit, or even a proven detriment.

There are areas of commerce and practice that have been de-regulated or never regulated - grandfathered, for lack of a simpler term. Vitamins, supplements, chiropractic techniques, and over-the-counter medications are all examples. False claims are rampant and are eventually, but often slowly, run down and put to an end by the FDA or other oversight bodies. Often after much harm has been done.

If someone has experienced pain during joint movement over and extended period of time, say 6 months or more, the difference between correctly identifying the cause and effective treatment - or not - can literally mean the difference between use of that limb or spinal mobility for the rest of the patient's life. Or not.

At least 85% of the content of this thread has tremendous power to do harm. Agree or not, that is your choice.

[Woody Allen]

If someone has experienced pain during joint movement over and extended period of time, say 6 months or more, the difference between correctly identifying the cause and effective treatment - or not - can literally mean the difference between use of that limb or spinal mobility for the rest of the patient's life. Or not.

At least 85% of the content of this thread has tremendous power to do harm. Agree or not, that is your choice.

Some in this shooting sport engage in the same repetitive movements, hundreds or thousands of the same movements daily/weekly. They have an injury. See go through the course of seeing their doctor, referred to an Ortho, get shots, PT, rubber bands etc. They never get better. No more bowhunting, shooting, bowling, baseball, football..... After months, maybe years of disability-they get surgery. And then the problems surface again.

How many reading this have battled for years with tendonitis? If so, you may be in the same boat next week, next month, next year.

I am sure there are some who are reading this nodding their head as they are living it. Why? They did what they are supposed to do-saw medical professionals, did the therapy. Or they simply self-treated. Most often-they saw the wrong professional/wrong self-treatment. Whatever they did most likely didn't address the problem, and most often caused more damage. Now they are looking for the answer-the elusive what will fix this.

You don't take your $3k blaster to the down the road gunsmith. Is a gunsmith a gunsmith...ah...no not really. Is any Ortho competent to correctly diagnose the type of injuries we suffer in this sport...ah...no not really. Yet they all claim they can. Chiropractors...yea...ultrasound, laser therapy, friction massage, electric stimulation therapy...ask to be directed to the studies that support these "treatments." Silence.

Big ten universities don't use professionals who don't get results, at least not for very long. They are in the result business, not billing the insurance company business, not the promises business.

Your a racehorse-don't see your local vet. See someone who treats racehorses whose job is to get them back on the track winning money.

[Tom D.]

First, thanks to the mods for NOT CLOSING this thread. Like godzilla, I have a recurring pain (in my left forearm) that I just can't get Drs. interested in, even a sports pain specialist. He did help with my wore out shoulders, tho. And, this is the first I had heard of tendonosis so this thread has been and is useful to me. Do any of the docs who were good enough to contribute to this thread have any suggestions as to how to get a Dr. to take my problem serious? No offense to them and the many great docs out there but often it is apparent why the business is call 'practice'.

[Aloha Robert]

Thanks for the MD's chipping in. I did seek professional medical advice but I was very disappointed in the direction that I given. That is why I started the post to see what the scope of cures or remedies were available out there from first hand experience.

After 6-8 visits with the doctor (over a 18 month period) all I got was a shot, 2 visits to the rehab clinic/a couple of rubber bands and a little arm compression band. I was told to lay off from doing anything that hurt it (originally baseball and softball) and it might get better. I have done everything that I was advised to do but no results.

Jerry told me that he had a surgery several years ago that removed a bit of material under the muscles in his forearm and that cured his issues.

I tried to get a referral to specialist and she (my doctor) said it wasn't necessary although she has not been able to help me get better over the last two years. I guess some of the doctors don’t take it as a serious aliment.

I have been taking fish oil, laying off all of the fun activities and even the not so fun ones. I wear an arm support (even at night) and take anti inflammatories. I am trying to incorporate the wrist curls as much as possible but back off if the pain comes back. I also have been montoring my diet but I normally do that anyway.

All in all I feel a little better but don’t think that I am any closer to getting rid of the problem.

I am the MD Sports Medicine guy with over 30 years experience with these types of probems.

More of story comes out now, but here are.

Key points

2 years

anatomic location not clear from post somewhere Shoulder or Elbow

No response to conservative therapy

Diagnosis unclear.

Treated by non specialist ( a big RED FLAG)

Diagnostic tests unknown.

SO again I am not YOUR doc but at this point the proper recommendations are

See a specialist and if not satisfied, see another one

Make sure specialist gives you precise diagnosis in term of location and type

For specialist to do this will probably require diagnostic testing which may be any where from Neck to Fingers in location. Types of Test might include MRI of primary or adjacent location, Xrays, or electrical tests.

AFTER the above the treatment plan can be proposed.

Since a lot of folks have made humerous suggestions and since your condition is chronic,I will say this, Fish Oil no matter what orifice you put it in will not fix you. But if you take enough by mouth you may need a silencer at the other end.

Best wishes to Godzilla for a speedy recovery

[Aloha Robert]

If someone has experienced pain during joint movement over and extended period of time, say 6 months or more, the difference between correctly identifying the cause and effective treatment - or not - can literally mean the difference between use of that limb or spinal mobility for the rest of the patient's life. Or not.

At least 85% of the content of this thread has tremendous power to do harm. Agree or not, that is your choice.

You don't take your $3k blaster to the down the road gunsmith. Is a gunsmith a gunsmith...ah...no not really. Is any Ortho competent to correctly diagnose the type of injuries we suffer in this sport...ah...no not really. Yet they all claim they can. Chiropractors...yea...ultrasound, laser therapy, friction massage, electric stimulation therapy...ask to be directed to the studies that support these "treatments." Silence.

Your a racehorse-don't see your local vet. See someone who treats racehorses whose job is to get them back on the track winning money.

There is so much on the thread besides Woody's astute comments

I agree this thread is useful and should not be closed.

As for the 85% harm idea, well I would say that the majority of stuff you read in lay media whether it be forums, newspapers, magazines or TV can be put in exactly the same light.

Another poster is correct a lot of what has been suggested by lay folks is either harmful or delays proper treatment making it ultimately more difficult or impossible to treat.

The analogy of vet for racehorse and great gunsmith for racers is a good one. Sad fact is the lions share of of both regular docs and orthopedists dont know much about soft tissue injuries. They are ok for the simple ones but its time to see a specialist in the field. Unless you require surgery you dont have to see an orthopedic specialist necessarily. There are excellent Family Practitioners, Physiatrist (Physical Medicine Guys not the head shrinkers), podiatrists etc.

Woody's suggestion of getting a referal from the Physical Therapists who treat athletes is a Pearl and half. You dont necessarily have to be treated by a Physical Therapist to get a suggestion of who really knows in the locality. To be clear, Physical Therapy by itself is unlikely to be sucessful after two years on any problem.

GET your self the best specialist you can find for your problem.

Edited December 5, 2009 by E-Tac CNC

[openmike]

E-tac is right. Get to a good ortho. I had the classic tennis elbow syndrome for a long time. I tried anti inflammitory diet stuff with no success.

A good doc located the problem, dosed it with Cortisone, and showed me how to protect it. No problems for years...

[Paul Burtchell]

http://www.activerelease.com/what_patients.asp

One more time.....

http://www.tendinosis.org/index.html

Eric is right-close the thread.

[redmanfixit]

You see what you want to see, and you hear what you want to hear.

[nueces5]

Thanks for the MD's chipping in. I did seek professional medical advice but I was very disappointed in the direction that I given. That is why I started the post to see what the scope of cures or remedies were available out there from first hand experience.

After 6-8 visits with the doctor (over a 18 month period) all I got was a shot, 2 visits to the rehab clinic/a couple of rubber bands and a little arm compression band. I was told to lay off from doing anything that hurt it (originally baseball and softball) and it might get better. I have done everything that I was advised to do but no results.

Jerry told me that he had a surgery several years ago that removed a bit of material under the muscles in his forearm and that cured his issues.

I tried to get a referral to specialist and she (my doctor) said it wasn't necessary although she has not been able to help me get better over the last two years. I guess some of the doctors don’t take it as a serious aliment.

I have been taking fish oil, laying off all of the fun activities and even the not so fun ones. I wear an arm support (even at night) and take anti inflammatories. I am trying to incorporate the wrist curls as much as possible but back off if the pain comes back. I also have been montoring my diet but I normally do that anyway.

All in all I feel a little better but don’t think that I am any closer to getting rid of the problem.

I am the MD Sports Medicine guy with over 30 years experience with these types of probems.

More of story comes out now, but here are.

Key points

2 years

anatomic location not clear from post somewhere Shoulder or Elbow

No response to conservative therapy

Diagnosis unclear.

Treated by non specialist ( a big RED FLAG)

Diagnostic tests unknown.

SO again I am not YOUR doc but at this point the proper recommendations are

See a specialist and if not satisfied, see another one

Make sure specialist gives you precise diagnosis in term of location and type

For specialist to do this will probably require diagnostic testing which may be any where from Neck to Fingers in location. Types of Test might include MRI of primary or adjacent location, Xrays, or electrical tests.

AFTER the above the treatment plan can be proposed.

Since a lot of folks have made humerous suggestions and since your condition is chronic,I will say this, Fish Oil no matter what orifice you put it in will not fix you. But if you take enough by mouth you may need a silencer at the other end.

Best wishes to Godzilla for a speedy recovery

I Agree

[Jake Di Vita]

I typed up a big long response to all of the physicians that have posted on this thread and deleted it several times.

Instead, I'll say that whatever treatment you decide to go for, make sure it is geared towards treating the cause and not the symptom...The cause in 99% of the cases being inflammation. I hope all you Docs can agree with that (do I need to produce a peer reviewed study? lol )

For who said they tried an anti-inflammatory diet that didn't work, I'd like to go over at least a few days of your daily nutrition journal. (If you changed your diet in order to affect a change in your body, I sure hope you measured and recorded what changes you made).

[Aloha Robert]

The cause in 99% of the cases being inflammation. I hope all you Docs can agree with that (do I need to produce a peer reviewed study? lol )

No that is not correct, inflamation by itself is not the cause, it is a result. It is the body's attempt to fix or annihilate something it does not want.

That being said the inlamation needs treatment before symptoms resolve. Then there is the type of inflamation which there are bunches of eg, acute, chronic, infectious, necrotizing, etc. etc. which influence how you treat it.

What Jake should have said is in almost all cases of tendinitis inflamation plays a major role.

As for Jake's comment about diet influencing inflamation, the answer is with regard to athletic or traumatic injuries the answer is there is no diet that will cure it period. There are some types of arthriris such as Lupus and Rheumatoid that a minority of patients will show improvement with dietary manipulation but what we talking about is a sports injury.

However for those that insist on dietary treatment and I know there are some, this is what I recommend. Drink a quart of pregnant Mare's piss by the light of the full moon.