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tendonitis - what to do?

tendonitis tendinitis

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8 replies to this topic

#1 buck1s

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Posted 04 February 2008 - 07:52 PM


Well, it seems between strength training and playing squash, I've developed a little tendonitis in my right arm. This is the arm I use to play squash, so I'm assuming that it's probably squash and not strength training that's the main culprit. However, I do plenty of pull-ups as part of my pulling work and I'm wondering if this is necessarily the best thing.

I've stopped playing squash and doing any pulling work for a little over 2 weeks now. My elbow is feeling better and I'm getting ready to start training again (no squash yet). Should I go back to doing multiple sets of 10-12 reps of pull ups, or should I put on the weight belt after the first set and drop reps to 4-5? Is it the magnitude of tension or the time under tension that would most exacerbate my tendonitis?

I'd appreciate any advice.

Chris

#2 Shepard

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Posted 04 February 2008 - 08:02 PM

My elbow is feeling better and I'm getting ready to start training again (no squash yet). Should I go back to doing multiple sets of 10-12 reps of pull ups, or should I put on the weight belt after the first set and drop reps to 4-5? Is it the magnitude of tension or the time under tension that would most exacerbate my tendonitis?


For most, I would say load would lead to pain over total volume. But, I could see volume being the main factor in certain cases. High rep sets of various arm movements have been used successfully by many people (myself included) to overcome tendon pain at the elbow.

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#3 ajnast4r

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Posted 04 February 2008 - 08:27 PM

physical therapy..

high rep low weight sets pretty much fixed my elbow, which has a torn tendon.

#4 buck1s

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Posted 04 February 2008 - 10:40 PM

Any suggestions as to which exercises (with low weight) might help? The pain is on the outside (topside) of the elbow. Thanks again.

Chris

#5 Shepard

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Posted 04 February 2008 - 10:51 PM

If you're talking about pullups aggravating it, I'll assume you're talking about the distal biceps tendon. That would be what I'd call the inside of the elbow, though.

Anyway, for that I'd say do band curls, cheat curls, or hammer curls. Fat bar curls, too...but some people seem to have elbow issues with those.

#6 nushu

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Posted 05 February 2008 - 01:35 AM

Any suggestions as to which exercises (with low weight) might help? The pain is on the outside (topside) of the elbow. Thanks again.

Chris



Work your forearm extensor muscles- reverse wrist curls. Start light with a weight you can get 10 reps with, do 3-4 sets. Then add weight when you get stronger. Also put a thick rubber band over your finger tips and extend them for high reps.

#7 niner

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Posted 05 February 2008 - 02:20 AM

Any suggestions as to which exercises (with low weight) might help? The pain is on the outside (topside) of the elbow. Thanks again.

Chris


Work your forearm extensor muscles- reverse wrist curls. Start light with a weight you can get 10 reps with, do 3-4 sets. Then add weight when you get stronger. Also put a thick rubber band over your finger tips and extend them for high reps.

If this is biceps tendinitis, then I have a PT program that worked well for me.

1. Elbows at sides, arms out, pull a rubber band in toward your chest, keeping your elbow at the side. We used rubber bands in PT, but at my gym I use a light weight on a pulley gizmo. ~20 reps each arm

2. Same as 1, but use other arm. Start with hand at chest, move it straight out. Keep elbow at side the whole time.

3. Lay on mat facing up, holding light dumbells straight up. Punch toward the ceiling, using shoulder muscles. Keep your elbows straight. ~30 reps

4. Using a lat pulldown bar, grab the bar and pull it down a few inches, using shoulder muscles. Don't bend your arms.
~30 reps

5. Corner stretches: Face a 90 degree inside corner, and put one hand on each wall. Lean forward, supporting yourself with your hands. Hold for 10 seconds. Do 5 reps.

I think this is a fairly general shoulder program, and I couldn't see how it was going to help, but it did. Tendinitis can be very tough to improve. If it were me, I would stop the pullups entirely. They can be replaced with other less injurious exercises. (I got my worst sports injury ever doing pullups; I now have chronic neck problems because of it.)

#8 TianZi

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Posted 05 February 2008 - 08:24 AM

Well, it seems between strength training and playing squash, I've developed a little tendonitis in my right arm. This is the arm I use to play squash, so I'm assuming that it's probably squash and not strength training that's the main culprit. However, I do plenty of pull-ups as part of my pulling work and I'm wondering if this is necessarily the best thing.

I've stopped playing squash and doing any pulling work for a little over 2 weeks now. My elbow is feeling better and I'm getting ready to start training again (no squash yet). Should I go back to doing multiple sets of 10-12 reps of pull ups, or should I put on the weight belt after the first set and drop reps to 4-5? Is it the magnitude of tension or the time under tension that would most exacerbate my tendonitis?

I'd appreciate any advice.

Chris


I have struggled in the past with tendinitis around the *outside* of the elbow, although it currently isn't a problem. This was caused by my intense resistance training regimen. By far and away, the exercises that for me caused the greatest amount of tendon pain involved curling motions for the biceps using free weights (although there are others for other muscle groups that were also extremely painful, depending on the angle of resistance). In particular, performing the preacher curl using two hands on a straight bar seems the most harmful exercise for the tendons around my elbow and upper arm; getting "stuck" on a rep and battling a heavy weight at a standstill at particular angles while doing a preacher curl was probably the primary driver for my tendon problems.

I do multiple sets of pull-ups using different grips twice a week. I found some association between pull-ups and tendon pain, but less than with bicep curling exercises. Each time, I do only one set of pull-ups unsupported, and that set I do with a palms-out grip. Through experience, I found that limiting my range of motion on the unsupported pull-ups seemed to lessen tendon pain. The other sets I do on a pull-up machine that allows me to perform pull-ups with variable levels of weight support; I save my palms-in and very wide grip pull-ups for the machine. If both grips cause pain in the tendons, you might also try a neutral grip (palms facing one another; this requires two parallel grip handles, or placing a narrow grip 2-hand detachable steel handle (such as you usually find attached to the cable for the middle back row) on top of a straight bar).

As far as tendon damage goes, I think angle of resistance is more important than the amount of weight you use or duration, but as between amount of weight and number of reps, I've found amount of weight to have a greater negative impact on my tendons, at least judging from dumbbell curls.

Months ago I did some (totally unscientific) research on the internet, and it seems most people who report tendinitis caused by weightlifting associate it with performing preacher curls (with "skullcrushers" for the triceps also commonly reported as causing tendon pain, but this isn't the case for me).

By way of contrast, pressing exercises seem to cause no pain at all in my tendons, and neither do most pulling exercises that don't involve a palms-up grip. I've found that one-hand curling exercises for the biceps are much less stressful on my tendons, perhaps because my tendons aren't "locked in" at a certain angle as with two-handed exercise. Using a cable (attached to a weight stack using a pulley) to perform one hand curls, or standing between two stacks and using two cables simultaneously to perform curls to my ears, causes less pain to my tendons than dumbbells, which in turn are less painful than using a 2-hand grip with weighted plates on a straight bar.

I've found that performing stretches for my forearms several times a day helps to reduce tendon pain and may be therapeutic. Examples include pulling back the fingers on each hand, one hand at a time, and holding at different angles; wrist rolls; and slowly twisting each hand inward/outward (using the opposite hand). There are some unusual exercises intended to loosen the forearms in the yoga classes I've attended that also seem to be helpful. Applying Ben-Gay before, during and after work-outs helps, as does wet heat/ice, and taking an anti-inflammatory regularly may have therapeutic value for tendinitis, in addition to the pain-masking effect. I've read that high doses of Vitamin E may be helpful in speeding repair of damaged tendons, as may certain amino acids. There have been some studies finding that eccentric loading exercises (negatives) are more beneficial for treating tendinitis than total rest, after a point (as you obtain most of the benefits of rest within the first 4-8 weeks), but I have not tried performing negatives to treat my tendinitis. If anything, I find the negative motion on curls to be more painful than the upward motion, but I didn't have a team of experts devising a specific rehabilitation program for me based on MRI scans.

Edited by TianZi, 05 February 2008 - 08:46 AM.


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#9 buck1s

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Posted 05 February 2008 - 03:23 PM

Thanks for all of the advice!!





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