Yet Another Testimonial

Target Tendonitis has gone international. Each month I ask previous customers for feedback on the book, and this month I’d like to share a testimonial from one in Latin America…

Dear Alex:

The book has been very beneficial. I have suffered from stubborn tendinosis three times. The first two ones were elbow tendinosis. I simply did too many pullups. These were not mere “tendinitis” . I aggravated the tendinitis because I didn`t rest enough. The point is I felt it in the morning only, but every morning was worse. So I had to quit pulling for months-well, more than a year-till I decided to perform [the recommended exercises].
I am currently curing from another one in my Achilles tendon. Now I´m better, but I had to stop running from last November to June. It was when I bought your book that I began doing [the recommended exercise], which improved my Achilles a lot.

To summarize : this stuff works and is very practical and easy to implement.

Thanks a lot, man. Tendinopathies really suck, and your book can help many people.

Santiago Ces Garcia
P.D. : Feel free to use my humble review.

There are more testimonials on the sidebar to the right, but if you’re suffering from long-term tendon pain, what are you waiting for? Take the free, one-minute Tendon Test and find out what to do to get started on your healing.

The Best Testimonial I’ve Received Yet

Dear Alex,

Thanks for checking in. I’m sorry I haven’t kept you updated, especially considering your very conscientious and generous communication. Since my last email we’ve been traveling. You’re entitled to some much deserved kudos!!

I feel I made tremendous progress, despite the “pep talk” (not!) the ortho gave me when I told him I was going to follow your protocol. I started with virtually no range of motion and tremendous pain in the elbow & shoulder to full range of motion and completely pain free for normal day to day activity in two weeks. I haven’t started working out yet. When we get home I’ll test it out on some light weights. Of course, I’m a bit nervous. I am a little confused to what my new regime will be. I do enjoy cross fit and wish my gym environment and trainer would be more supportive of what I need to do to modify.

Now, that I understand the idea of healing and maintaining tendon health, I’m excited to work on other areas (knees, back). Although, I am confused about how to target the back…

When we get home, there are many people I’m looking forward to recommending your book. I’ve seen a couple of msg boards out their full of people who could use your help. It’s quite sad to realize how many people have really been suffering for a long time. I won’t give away the secret but will definitely send them in your direction.

Thanks so much! Besides the healing, you’ve also provided me w/a tremendous amount of empowerment.

Bobbi Casellas

Bobbi is a 42-year-old weight trainer, crossfitter and generally very active. A testimonial like this speaks for itself. I have nothing to add, except to say congratulations to Bobbi for taking matters into her own hands and deciding to try something new–despite the advice of her orthopedist!

Tendon Degeneration

I got a very interesting question the other day from someone who saw one of my videos on YouTube. He asked: “How can there be a quick recovery for tendonosis, which is tendon degeneration, if it takes collagen (what tendons are made of) 100 days on average to regenerate?”

This is a really excellent question, maybe the best one I’ve ever gotten. To begin with, it’s important to remember that “degeneration” doesn’t always mean “destruction”. Degeneration in the context of tendonosis can mean several things, one of which is destruction of the collagen fibers (such as is sometimes seen in the case of Levaquin patients, and in those cases recovery generally does take several months, if it happens at all), but most of the time it simply implies a degeneration in function or ease of movement rather than actual damage to the collagen fibers themselves.

What happens is this: in much the same way that adhesions affect muscle tissue, tendons that are affected by tendonosis develop points or sections along the fibers that begin to stick together. With muscle fibers, the mechanism is pretty clearly understood: tiny fibers are grouped into bundles to create larger fibers, which are in turn grouped into still larger bundles, until you have a three-tier structure.

The structure of muscle fiber and tendon attachment

These bundles slide along each other at every level when a muscle is functioning normally, but when adhesions develop they stick at certain points, which then causes pain during movement. A good physical therapist can usually find these points simply by feeling along the muscle, and then use finger pressure to break up the adhesions and get the muscle back into good working order.

With tendons, the situation isn’t as clear. For one thing, tendons don’t contract…but they do stretch. Perhaps because of this, generally speaking simple finger pressure or massage is not enough to break up the adhesions that form. This is partly because collagen isn’t as flexible as muscle fiber, and partly because the location of the tendon itself can be harder to get at. Also, since tendon fibers don’t slide along each other the way muscle fibers do, the theory is that the collagen fibers somehow get intertwined, developing what might be visualized as “crosshatches” of collagen. What’s needed is a way to re-align the fibers so that they no longer interfere with each other.

If you could somehow run a comb through the collagen and “comb it out straight”, that would be ideal. But since that’s not possible, the next best thing is specialized exercises that, over the course of a couple of weeks, will usually accomplish the same effect. This does not need to cost a lot of money; there is a large body of research that shows that simple tendon strengthening and rehab exercises done at home can be just as effective as platelet-rich plasma and other such “cutting-edge” treatments.

Sign language tendonitis

Tendon problems aren’t just for athletes and computer programmers. It can strike people who you would never think would get it. One such group is sign language interpreters.

Just like anyone else who performs excessive repetitive motions, sign language specialists can develop tendon issues. Common problem areas are the thumb, wrists (similar to carpal tunnel syndrome), as you might expect, but also in the elbow flexors. Although it might be thought of as a sort of niche condition, the remedy is the same as for any other situation: icing, rest and NSAIDs for the short-term inflammation, and in more advanced cases a structured set of exercises performed in a particular manner to help reverse any actual tendon damage. (In this case you will actually have tendonosis, although most medical professionals don’t bother to make the distinction.)

If you work with sign language regularly, it would pay to treat your hands and forearms in much the same way an athlete does. Be sure to stretch your fingers, hands and forearms after long signing sessions. Pay attention to your nutrition, especially aspects that help prevent inflammation and support tendon regeneration. And try if at all possible to take regular breaks during work. Five to ten minutes every hour is a good rule of, er, thumb.

Another testimonial (from a tennis player)

Just received another nice testimonial from a woman named Cindy Sekelick. She was suffering from lateral epicondylitis (otherwise known as tennis elbow) and wrote in to say:

Hi Alex,

Implementing your ideas really did help me. I was injured last June and in the last few weeks I can say my arm is almost healed. I play tennis so that was a strong motivation for getting my arm back to normal.

I am so glad your information was available. Thank you so much.


CIndy had suffered from tendon pain for over half a year, and bought Target Tendonitis in January. Less than three months later, she’s almost back to normal.

If you’ve been suffering from a tendon condition for more than a couple of weeks, do you really want to wait any longer? You can try the techniques and nutritional recommendations in Target Tendonitis absolutely risk-free for 60 days – more than enough time to see whether they work as advertised. So what have you got to lose…other than your tendon pain, of course. 😉

How to tell the difference between arthritis and tendonitis

The initial symptoms of arthritis and tendonitis can feel very similar, so here’s an easy home-diagnosis way to tell the difference: try taking glucosamine for two weeks. If it helps, you likely have osteoarthritis. If not, it’s more likely a tendon problem.

What’s the reasoning here? Glucosamine (often packaged with MSM and/or chondroitin) has been shown in quite a few scientific studies to help with cartilage formation. Cartilage is what your joints are made of, and what arthritis attacks, so upping the rate of production in turn helps your joints. End result: you feel better…if you have arthritis.

On the other hand, glucosamine will not help with collagen formation, and tendons are made of collagen. So it stands to reason that if you feel like you have “joint pain”, take glucosamine, and don’t experience any relief, one very likely culprit could be your tendons. (Tendon insertion points are often very close to joints and it can be difficult to tell exactly where the pain is coming from.)

Taking NSAIDs, using ice and so on can provide temporary relief for either condition, but since both arthritis and tendonitis are both the result of inflammation, using these treatments won’t help you distinguish between the two. And knowing which one you have is of course very important if you intend to treat the condition yourself.

If you do decide that you have a tendon problem, however, and you’ve had your pain for more than a couple of weeks, I caution you against assuming that the issue is tendonitis. More likely it’s tendonosis, which is an actual degeneration of the tendon. (This is especially true if you take NSAIDs and they don’t help.) If you think that this might be your problem, have a look at my tendon test. It’ll only take a minute, is completely free, will tell you whether you have tendonitis or tendonosis, and give you some options about what to do about it.

Nutrition for tendon pain

I recently received a question from someone who purchased Target Tendonitis. He asked about the advisability of fasting if you have tendonosis.

Although fasting can have some beneficial effects, I do not advise anyone who is suffering from tendon or fascia problems to do it. The reason is simple: your body needs nutrients to heal itself, and if you’re fasting you’re not providing it with the basic “stuff” that’s necessary to do the job. I recommend some nutritional supplements in the book, but these recommendations are based on the assumption that your basic nutritional needs are already being met. If they aren’t, the supplements aren’t going to do you much good by themselves. A diet that is lacking in vitamins, minerals or protein (to say nothing of all three at once!) is going to pose serious, serious problems when it comes to healing your tendons.

Assuming that your basic diet is okay, one thing you can do to help heal yourself if you have tendonosis or fasciosis is get a good kelp supplement and take it regularly. Kelp contains iodine, which is helpful for the formation of collagen, the basic building block of tendons and fasciae. My favorite out of the products listed on Amazon is Icelandic kelp, which is harvested during the cold months and washed in high-mineral fresh water, which adds further minerals to the already good mix that kelp naturally contains. (Collagen supplements, by the way, are totally ineffective.)

Note, however, that just taking a supplement isn’t going to be enough to cure yourself if you have long-term tendon pain. Anything over about two weeks is most likely going to be tendonosis, not tendonitis (I know, I know, but believe me, your doctor is wrong. Do the research yourself and see.), and in that case the collagen fibers in your tendon have become either bunched or damaged to the point that they are going to require actual realignment in order to work properly. This is what the exercises in Target Tendonitis provide (along with a lot more detail about the nutritional side of things), and why it has such a high success rate for people who haven’t seen much effect from nutritional therapies alone. A combined, holistic approach works much more quickly than any single measure.

A success story

I’d like to share a success story with you today. Jonathan, a 30-year-old football player, bought a copy of Target Tendonitis last month. Here is his email to me:

Hi, I bought your book today [Feb. 15th] and had a quick read on my kindle.

I have been having post tibial tendonitis for 7 months.. From what your book says it might not be the case and is probably tendonisis. I did an MRI back in January and it showed that my deltoid ligaments were still inflamed. I stopped exercising (running or football) for about 6 months although I did the elliptical once in a while but things got worse when I had to walk a lot for 1 week going up and down the stairs.

That made my ankle inflamed again . My doctor finally gave me a cortisone injection. It has been 4 days now and the pain has gone down a bit. I definitely have less pain although it is not 100% as i can feel that my tendon is somehow weak. I wanted to ask you if I can start [your recommended] exercises to start strengthening my tendons and also what kind of exercise I can do to treat Post tibial tendonisis. The book doesn’t show any examples for that.

Since working with Jonathan, I have received so many complaints about PTT, plantar fasciitis and achilles tendon pain that I created a new website specifically to talk about these problems. If you have any of these issues, I recommend that you check it out because it has a LOT more information about them than Target Tendonitis does. But at the time I gave Jonathan some specific movement patterns and asked him to try them for a couple of weeks.

On March 3rd, I followed up to ask how he was feeling. This was the unedited response:

Hi Alex, much better! I get no pain when sitting and almost no pain when walking, just some stiffness. I went to do some deep tissue massage last week… Boy did it hurt 🙂 I am still doing my exercises but i do them every 2 days and now I don’t feel any pain doing them but only some stiffness the next day which I usually tackle by stretching a little.

Congratulations to Jonathan for taking the time to try something new and on his speedy recovery. If you’ve been suffering from tendon pain in your feet/ankles for more than a couple of weeks and would like to experience similar results, Target Plantar Fasciitis and Posterior Tibial Tendonitis has information that can help you out.

Doctors are starting to catch up with the research

A reader sent this link in to me a few days ago. (Thanks, James!) It’s from a fairly hard-core weightlifting gym that has a website and forum attached. There’s a pretty good discussion of tendon pain, but the part that I wanted to show you is the following. It’s a summary of what a doctor said when he visited the gym to do a presentation on tendonopathy:

The common view of tendon injuries was once that the majority of the time a patient comes in with a tendon problem, it must be a tendonitis. Tendonitis implies that there is an inflammation of the tendon which needs to be decreased, and then the problem will go away. A typical true tendonitis will resolve in 2-4 weeks if it is a new onset, and if it is a longer standing tendonitis it should be better in 4-6 weeks – recovery rate from a “true” tendonitis is 99%. The common tendonitis treatment is anti-inflammatories, rest, and ice. Typically people who have had long term problem and go in for treatment with this protocol will not respond very well and will become quite frustrated…

…New research has lead medical professionals to realize that in the majority of patients (about 90%) who come in with “tendonitis” the problem is no longer tendonitis, but tendonosis which is a degenerative condition of the tendon.

There you have it; as good a summary as I’ve seen. (For the entire thread, click here.) If you’ve been diagnosed with tendonitis but it hasn’t gone away after a few weeks of aggressive icing and so on, chances are about 99% that it isn’t tendonitis at all.

If your doctor doesn’t understand this distinction, or if he pays lip-service to the idea of “tendonosis” but still insists on treating you with ice, NSAIDs and the rest of the usual prescription, you owe it to yourself to get better information. Trying to treat a tendon degeneration problem with protocols designed to combat inflammation is just asking for failure.

The most important thing

The new year is here and since this month also marks the one-year anniversary of this blog, I thought I’d start things off by reiterating the most important single thing I can tell you about tendonitis. So here it is: if you’ve had tendon pain for more than a couple of weeks and have been faithfully applying the usual doctor’s prescription of rest, icing and NSAIDs, without much effect…you probably don’t have tendonitis.

Any kind of “itis” is inflammation. If you really do have inflammation, chances are excellent that it will get better with the above treatment. So it stands to reason that if you’ve tried the treatment for a while and your pain doesn’t get better, you didn’t actually have inflammation in the first place.

Estimates range anywhere from 50% to over 90% that most diagnosed cases of “tendonitis” are actually tendonosis. This means that whatever problem you have with your tendons, it has gone beyond inflammation and now involves actual degeneration of the tendon itself. If this is the case, you’re not going to experience much relief with rest, ice and aspirin, because none of that is designed to repair your tendon.

To get better, you’re going to need a fresh approach. One part is good nutrition; either clean up your diet or else get some supplements that will give your body the building blocks it needs to heal. The other part is a set of exercises that will signal your body to start repairing itself. Particularly in regular exercisers and older people, the usual repair mechanisms often need an extra boost to get the upper hand against tendonopathy.

Target Tendonitis gives advice on both of these topics. It spells out the types of exercises you need to fix your tendons, and also gives specific recommendations about the sort of food and supplements that you need to help your tendons function free of pain. At less than thirty bucks (still!), it’s the best tendon-healing value on the market today.