As muscle builders push their bodies to the limits muscle injuries become more common. Tendonitis is becoming an increasing problem for professional bodybuilders and gym user alike. But like so many muscle building related injuries, tendonitis can be (almost) prevented and treated to full recovery. Tendonitis often starts out as a small insignificant pain in a joint so it's often ignored. But left untreated tendonitis can be untreatable and may stop you from training. The aim of this article is to spread awareness about tendonitis so it can be treated early and completely rehabilitated.
How tendonitis occurs.
A tendon is the end part of a muscle that attaches the muscle to the bone. The normally very elastic and soft muscle tapers off at the end to form the much more dense and stiff tendon. While this density makes the tendons stronger, the lack of elasticity of the tendon and the constant pulling on its attachment to the bone with movement, makes it much more susceptible to a low level of tearing. This tearing will produce the inflammation and irritation known as tendonitis. Tendonitis is usually seen after excessive repetitive movement with which the tendon gradually becomes tighter until the fibers start to tear. For example, a guy who has been training his biceps with heavy curls for a few years may experience tendonitis in the biceps, elbow or wrist.
Where does tendonitis occur?
Tendonitis is most likely to occur in the areas of your body that you use the most. So for bodybuilders, these are the most likely places you'll experience tendonitis:
- Elbows
- Wrist
- Biceps
- Shoulders
- Triceps
- Knee joint
- Leg
Other areas where tendonitis occurs include the hips and ankles. As these areas are not commonly put under too much pressure tendonitis is much less likely. The most common place for tendonitis to occur is in the arms (biceps, elbows and triceps).
Tendonitis symptoms.
Tendonitis is often ignored by weight trainers because it starts off with only a slight pain and stiffness in the affected area. Most lifters just write this off as stiffness from a heavy training session. Usually with tendonitis the pain will get worse over time. After you have finished your workout the pain with be the worst and the following day expect stiffness tightness in the area. If the pain is in a joint, you may have trouble extending the joint fully. It is also common to feel the pain when the affected area is under strain, ie when you're lifting weights.
What do I do if I think I have tendonitis?
See a doctor. If the pain occurs after every workout and you can feel it on rest days it's best to go a see a doctor (preferably a sports doctor) immediately. If tendonitis goes untreated for too long it may become permanent. Even if you are unsure, you should consult a doctor. You may have to stop working the muscle for a few weeks but that's much better than having a permanent injury!
Tendonitis treatment.
With the correct care for the area, the pain in the tendon should lessen over 3-4 weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least 6 weeks following the initial injury. This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue will continue to form past 6 weeks in some cases and as long as a year in severe cases. After 6 months this condition is considered chronic and much more difficult to treat. The initial approach to treating tendonitis is to support and protect the tendons by bracing any areas of the tendon that are being pulled on during use. It is important to loosen up the tendon, lessen the pain, and minimize any inflammation.
This can be done with the use of medicated creams, ice and anti-inflammatory agents. These treatments can reduce swelling, relieve pain and dilate the blood vessels. Cortisone injections can reduce inflammation, but unfortunately are very caustic and can cause a weakening of the tendon structure and a create more scar tissue.
After the scar tissue has begun to accumulate, it's important to perform procedures that break down the scar tissue in the tendon tissue, so as to let the tendon and muscle regain it's normal flexibility and lessen the chance of further injury. The tendon is still very fragile so in the initial stages only light stretching can be performed. Then the patient may move on to a daily routine of light exercises and stretching depending on the tendon soreness and pain.
How to prevent tendonitis.
Prevention of tendonitis is easy, and everyone who's lifting weights should be doing this by default. First, you need to stretch your muscles regularly. This means before you work the muscle you should be stretching it fully. Make sure you hold the stretch tight for at least 20 seconds to fully stretch the muscle. You should also stretch your muscle either immediately after the exercise or after your workout.
Second it's very important you warm up each muscle before working it. You should be doing this anyway! Yet I see so many people in the gym just jump straight into it. At the beginning of your workout you should be stretching and warming up all the muscles you plan to work. In addition to this, make sure you do at least 1 light weight high rep set of the exercise you are about to do. This will get your muscle ready for the movement and lessen the chance of injury.
To wrap things up I would just like to say that tendonitis should not be as bigger problem as it is in gyms around the globe. You can severely limit your chance of getting tendonitis by simply stretching and warming up properly. If you are over the age of 35 you are at higher risk, so this especially concerns you. If you think you have tendonitis, stop working out and head down to the doctors. It might be nothing, but it could be serious. Do you want to risk it?
46 Comments
HI! Is there some sort of wrist/glove type of accessory to decrease the chance of having this? I had this injury about a year ago and it took 6 months before it got fully recovered. I don't want it to happen again...
Neil,
If you had it in your wrist, then the most important thing you can do is understand how to effectively stack your joints during pressing (both horizontal and vertical).
I get a pain in the back of my elbow when I tense it only happens when I do that or skull crushers but I have stopped doing them since the pain started. Is the serious?
I have tendenitus in my left should and they have done everything but surgery and seems like they r putting it of but I'm in a lot of pain all the time
I'm having severe pain in my left tricep muscle but only happens when I work after work it seems to calm down
I hurt my wrist doing burpies and long bike rides, at first I didn't think any thing about it my hands would go numb then one day they hurt so bad I couldn't pick up a cup I have had the braces on and not straining my hands and wrist for about three weeks will I be able to go back to heavy lifting and cardo soon
Hello guyzz...from past few weeks im experiencing an akward pain in the upper back & shoulder area.
I've been gymming since 8 months now. Im not able to figure out the reason for the pain. I've always worked out my chest & shoulders in steps and after a warm up and stretching excersises.I also give 2-3days rest to my body. Dont know what has went wrong. My gym instructor is asking me to give rest to my chest & shoulder for a few weeks. cant afford to do that.....have something lined up next month.
Can anyone help me with a solution..??
I went to the hospital due to a lump on my leg that I had for about 2 weeks. The doctor said it was tendonitis so I kept off my leg for 2 weeks . The swelling went down, the redness is gone but there is still a small bump there. . Will that ever go away??
I recently had hip surgery for femural acetabular impingement (FAI). It's what A-rod had surgery for. Unfortunately, they now think the pain I had been suffering from in my sit bone was/is tendinitus. It's now been there for over a year and I"m going to see a surgeon in a few weeks. If this started out mild, could it now have become an avulsion or a much more serious (and permanent!) form of tendinosis that would now have to be treated with surgery? Thanks for the feedback!
my 11 year old has achillies tendonitis should he be doing swimming or any sports limping alot being refered to a specialist
Yes, especially sprints with no warming up. Really? Have some common sense and being him to a real doctor
I have had eblow pain for about 6 months. Had physical therapy dident work, took the pain away but once used they will hurt. I have been lifting weights for over 5 years. Im 25 years old. Im seeing a chiropractor right now. He takes the pain away intill i go to use them for all most anything. taking fish oil glucosamine and anti inflammatory. Resting, using a steam room, swimming once a week. they make a very loud grinding noise when i flex the tri and bi. will it get better what do you guys think?
You couldn't be more correct about warming up and after working out, but like the many you mentioned, who just jump into their work-out: I am a victim of what I now term work-out laziness. I know understand (and feel the pain and delay to work-out)the warm up is just as important as the work-out. Nice article!
For the past 3 months i have been getting tendonitis everywhere! It started with a strain in my arm and then my leg. Since then i have been getting tendon pain all over including my neck and wrists. Iv never known anything like it! Its as if my tendons have suddenly become week. It effects my work and iv had to stop training! I did a course of steroids at the start of the year so i wonder if this may have had some effect. Anyone else had a similar problem or know why this may be?
Most of this comment is based on my research on the web etc, not personal experience although I do know how bad it feels when your work/job is threatened by this issue!
If you're in the UK you can ask a GP if you could do some physiotherapy for free once he's confirmed what the problem is (they are very happy to oblige because refering you to a physiotherapist doesn't affect their budget as a GP on the NHS). Physiotherapists should know what the best course of action is, perhaps better than the GP himself since they're more specialised.
IMO it's what this article says and that you haven't been warming up properly before your reps, I don't think it's much to do with the steroids, I guess your tendons can keep up as long as you warm them up. Also warming down is supposed to be good
By warming up I mean doing 20 reps on a very small weight (as long as you experience little or no pain) just to get the muscles and tendons moving with the right action and then only increase weight if there's no pain.
From my own reserach (lots of links):
A study done in 1986 suggests that 'eccentric contraction' of the affected tendon is likely to be helpful for recovery from chronic tendinitis (after 6 weeks of daily eccentric contraction style physio and icing of joints to reduce inflammation 44% of patients recovered completely and 43% had markedly reduced pain): http://www.umphysicians.org/prod/groups/ump/@pub/@ump/documents/content/ump_content_421642.pdf
In contrast, for tendinitis (but perhaps not 'chronic tendinitis'?), the NHS suggests resting and icing amongst other options: http://www.nhs.uk/Conditions/Tendonitis/Pages/Treatment.aspx also the comments might be worth reading and researching in relation to taking amino acid tablets.
Wikipedia article on 'tendons' suggests that 'chronic tendon injuries' SHOULDN'T be rested and should be worked: http://en.wikipedia.org/wiki/Tendon#Effects_of_activity_on_healing
Wikipedia article on 'tendonitis' says you SHOULD rest it: http://en.wikipedia.org/wiki/Tendonitis#Treatment.
Wikipedia articles on 'Achilles tendinitis' and 'muscle contraction' say you SHOULDN'T rest it: http://en.wikipedia.org/wiki/Achilles_tendinitis#Treatment
Webmd says you SHOULD rest it: http://www.webmd.com/fitness-exercise/arthritis-tendinitis?page=2
My doctor told me that there's nothing I can do about my tendinitis except to open and close my hands and stretch them out (I have it in my hands) when I'm off work.
For myself at the moment I'm going with the eccentric contractions theory and icing my joints to reduce inflammation because I'm sick of resting my joints
Hi I have had tendonitis in my Achillies but, there is a sharp shooting pain in the joint of my upper left leg. (or atleast i think it's the joint) I know it can't be tendonitis but I can't get informtion anywhere else. This has been going on for a few days now. I have a basketball tournement today. My parents don't believe when I feel the pain and I tell them. I feel the pain when i walk (or run), lift my leg, try to stretch it, and when i cross my legs. I'm getting new shoes if that will help. (I don't think it will) Anyways please get information for me ASAP. Thank you
hi all. I had sciatica in my back not long after i had my secound baby, which travelled down my left leg. I had to walk a very long way to my physiotherapy clinic. And after a few treatments, i started to get pain behind my right knee and it went into my calf. My doctor said that i have tendonitis, coz i had pain and my leg was tender. Ive had this problem before but i didnt know what is was. And its oviously just decided to flare up again? I take painkillers and i use icepacks but nothing helps that much. I have a 2 year old and a 5 month old to look after and its getting me down having to be in pain and discomfort. Can anyone give me some advice please thanx.
Hi Steve ,
I am 18 years old and have been working out for a long time now. Recently I have been throwing a football a lot. Whenever I throw the ball very far after about 10 throws my arm is aching in the area above my elbow towards my shoulder.I was wondering if this is normal due to me throwing deep. I can throw 30 yards and shorter as many times as I want with no pain. The pain stays for a few hours after throwing. What do you think could be wrong with my arm
Hi Steve,
I have been suffering with hip tendonitis for about 8 months. At first I did not realize what it was because it would come and go but once I figured it out I cut back my running and weights but it still worsened. I have completely stopped working out for almost 6 weeks now and the pain is still there. I will say that the pain is better, some days there is no pain and others it is bad. Is there anything I can do to help the situation? I am afraid to stretch even because it might make it worse.
can you show me reply Katie 1/26/2012 My problem the same. Over 3 months now severe hip pain
from thigh and knee tendernitis. Have had pills shots and physical therapt tono avail thanks
Hey Steve,
I have shoulder tendonitis. I've taken almost a month off. My orthopedic doc told me wait 10 more days and I cant start shoulder/ chest lightly and slowly progress heavier. How long will tendonitis last ? I HATE not being able to be in the gym and pumping iron. Ive given it a good month to rest. I am just nervous of injuring it more from heavy lifting. I was noted by the doctor to stay away from barbell press and at most do dumbbells due to less strain on shoulder joint. Is it normal for many body builders to deal with shoulder tendonitis and still continue to work out like that want ? I dont want all my hard work to go to wait because a damn tendon.
Tendinitis can last for decades. My best advice is to keep a good balance between heavy shoulder, chest and back movements and to take things slowly.
Most people overwork the chest which can cause all kinds of issues.
I am a 16 year old girl and I play tennis. I've had tendonitis just over a month now and the pain hasn't really gone away yet. I have been to the physiotherapist twice now. I have been told that I have tendonitis in my wrist. I'm just wondering if my tendonitis will eventually go away? I would also like to know if there are any good creams that will help cure tendonitis?
Hi Beray,
I would recommend asking your question on the forum. You will receive some great advice.
http://www.muscleandstrength.com/forum/
My elbow pain just stays at that area. It does not go down to the wrist nor up to the shoulders. The precise area for the pain is on the inside of the elbow and an inch above the bone protrusion. From what I read, this cannot be tendonitis because people who suffer from those have their injuries spread from the point of origin moving either up or down their arm, or both ways. How can my problem be fixed? I am doing my powerlifts three times a week with each lift done per workout. I know the pain will start from the squat and the bench. Any kind of help will be appreciated. Thank you in advance.
Scott, did you get any info on your elbow pain?
I have the exact same pain in the same location from
doing the same thing. It's been over a month, I've
rested it, iced it, wrapped it, body's shrinking,
not happy
i've been training a long time and have and continue to experience tendonitis from my wrist shooting up and my elbow shooting down in the same arm only from preacher curls. my solution stop preacher curls do a different exercise in my dealings with tendonitis it will be more server in certain actions and angled movements, try doing a different angle ie for this scenario hammer curls or checks.
I am a 77 year old female who is active and in good health. However, every muscle I have hurts when I use it. I had a pulled achiles tendon once and the pain in my muscles is the same as that pain. Aleve doesn't touch it nor does other pain killers. It did not respond to cortozone (only my stomach lining responded negatively to that!) I have told three GPs and one Orthopedic surgeon about it. Their response was that it was probably an inherited tendency for the tendons to become inflexible. If so, is there anything available to keep me pain free enough that I can continue to do the things I need to do.......walk a reasonable distance, etc. I'd really appreciate the help. Annabelle Robson
Hi Annabelle,
This might be a good question for the forum. It is a bit beyond my areas of expertise.
http://www.muscleandstrength.com/forum/
Great article. I had shoulder tendonitis about 2 years ago which got so bad I could no longer do many lifts without pain. I started up weights again about six months ago and the shoulder is perfect but now I have elbow tendonitis which has slowly gotten worse so on the one hand, I am not concerned as I know with rest it will return to being perfect but I was really on a roll in the gym so hate to give it up. I do stretch and warm up every session. My first 5-6 sets of each session are warmups, starting at a very low weight with high reps. Its frustrating to go through it again.
I think that a lot of people with pains are missing the first sentence under "What to do if I think I have tendonitis?" I've had a pain in my elbow/forearm that started after skullcrusher workout a month ago. I'm going to make a doctor's appointment next.
Ive had elbow tendonitis for about 3 months and seems to be slowly worsening. I dont find ice to help and stretching causes pain. Originially only hurt when doing one arm chins, now its everything, closing a door, writing with a pen etc
I'd let a doctor know about it. I've complained of similar pain (mostly dominant wrist, but sometimes ankles)and a rhuematologist said it might be tendonitis or lack of Vitamin D.
I just had the same thing happen to me. I was in pain for a few months and it got so bad that I could not sleep. I went to an orthopedic doctor that specializes in sports medicine. I was given a wrist brace for my elbow tendonitis and have stopped using my arm completely for 2 weeks and I feel so much better! No more shooting pain, I can open a door and write with a pen again. I am going for physical therapy to ensure that this does not happen again and I can learn propper stretching exercises for my arm.
When I try to bench press/dumbell press, my elbow seems to lose power and it gives way. There is no pain or soreness, no anything. It just gets weaker as I try to press the weight. Some trainers think it could be my elbow but some seem to think it could be my shoulder causing the weakening in my elbow. Any thoughts on what it could be and possible remedies on what I can do to regain full power back in my elbow?
Thanks alot,
Mike
Hi Mike,
I recommend seeing a doctor about this condition.
so i had this pain in my shoulder, at first it was just a slight uncomfortable feeling but it got worse. i especially noticed pain during dips, military press, and incline BP. through about a mnth it got worse, until i realized this pain isnt normal, i should have stopped at the start. anyways since late november, i havent been working out my shoulders or doing any chest or back exercises( basically no exercise involving shoulder movement)just focusing on what i can do (bi/tri-cep, forearm, legs & abs)
how soon should i start to rehab my shoulder, n what would u recomend
Hi Marius,
I would recommend asking your question on the forum. You will receive some quality advice.
http://www.muscleandstrength.com/forum/
i hav same dis problem,, b48 mnths, i can only do arms nd legs olso as u do,, but i thnk u should do exercise regularly, not heavy weight, just light weight for shoulder nd chest, nd ice therapy is da best treatment, through ur swelling will become less, thnx
Hey Marius, i learned the doing reverse grip benches and dumbbell presses greatly and almost completely has reduced any shoulder pain I had. I still get to work chest. Sadly my sore elbow has me looking on this site now! lol
I've got a peculiar situation.I experience a burning sensation in both my knees whenever I bend them, get up from a seat, climb stairs, go for a jog. Yet, there doesn't appear to be any sort of inflammation. I've visited several doctors and all of them tell me that there's really nothing to worry and that basic rest should take care of the problem. The trouble is, that after 'resting' my ass off, the problem still persists and I'm losing the toned body that I had until a couple of months ago. Kindly help.
Tendons arent actually that big so inflammation can easily go unnoticed, that said you could still get decent cardio out of an exercise bike. That would put less strain on your joints and exercise bikes have tension adjustment so you can feel out whats to much. I had tennis elbow it got pretty bad even after nine months it still acts up every now and again, it took alot of rest and theraputic massage to fix it.
Ice works pretty good for the pain, at least i found it did.D
Usually burning sensations are due to damage or pressure on a nerve. You could have slight tendonitis in which the tendon itself is not inflammed enough for you to notice and is causing Peripheral neuropathy.Peripheral neuropathy is a common condition and can result from certain metabolic disorders, infections, malignancy, inflammation, vitamin deficiencies, toxins, inherited conditions, and other abnormal processes.
Hello, I know it's been about 3 years, but hopefully I will get a reply! I'm suffering from the exact same problem! I'd like to know what happened with you???
I had the same issue it turned out my tendons were deceased and they had to deflate the ulna nerve. I was out of work for 6 weeks but it took a lot longer for the nerve to stop hurting/burning
It could also be arthritis. I had terrible pain in both knees, though more in the right knee, and went to an orthopedist. What helped was strengthening my quadriceps and going to yoga classes (which helped stretch the knee area), and losing a few pounds (taking weight off of the knees).