Archive for June, 2010

Reader questions

Wednesday, June 23rd, 2010

I'm going to start answering some of the questions I've been getting from readers here. This one's from Lena, who thinks she has tendonitis:

About six months ago I was diagnosed with tendonitis. When I was diagnosed, I was given a brace to wear for two weeks. During that time, the pain was fine, until I took the brace off to shower. When I did, the pain came back worse than ever.

After the two weeks, my hand was better for about a week, and then the pain was back daily. Usually it's fine, but occasionally I'll bang it against something, or someone will grab my wrist, and I'm hit with very dibilitating pain.

My options are physical therapy, doing nothing and trying to be careful, or getting a cast. The cast would force me to rest the tendon for several weeks.

Does anyone have experience to share? I'd like some advice for which option is the best. This is worrying me a lot and I'd love some feedback.

Thanks!

Lena, you very likely do not have tendonitis (which is inflammation) but tendonosis (which is actual degeneration of the tendon). The brace helps with the pain because it keeps you from using the tendons, but - as you've seen - when you take it off you're back to square one. Simple cases of inflammation will generally go away within two weeks, especially if you've immobilized the area, but obviously that hasn't happened with you.

NSAIDs, ice and the other usual anti-tendonitis treatments aren't going to work for you because you don't have inflammation. For tendon degeneration you need a different approach, one that involves actually rebuilding the tendon collagen via specific exercises and nutrition. Unfortunately, most doctors don't have time to keep up with the latest research in this area, so the best they can do is cortisone shots and (in severe cases) surgery. But there are better alternatives out there. I can't give away the farm here, but I will say that my book has a long section that gives you instruction on how to design and execute these types of exercises, as well as a complete section on the types of foods and supplements that you should be putting into your body.

De Quervain’s Syndrome

Monday, June 14th, 2010

I've been getting some questions about De Quervain's Syndrome lately, so I thought I'd answer a few of them here.

First, De Quervain's Syndrome is neither tendonitis nor tendonosis. That's right: there are still more kinds of tendon pain. In this case, what you're looking at is something called paratenonitis.

Tendons are covered with sheaths, called the peritendon, and when you have problems with the peritendon, you get paratenonitis. Paratenonitis can occur by itself, or in conjunction with problems with the tendon inside, which makes things complicated when you try to diagnose it and/or cure it.

Since paratenonitis usually has a large component of inflammation, if you suffer from De Quervain's Syndrome my first line of defense would be NSAIDs, ice, stretches and rest. If that doesn't get rid of the pain within a week or two, then it's likely that you've also got some tendonosis going on, and perhaps some actual degeneration of the peritendon as well. In that case, you might want to give the techniques in my book a try.

Forearm tendon pain from weight training

Friday, June 4th, 2010

It's actually becoming a little hard to remember at this point, but the fact is that before the mid-1970s or so, not many adults exercised on a regular basis. But then a guy named Jim Fixx started the jogging craze, and a few years later a woman named Jane Fonda started the aerobics craze, and a couple of years after that some Austrian guy named Arnold something-or-other hit the screen and made everyone want to have muscles. Far from being mere fads, these pursuits have been part of the Western lifestyle ever since.

And this is great. The benefits of consistent exercise, especially resistance exercise, are legion. Aside from the obvious looks and health advantages, a recent study by Barbara Strasser and her colleagues in the May 2010 issue of Sports Medicine gave some pretty convincing numbers regarding how much money the average 50-year-old would save by starting a weight-training program. Even counting the costs of gym memberships, workout clothes and so on, it's pretty obvious that you'll end up saving a lot on medical expenses down the road.

But as with every good thing, there are some drawbacks. One of the biggest with weight-training is the development of tendon pain in the forearms, mainly from gripping the bar over and over again in exactly the same way. Barbells and dumbbells in regular gyms are all exactly the same diameter, which can quickly lead to overuse pattern injuries such as tendonitis and tendonosis. (Click here for a quick, free test to find out which one you have.) Ask anyone who's ever had forearm tendon pain: it's difficult just to shake someone's hand, much less hold on to a bar loaded up with weights.

Fortunately, there are some ways you can get around this problem. One is to use machines, which often come with pads that don't require you to grip anything. Machines are not as good as free weights, though, because you don't have to balance anything, and therefore those small-but-important stabilizer muscles in your body don't get trained.

A much better solution has been provided by a company called Fatgripz. Fatgripz are devices that you can attach to a barbell or dumbbell to make them, well, fatter. Instead of the usual inch or so diameter of the bar, now you're dealing with 2.25" (5.7cm).

Fatgripz

This means that your hand doesn't close as much, which means that now you're exercising with all the muscles and tendons in your forearm in different positions. The result? Less pattern overload, and less tendon pain. In fact, by using Fatgrips on a regular basis (not every workout, but maybe every other workout) before you develop tendon pain, you might just be able to prevent it altogether. But for those who do have forearm tendon pain stemming from their time in the gym, Fatgripz offers a convenient and economical solution.

They also come with a two-month money-back guarantee, so it's hard to see a downside to getting a pair. Yes, if you decide to return them you'll be out a few bucks for postage. But they're quality goods, virtually indestructible, and I don't know anyone who's tried them and not liked them. When you compare the small chance of not liking these things to the potential for eliminating your forearm pain, it's really a no-brainer.