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Tendon Pain...

Tendonitis, Supplements, and What to Do…

Training hard will eventually lead to tendon pain in many. It is annoying and frustrating as training routines need to be modified or abandoned. One thing for sure is once it is there, you want it gone.

Tendinopathy, formally called tendonitis, is an active tendon injury. Some real time characteristics are that you can probably put your finger on the exact spot of pain and it often can feel a little better with a warm up. With that warmup, it hurts a lot more later…

Common sites of tendinopathy on the body are along the forearm (radial) bone, the inner and outer elbow (commonly known as golfer’s or tennis elbow), and tendons around the knee, shoulder and ankle. But hey, any place there is a tendon, you can have the problem.


What not to do:

-Ibuprofen...  It seems like a great go to but it really does the opposite of healing. It lowers collagen formation and increases tendon healing time. [1] I personally believe a once or twice dose is not going to be detrimental especially in the beginning.

-Train through it. You have to let your “OCD” go. It is time for a pyrrhic victory. This does not have a happy ending as tendons can eventually snap.

-Take lots of time off. Taking extended time off will just make you weaker (but you already know that). Tendons need tension to heal but it is better to make sure you are out of the initial pain stage (estimated 4-7 days). [2]

-Eat tons of sugar. I mean I hope this really does not have to be said. Sugar will delay tendon healing. [3]

-Get a cortisone shot- It works in a moment but greatly increases the chance of the tendon snapping. [4]


Supplements that might help:


-Curcumin-It may speed the healing, lower pain, and it has been shown to reduce scar tissue. [5,6]

-Vitamin C-It may help a little but will not act alone. The vitamin might help more in the beginning of healing and helps with scar tissue. [5]

-Vitamin B5/Pantothenic Acid- This has been shown to help but you might need a gram or more a day. [7]

-Heteroperys Aphrodisica-A study of this Brazilian herb showed lots of promise. [8]

-White Willow- will help with the pain if needed and will not get in the way of healing. It’s nature’s aspirin and has more than just aspirin in it to fight discomfort. It is also easy on the gut and kidneys. [9]

-Fish Oil- might help with managing the discomfort. [10]

-Collagen Peptides-May help the speed of healing. [11]


Closing thoughts:


Take some time off with that tendon until the pain mostly goes away. Use some supplements and then hit the weights light and easy. Many of the rehab protocols emphasize eccentric training. A pain in your elbow does not mean you have to stop leg training. That may sound funny but I have heard that excuse many times through the years.

A mentor of mine, Charles Poliquin, used to emphasize a liver detox to improve tendon healing speed. Generally, this is not bad advice for any time. Liver detox is both a science and an art form but generally, there needs to be a mix of vitamins, minerals, and amino acids. Think “I need a multivitamin and a protein shake” will do some of this. For more information, click this link:

Before you jump back in, reevaluate your program and learn why you are getting tendon pain to begin with. It could be bad form, overtraining, or not balancing the strength of the muscles around your joint.

Also, the gear isn’t going to help. One study showed a nine-fold incidence of tendon rupture in steroid users. [11] 



Works Cited

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) 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

3)Korntner S, Kunkel N, Lehner C, et al. A high-glucose diet affects Achilles tendon healing in rats. Scientific Reports. 2017;7:780. doi:10.1038/s41598-017-00700-z.

4)Woon CY-L, Phoon E-S, Lee JY-L, Ng S-W, Teoh L-C. Hazards of steroid injection: Suppurative extensor tendon rupture. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India. 2010;43(1):97-100. doi:10.4103/0970-0358.63971.

5)Fusini F, Bisicchia S, Bottegoni C, Gigante A, Zanchini F, Busilacchi A. Nutraceutical supplement in the management of tendinopathies: a systematic review. Muscles, Ligaments and Tendons Journal. 2016;6(1):48-57. doi:10.11138/mltj/2016.6.1.048.

6)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

7) Aprahamian, M., Dentinger, A., Stock-Damgé, C., Kouassi, J. C., & Grenier, J. F. (1985). Effects of supplemental pantothenic acid on wound healing: Experimental study in rabbit. The American Journal of Clinical Nutrition,41(3), 578-589. doi:10.1093/ajcn/41.3.578

8)Monteiro JC, Gomes ML, Tomiosso TC, et al. More resistant tendons obtained from the association of Heteropterys aphrodisiaca and endurance training. BMC Complementary and Alternative Medicine. 2011;11:51. doi:10.1186/1472-6882-11-51.

9) 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

10) Maroon, J. C., & Bost, J. W. (2006). ω-3 Fatty acids (fish oil) as an anti-inflammatory: An alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical Neurology,65(4), 326-331. doi:10.1016/j.surneu.2005.10.023

11) Minaguchi, J., Koyama, Y., Meguri, N., Hosaka, Y., Ueda, H., Kusubata, M., . . . Takehana, K. (2005). Effects of Ingestion of Collagen Peptide on Collagen Fibrils and Glycosaminoglycans in Achilles Tendon. Journal of Nutritional Science and Vitaminology,51(3), 169-174. doi:10.3177/jnsv.51.169


12)Kanayama, G., Deluca, J., Meehan, W. P., Hudson, J. I., Isaacs, S., Baggish, A., . . . Pope, H. G. (2015). Ruptured Tendons in Anabolic-Androgenic Steroid Users. The American Journal of Sports Medicine,43(11), 2638-2644. doi:10.1177/0363546515602010