Treating Tendonitis

Posted by Jean Carr     Category: Chinese Medicine

Treating Tendonitis: From Rotator Cuff to Tennis Elbow & Carpal Tunnel Syndrome

Tendonitis is challenging to treat.  Tendonitis is a sinew problem that develops over a period of time, usually from repetitive stress on the tendons.  This results in micro-tears at the attachments of the tendons and the bone.  The tendon becomes swollen and inflamed.  Rest usually helps the pain, but when activity is resumed, the micro-tears are stressed again, causing more inflammation and pain.

There is usually no recollection of a specific injury with tendonitis.  It is an overuse syndrome from incorrect form in sports, non-ergonomic form or a repetitive isolation of  muscles that are used too often without enough time to recover. As we get older, it takes longer for our bodies to recover, so overuse injuries can happen more as we age.   Tendonitis occurs most frequently in the rotator cuff, Achilles’ tendon, elbow, knee and wrist.  When the pain is in the elbow, it is called Tennis or Golfer’s Elbow.  Carpal tunnel syndrome is a form of tendonitis in which the wrist sheaths become inflamed and create pressure on the median nerve.

Where there is stagnation, there is pain.

Where there is free flow, there is no pain.

Activity typically increases the tendon pain, but sometimes the pain is lessened with movement and increases when the activity stops.  This is because movement brings circulation to the area creating free flow of blood and qi.  A statement of fact in Chinese medicine is that pain is due to stagnation.  Where there is free flow, there is no pain.

Healing takes longer with joints and sinews, tendons and ligaments.  These tissues have fewer capillaries.  There is less qi and blood supply to nourish and repair the injured tendons.

Injuries are acute or chronic.  By the time most people realize they have tendonitis, it is usually a chronic stage sinew injury.  But every time you continue to use a painful tendon, especially if you engage in the overuse activity that caused the injury, you can in essence reinjure it, making the injury both acute and chronic.

Treatment in Chinese medicine is guided by whether the injury is acute or chronic.  Acute injuries are treated with cooling herbs; chronic injuries are treated with warming herbs.   Diagnosis of acute or chronic is critical.  The treatment for each phase of injury is different.  The wrong treatment can make the injury worse.

Tendonitis is often both a chronic and acute injury because the client keeps on using it despite the pain. Treatment becomes a delicate balance of cooling herbs or warming herbs.   How do you know which one to use?  For external treatments, use a small amount of the warming liniment or soak.  If it aggravates your tendonitis, switch to more cooling or neutral herbs until the inflammation is gone.  Then you will need to increase the healing circulation of qi and blood by using warming herbs.  You may go back and forth for a while if you keep re-injuring the tendon.

There are internal herbs as well as external treatments available. See your practitioner for the cooling or warming treatments that would be best for your condition.

Do not be tempted to use ice or ice packs instead of Chinese liniments and herbs for your cooling treatments! See the article on “Ice is for Dead People” for a full explanation.

Ice can be appropriate the first 24 hours of an injury for 10 minutes at a time if you do not have any Chinese cooling liniments.  Do not use ice after the first 24 hours.  Ice inhibits the swelling by creating stagnation of blood and body fluids.  Continuing to use ice even alternately with heat will simply create more stagnation.  Alternate hot and cold treatments is like driving with the brakes on.  Remember, stagnation is pain.  Think of Minnesota in the winter.  There is lots of ice.  It’s very cold.  Nothing moves.  You want circulation to return the injured tissues to a state of health.

Certain Chinese herbs can both increase the circulation of qi and blood while “cooling” the inflamed tissues.  Western pharmaceuticals are not able to do this.  Western trained personnel recommend the only treatment option they know: ice.  Chinese Medicine has 3000 years of history treating injuries.  I did not see one bag of ice was used by the Chinese at the Olympics in Beijing.  My favorite Chinese statement is: “Ice is for dead people.”

Other treatments include: rest, a nourishing diet and acupuncture.  Gentle exercises like walking and Qigong can circulate the qi to help with the healing.  If the injury is due to incorrect exercise form, the body will need to be retrained to use the muscles properly after the injury has healed.  Working out at this time would be another repetitive form of exercise that would keep your tendonitis from healing.

You need to allow your injury to heal by resting it.  If it hurts, your body is trying to tell you to stop!  For my clients who are active in sports, rest is the hardest prescription for them to follow.  Ignoring pain and not allowing healing can have consequences.  The body will start protecting itself from further injury by thickening the tendon and developing calcium deposits.  You will have a more challenging problem to heal.  Take the time to heal now.

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