Why Taking NSAIDS May be Making Your Tendonitis Worse
Relieve Your Tendon Pain
The pain seemed to come from nowhere. It was a little thing and over a short amount of time just got worse. Now it effects moving around or sleeping…
At first it might have been solved by warming up a little better or popping a pill before you played or started your day... Now you might feel it much of the time... Like in your daily activities or worse, it can become something that keeps you up at night.
Have you stopped doing your activity or changed the way you move to avoid the pain?
Any tendon can be overstrained to have pain but the most common are in the elbows and knees.
"Stopping (your activity) and Popping (a pill)" just might be making your problem worse.
(Even though it seems logical)
My Journey
I have been a personal trainer and strength coach for over 20 years. I have competed in powerlifting and bodybuilding, coached records in power lifting, owned gyms, and have logged more than 32,000 billable training hours with clients.
I became fascinated (and a lot bothered) by tendons. There were many days I had to help clients with tendon pains from their sports. Mostly, it was tennis players and golfers but almost any athlete had a tendon issue. There were even tendon issues resulting from work injuries. Also, the older someone was, the more time they had to beat up their tendons and have some pain.
I did so much research to help clients that I published a book on Amazon on the topic.
The Research
Research is a useful tool to understand this problem. Surprisingly, some things that seem logical to do may make your problem worse.
Here are some "not so obvious" research points:
1) Ibuprofen will lower the pain but will reduce the healing capacity of the tendon. It inhibits collagen formation which is the primary structural component of tendons. [1] Ibuprofen apparently does not even help it go away with one week of use [2] which removes the “why” of why to use it at all.
2) Taking time off will not promote correct healing of the tendon. Tension is needed to stimulate proper collagen formation and create a fully healed tendon.[3]
The Double Whammy
Time off and popping NSAIDs(Non-Steroidal Anti-Inflammatory Drugs) is a powerful combination to promote that "forever" tendonitis-the kind that does not go away... This has often been called Tendonosis but the new term these days is called Tendonopathy for all tendon conditions. Most just call it Tendonitis…
Translation: Your strategy of not working out and popping NSAIDs is making that tendon pain last and hurt longer than it needs to.
Ibuprofen, by the way, is also not good for you. Doing it once a month for a headache is not probably a concern. The concern comes when you become a regular user. I single out Ibuprofen because I learned if you are active or over 50 years old, that bottle has probably migrated from the medicine cabinet to a spot next to the bathroom sink. If it is next to the bathroom sink, you probably qualify as a regular user or close to it. Many clients confessed the “actual” location next to the sink. I mean manufacturers do sell more than 650 million bucks a year of this product in the U.S.
The science says that Ibuprofen not only impedes tendon healing by suppressing collagen formation, it inhibits muscle and bone formation too. Collagen is everywhere in your body, tendons are about 86% collagen [4] and yes, even bone is up to 30% collagen [5]. It is also in your skin. I mean the research does not specifically say that your skin will be compromised or age faster but there's lots of collagen there (70% of the proteins) with a lot of collagen formation.
Ibuprofen is also implicated in:
1) Gut Issues-1 in 5 chronic users will develop gastric damage [6]
2) Kidney Cancer- Acetomenophin and NSAIDs [7]
3) Raising blood pressure [8] It may do this with inhibition to Nitric Oxide formation[9] which also may have an effect on erectile dysfunction. [10]
4) Lowering Testosterone [11]
The FDA also issued a public warning (2x) that Ibuprofen increases heart attacks and strokes from more than a week of use. [12] The fact that the FDA issued this a second time is overly concerning.
These health hazards are listed on the labels/boxes/websites of the NSAIDs. The writing may be extra small but the concern should be extra-large.
OK... Realistically, popping it once a month is probably reasonably low risk but dosing daily or often is increasing the risk of serious side effects and it slows healing...
Translation: Popping NSAIDs may feel good in the moment but it prolongs the healing time of the tendon you want fixed and there is the worry of side effects.
I know, another bad thing... So now what? Stay with me here, there is a light at the end of this tunnel.
The Discovery
Years ago I had lunch with a friend of mine that is also a Naturopathic Doctor. I explained the dilemma of tendon pain, healing and NSAID induced side effects and together we came up with a natural formula.
Scribbled on a napkin and a few emails later, the formula was ready.
I created a sample batch and tested them in a health club I owned. I handed out single doses and they were a hit. They were so “well received” that members thought it was OK to go in my office when I was not there and take a few. Nevertheless, I ran out of my original batch.
It was a revelation that this product was confirmed to reduce discomfort and people were willing to go into my office without permission for a few pills to feel better.
It also helped them to heal unlike the more risky alternative.
Now, I just recently began selling to formula to the public.
I call the product Tendon Medic.
The Formula
This formulation works extremely well and quick. By quick, I mean 20 or so minutes. I really want to tell you just how awesome this is but I am limited to what I can say...
Try out this product to promote healing and virtually eliminate risky side effects. (Just for the record, there is no side effect free pill, food, vaccine, marriage or check in the mail.)
All of these ingredients were chosen based on their ability to:
- Get you out of discomfort now…
- Lower inflammation
- Assist in healing you faster.
- Have virtually no side effects and be safe
Here are the ingredients:
Turmeric: A superstar that decreases inflammation, helps reduce cancer rates and may promote proper collagen formation for tendons. [13] (It is the exact opposite of what Ibuprofen does with collagen).
White Willow Bark/Salicin: Nature's aspirin with minimal side effects associated with the "engineered or synthetic" form. It reduces inflammation, fights cancer and is easy on the gut. It does not affect blood clotting. [14] [15] White Willow Bark has a protective effect on arteries and veins [16] and may not age skin like aspirin.[17]
Devil's Claw: A potent natural anti inflammatory and may also help protect cartilage. [18]
Ginger: A potent natural anti inflammatory and natural bad microbe killer.[19]
Boswelia Serrata: Helps to block inflammatory markers that destroy collagen and cartilage. [20]
Enzymes: Enzymes help with absorption and are anti-inflammatory and help heal tendons. [21] With these added enzymes, the product works slightly better on an empty stomach but will also work well with food too.
Tendon Medic's Compliment
Tendon Soothe
I also have a complimentary product called Tendon Soothe. This is a cream or balm that you can apply directly to the pain. With tendon pain, you can often put your finger on the spot that hurts.
Dab a little cream to knock out the pain. This product has an FDA approved painkiller in it along with other natural remedies like Arnica and Aloe.
I created this product to make sure folks were able to attack that discomfort from all angles.
Start getting better today!
Respect the Pain
Take Tendon Medic when you are having tendon issues from sport or regular movements to manage discomfort. This will help keep the side effects from ibuprofen away. This is not a way to enable you through your sport or strenuous activity. Pain is there for a reason and the “No Pain; No Gain” will eventually become “No Pain; No Pain!” if you do not heed the warning.
Tendon Medic will also help with nagging joint discomfort due to wear and tear. It helps you get through the day without worrying if the Ibuprofen side effects will show up. Tendon Medic was formulated to help cartilage and arthritis as well.
Reality
In time, you have to work out the affected area to heal your tendonitis... This requires going light and slow and "training to the pain not through the pain."
If you have tendon pain, there has to be gym workouts. Taking it easy by the way is not going from singles to doubles in tennis. I mean let's face it, training "through the pain" is what got you here to begin with.
First, wait for the acute pain to pass. Simply, wait until the big part of the pain is over. This could be anywhere from 2 to 7 days. This is the most optimal time to take Tendon Medic.
Second, begin workouts and movement to send blood flow to the area. Doing the “thing” that made it hurt the most is not a good idea as you will be back to the big pain again.
An ordinary time period to heal is an estimated 6 weeks but you can be virtually pain free in 2 weeks. The difference is that you can sleep and pour a cup of coffee without pain in 2 wreaks but it takes six weeks before you can start doing backhands in tennis or long drives in golf.
In my experience, the primary observed problem leading to tendonitis is muscle weakness and imbalance. Some quick examples are uneven grip strength leading to golfer's or tennis elbow, weak outer hip muscles contributing to the dreaded runner's IT Band Syndrome, and improper running mechanics leading to shin splints. Getting help from a trainer or Physical therapist could be useful. Contact me if I can be of service to you as I have helped many get "back in the game" Also contact me if you have a question about the product.
My contact:
Michael Wohltmann
epochnutritionsciences@gmail.com
References
1)Morrey, B. (2011). Ibuprofen Upregulates Expressions of Matrix Metalloproteinase-1, -8, -9, and -13 without Affecting Expressions of Types I and III Collagen in Tendon Cells. Yearbook of Orthopedics, 2011, 35. doi:10.1016/j.yort.2011.04.074
2) Heinemeier, K. M., Øhlenschlæger, T. F., Mikkelsen, U. R., Sønder, F., Schjerling, P., Svensson, R. B., & Kjaer, M. (2017). Effects of anti-inflammatory (NSAID) treatment on human tendinopathic tissue. Journal of Applied Physiology,123(5), 1397-1405. doi:10.1152/japplphysiol.00281.2017
3) Murtaugh, B., & Ihm, J. M. (2013). Eccentric Training for the Treatment of Tendinopathies. Current Sports Medicine Reports, 12(3), 175-182. doi:10.1249/jsr.0b013e3182933761
4) Jozsa, L., and Kannus, P., Human Tendons: Anatomy, Physiology, and Pathology. Human Kinetics: Champaign, IL, 1997
5) Feng X. Chemical and Biochemical Basis of Cell-Bone Matrix Interaction in Health and Disease. Curr Chem Biol. 2009;3(2):189-196.
6) Rang HP, Dale MM, Ritter JM. Anti-inflammatory and immunosuppressant drugs. In: Pharmacology. 5th ed., Churchil Livingstone Edinburgh London, 1999. p. 248.
7) Choueiri TK, Je Y, Cho E. Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies. International journal of cancer Journal international du cancer. 2014;134(2):384-396. doi:10.1002/ijc.28093.
8) Palmer R, Weiss R, Zusman RM, Haig A, Flavin S, MacDonald B. Effects of nabumetone, celecoxib, and ibuprofen on blood pressure control in hypertensive patients on angiotensin converting enzyme inhibitors. Am J Hypertens 2003. Feb;16(2):135-139. 10.1016/S0895-7061(02)03203-X
9) Vandivier, R.W., Eidsath, A., Banks, S.M., Preas, H.L., Leighton, S.B., Godin, P.J., Suffredini, A.F., & Danner, R.L. (1999). Down-Regulation of Nitric Oxide Production by Ibuprofen in Human Volunteers 1.
10) Ferrini MG, Gonzalez-Cadavid NF, Rajfer J. Aging related erectile dysfunction—potential mechanism to halt or delay its onset. Translational Andrology and Urology. 2017;6(1):20-27. doi:10.21037/tau.2016.11.18.
11) Kristensen DM, Desdoits-Lethimonier C, Mackey AL, et al. Ibuprofen alters human testicular physiology to produce a state of compensated hypogonadism. Proceedings of the National Academy of Sciences of the United States of America. 2018;115(4):E715-E724. doi:10.1073/pnas.1715035115.
12)Center for Drug Evaluation and Research. (n.d.). Drug Safety and Availability - FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. Retrieved August 20, 2018, from https://www.fda.gov/Drugs/DrugSafety/ucm451800.htm
13) Jiang, D., Gao, P., Lin, H., & Geng, H. (2015). Curcumin improves tendon healing in rats: A histological, biochemical, and functional evaluation. Connective Tissue Research, 57(1), 20-27. doi:10.3109/03008207.2015.1087517
14) Shara, M., & Stohs, S. J. (2015). Efficacy and Safety of White Willow Bark (Salix alba) Extracts. Phytotherapy Research, 29(8), 1112-1116. doi:10.1002/ptr.5377
15) Chrubasik, S. (2001). Treatment of low back pain with a herbal or synthetic anti-rheumatic: A randomized controlled study. Willow bark extract for low back pain. Rheumatology,40(12), 1388-1393. doi:10.1093/rheumatology/40.12.1388
16) Ishikado A, Sono Y, Matsumoto M, et al. Willow bark extract increases antioxidant enzymes and reduces oxidative stress through activation of Nrf2 in vascular endothelial cells and Caenorhabditis elegans. Free Radic Biol Med. 2012;65:1506-1515.
17) Lee, M. E., Kim, S. R., Lee, S., Jung, Y., Choi, S. S., Kim, W. J., & Han, J. A. (2012). Cyclooxygenase-2 inhibitors modulate skin aging in a catalytic activity-independent manner. Experimental & Molecular Medicine,44(9), 536. doi:10.3858/emm.2012.44.9.061
18) Fiebich, B.; Heinrich, M.; Hiller, K.; Kammerer, N. Inhibition of TNF-α synthesis in LPS-stimulated primary human monocytes by Harpagophytum extract SteiHap 69. Phytomedicine 2001, 8, 28–30.
19) Grzanna, R.; Lindmark, L.; Frondoza, C.G. Ginger—An herbal medicinal product with broad anti-inflammatory actions. J. Med. Food 2005, 8, 125–132.
20) Blain, E.J.; Ali, A.Y.; Duance, V.C. Boswellia frereana (frankincense) suppresses cytokine-induced matrix metalloproteinase expression and production of pro-inflammatory molecules in articular cartilage. Phyther. Res. 2009, 24, 905–912.
21) Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A. Nutraceutical supplement in the management of tendinopathies: a systematic review. Muscles Ligaments Tendons J. 2016;6(1):48-57. Published 2016 May 19. doi:10.11138/mltj/2016.6.1.048