Tendinitis is scar tissue. The tendon was slightly torn, not split down the middle, just some of the fibers broken. One way tendons tear is overuse in a repetitive motion (anything from tennis to keyboard). Tendons will also tear from a single blow (a fall or a car accident). Sometimes both happen at the same time; while vacuuming, you fatigue your biceps tendon and then you can unexpectedly knock the vacuum against a table leg.
How do you know if you have tendonitis? Only a doctor can diagnose it, but here are some signs and symptoms. Does a particular action cause pain? With tendinitis, refraining from that and similar activities reduces the pain in a week or two, and the pain may go away entirely if you stop the activity altogether. Just because the pain is gone doesn’t mean it’s healed: the scar tissue is still there. And who wants to spend their whole life avoiding activities?
Imagine a violin bow, made of long, parallel horsehairs pulled into one thick strand. Imagine that this bow is frayed in the middle and, to repair it, you glue a cotton ball to it. Would you expect this to be a permanent solution? The next time you tried to strum the violin with the bow, the cotton ball would hit the strings with every stroke. Like the arch, the tendon fibers are parallel, and like cotton, the scar tissue fibers are randomly directed, with a sticky substance in between. Scar tissue creates a lump. Although the lump is smaller than a grain of rice, it rubs against other tissues every time you move the joint. That hurts! What’s worse, random fiber direction does not have the tensile strength of parallel fibers. Which means that no matter how long you rest from tendinitis, the next time you push yourself 100% (spin a racket at full force or write for ten hours), the scar tissue will tear again, just as bad as the first time. time. .
The solution is to mechanically remove excess scar tissue.
One theory I learned at the Brian Utting School of Massage comes from British Dr. James Cyriax. Rubbing scar tissue perpendicular to the tendon fibers breaks only the scar fibers that are perpendicular to the tendon, but only tears the fibers that are parallel. After applying “cross-fiber friction” for several weeks, the remaining intact scar tissue lies flat with the tendon. Because the fibers that remain intact are the fibers that are parallel to the tendon, the scar tissue has 100% of the original strength of the tendon. The textbook treatment includes two minutes of interfiber friction as hard as you can take, with tears in your eyes. This would be done no more than two or three times a week, followed by ice. I have used this method on many people but found that they would not continue with the treatment, it hurts too much. So instead of painfully rubbing, I now use an ice cup. Since switching to the ice treatment, I find that many more people continue their treatment at home.
Ice is like magic!
How to treat your own tendinitis:
Put water in your freezer now, so it’s ready tomorrow morning. Freeze the water in a small yogurt cup or 6-8 oz. paper cup. Tomorrow, when the ice is ready, take it out of the glass and hold it with a hand towel to catch the drops. Use not the flat surface, but the edge of the ice to saw perpendicularly through the tendon at the exact site of the small scar tissue injury. Chill an area no larger than the size of a dime.
put on ice no more than five minutes (watch a clock or set a timer!) or until numb, whichever comes first. (You can check for numbness by removing the ice, gently dragging a finger over the area to see if you can still feel it.) If it freezes for more than five minutes, it will freeze. Yo, you don’t want frostbite. Ice only for five minutes. When sensation returns in about five more minutes, you can apply ice again. You could freeze up to six times an hour while watching a TV show.
Yes, it must be a mug! An ice pack or gel pack won’t work; the cold spreads over too large an area, and the small place that needs it doesn’t get cold enough, the melting water keeps 32 degrees. A cup of ice holds a larger thermal mass than your freezer, perhaps ten degrees below zero. The rim of the cup applies the cold to a much smaller point. Also, your whole body will shiver if you chill a large area. You will hardly notice the cold if you only chill the size of a dime. You might even sit in a hot tub or warm bath while you ice the limb.
Ice at least once a day, until the pain is gone and your strength is back to 100%.
How does it work? The ice threatens to freeze the cells to death. The body wants all cells to live, so it sends lots of warm, fresh blood to the area. This reddening effect removes scar tissue, which is why I call it the “erosion effect.” Second, the blood brings macrophages. Macrophages are very large white blood cells that completely surround a piece of scar tissue and transport it to the liver or spleen for processing. A certain percentage of white blood cells are present in all blood, so the more blood that can pass through the scar tissue, the more macrophages will “see” the scar tissue. That’s why we chill just the size of a dime, to narrow down the focus where all these macrophages are going to arrive and all this erosion is going to happen.
How long will it take to heal? You won’t believe the results if you apply ice at least once a day.
Here’s the fine print: It may be difficult for you to find the exact location of the scar tissue injury. The lump isn’t always big enough to feel, it could be as small as a grain of salt. Some people can pinpoint exactly where the place is, but most feel it is confusing and vague.
If you can’t find the exact spot, check an anatomy book from the library. Likely places for tendinitis pain are:
- anterior part of the shoulder (subscapularis and/or biceps),
- upper part of the shoulder (supraspinatus),
- back of the shoulder (infraspinatus and/or triceps),
- wrist (superior insertion of the extensor digitorum near the elbow),
- sits bone (hamstrings),
- bottom of the foot (inner or outer curve of the plantar fascia of the heel)
- snout (pectineum)
- front of the hip (psoas or Tensor Fascia Latte)
- knee (just above or below the kneecap)
As you look at the pictures in the anatomy book, keep in mind that the most likely places for tendinitis are 1) where the tendon attaches to the bone and 2) where the reddish muscle becomes the yellowish tendon. One obstacle is that you feel the pain “distal” or further from the brain than the actual injury. If all you have is a vague sense of location, try pushing on the nearest tendon and following it “upstream” until you find the source of the pain. In almost all cases, people don’t realize there’s a little sore spot until we start poking at the tendons.
How do you know you’ve found it?
“OW, that’s it, you’re exactly IN it!”
Even when you think you’re right, move in very small increments in each direction, playing a game of “warmer, cooler” to zero in on the point of maximum pain. This is the scar tissue injury that you will ice for five minutes.
If you can’t find it yourself, find a therapist who knows anatomy well. Unfortunately, only a small percentage of therapists and physicians have ever been trained to feel where tendons join bones and muscles. Call a few and ask if they can help you find the exact location of a tendinitis injury. Go at least once and bring a permanent marker so they can put a dot on the injury. So you can find it again when you get home, to make your daily homemade icing. If the pain is somewhere you can’t reach, like the back of your shoulder, this point will help your spouse or friend ice it every day at home.
This article is not intended to give you a diagnosis, only a doctor can diagnose you. That said, it won’t hurt to put ice on parts of your body, so give it a try! Sometimes a person who has been diagnosed with “carpal tunnel syndrome” feels relief after applying ice to the flexor and extensor tendons of the elbow. In every case of “plantar fasciitis” that I have seen, the person got better when we treated the scar tissue lesions on the bottom of the heel.
The purpose of pain is to help you learn to do something different. How did this scar tissue occur in the first place? Putting ice on the injury will make it go away, but you still need to change something about the way you do this activity, so you don’t create a new injury.
My sincere intention is that you are empowered to heal from this lingering pain and make changes for a happier future. Happy frosting!
