Tendon Pain; Thinking Towards Exercise

There are two traditional treatments for the relief of tendon pain in clinical trials. The first is corticosteroid injections into the injured tendon, shown only to provide short-term relief. The second is resting the injured joint, which may prevent matters from getting worse, but may also fail to make them better.

Tendinopathies, as these injuries are called, are particularly vexing orthopedic problems. The underlying pathology of tendinopathies is still a mystery; what works well for one patient may do little or nothing for another. Most tendinopathies are precipitated by overuse and commonly afflict overzealous athletes, amateur and professional alike.

In the November 2011 issue of The Lancet, Alexander Scott & Karim Khan of the University of British Columbia noted that although “coticosteriod injection does not impair recovery of shoulder tendinopathy, patients should be advised that evidence for even short term benefits at the shoulder is limited.” They concluded by stating that “specific exercise therapy might produce more cures at 6-12 months than one or more corticosteriod injections.”

In other words, working the joint lightly in a way that does not aggravate the injury but rather strengthens supporting tissues and stimulates blood flow to the painful area may promote healing faster. After exercise, using heat or ice on the area helps with potential inflammation. Traditional physical therapy, with its wide variety of exercises, helps to strengthen the area and increase your range of motion, thereby improving your flexibility and reducing pain.

Dynaband Exercises

Physical, occupational and movement therapists usually prescribe eccentric exercises involving muscle contractions as the muscle fibers lengthen. Eccentric exercises must be performed in a slow, controlled manner, focusing on your contracted muscle. Marilyn Moffat, a professor of Physical Therapy at New York University and President of the World Confederation for Physical Therapy, prefers “very protective” isometric exercises, at least at the onset of treatment until the tendon injury begins to heal. These isometric exercises involve no movement, allowing the muscles to contract without producing pain.

An example of one of these exercises is having the patient push his or her fists against the wall with upper arms against the body and elbows bent at 90 degrees. Another exercise, one which I also demonstrate in my videos, is holding the dynaband in each hand, thumbs upwards to the sky, with about a foot of band showing. The beauty of the dynaband exercises is that you can adjust the band depending on your strength level and injury issues. The upper arms are firmly placed on the ribcage, and elbows are bent at 90 degrees. The patient inhales and exhales, trying to pull the dynaband apart. The abdominals should contract as the dynaband is opened on the exhale. This is a wonderful exercise for strengthening the shoulders. Remember: you do not want your injured muscles to weaken, which is what happens when you rest and do not exercise the weak area.
*Author;Jane E.Brody,Personal Health, New York Times, March 1,2011
*Additions; Sharon Frazier