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Old 09-16-2006, 11:12 PM
arthur arthur is offline
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Question tendon mysteries

I had picked a too heavy load about 4 years ago. There was great pain in both my bicep's tendon. Due to wrong information I just rested without any rehabilitation and till now my tendons paiwhen working even with moderate load.

Please tell now what kind of rehabilitation should I start.
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Old 09-17-2006, 05:49 AM
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Quote:
Originally Posted by arthur View Post
I had picked a too heavy load about 4 years ago. There was great pain in both my bicep's tendon. Due to wrong information I just rested without any rehabilitation and till now my tendons paiwhen working even with moderate load.

Please tell now what kind of rehabilitation should I start.
You should really be seeing a physiotherapist. I'm not a doctor nor can I provide you with advice on what kind of rehab to do. Too much liability on my part if your condition worstens. Sorry Bro.
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Old 09-17-2006, 06:23 AM
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physiotherapist...kane is right...probably eric will have some more advice, but try reading his sticky thread on muscle injuries, etc. i think it will be a good start.

best of luck and sorry to hear about this...

Sentinel
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Old 09-17-2006, 10:51 AM
EricT EricT is offline
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Well it's not a mystery I don't think. If the original injury was bad enough and you just took time off then prob it basically just "healed wrong." Scar tissue and the loss of flexibility/pliability and, if it were the muscle, contractile properties is the problem.

Definitely a physiotherapist is a good idea especially for a chronic problem cuz they have tools that can really help in remodeling the tissue and will be better equipped to evaluate you particular injury to plan a suitable rehab.

The first post in the Injuries sticky, as Sentinel mentioned, will tell you the basics of what to do. Mostly ignore the first aid stuff, i.e. R.I.C.E. since it's too late now!

I will give you the basics of what you need to do stressing that I am not a doctor, blah, blah, blah. If you pay attention to your body and do it STEP BY STEP, though, I don't think you will further damage yourself. You have to take it slowly and methodically if you ever want your biceps to work right again and not continually get reinjurred.

Unless you think you have a active injury (look up acute vs. chronic muscle/tendon injuries and symptoms) then there is not use of taking complete rest again. You will need to take time off from lifting and begin ACTIVE recovery.

The one thing to keep in mind is that all this is depending on whether this is in fact an old injury or whether you have reinjurred it. That is for you (and a doctor?) to asses. Scar tissue is easy to tear and that can result in more tearing of surrounding tissues and and even worse injury than before. So IF it is active then start from the beginning and use R.I.C.E. therapy then go from there.

Here are the basic tools if it is rehab of an old injury but the injuries thread will give you more details.

HEAT (NO HEAT for NEW INJURIES...ICE ONLY)
STRETCHING
MASSAGE

No weights for the first 2 weeks up to perhaps 4 weeks. The goal here is to begin remodeling the tissue and regain normal flexibitity and range of motion. NO PAIN. If it hurts at this stage don't do it. Only slight discomfort is allowed.

There are different types of stretching you can use. I would recommend trying PNF stretching at the end of this phase. It combines stetching with isometrics and I think it will work wonders and be much better than just going from the stretch/massage phase into isometric exercise. It should get you ready for some very light weight high rep work.

Everything hinges on how it feels so you'll have to evalute your progress but I wouldn't do anything else but heat-stretch-massage for at least two weeks. Then you can try out light weights. Do what is comfortable. If just holding a weight hurts then you can't hold a weight. If you can't lift a weight then you may still be able to do some isometrics (and PNF). When you do hit the weights it will have to be pretty high reps.

HST may be a good choice for a program in this rehab. Starts with high reps and supmaximal weights so it shoud be perfect for slowy building back up work capacity but ONLY after there is no pain and flexibility is regained (flexibility and pain will go hand in hand here).

Hope some of this helps .
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Old 09-17-2006, 11:21 PM
arthur arthur is offline
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Thanks again ERIC 3237 for the reply.I really feel indebted t u for the superb advice.

To Kane - I impose no liability or whatsoever on anyone giving any advice and accept the advice on my own responsibility,is that satisfying now.

Eric, I couldnt understand whether your rehab was for old or new injury.

My tendon was hurt 4 yrs ago, so its an old injury.
Now do I stretch or what.

Also i would be v.v.grateful if u tell some of rehab info.
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  #6  
Old 09-18-2006, 05:39 AM
EricT EricT is offline
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quote=Eric]The one thing to keep in mind is that all this is depending on whether this is in fact an old injury or whether you have reinjurred it.[/quote]

I was assuming that your are just dealing with some tight scar tissue. But scar tissue is a reason that people re-injure old injury sites over and over sometimes. So I wanted to be clear that you need to EVALUATE whether you may have re torn it (even a little) when you picked up the weights, in which case you should treat it as a NEW injury. Probably not, I know but I wanted to be clear. So, yes, based on what you're saying you should stretch it.

BUT I do not want to try to be specific. If you are looking for rehab info over the internet there is some but most of it is very general. A doctor really should be involved in this and and MRI may be useful in determining the course of treatment or rehab. It it is a tendon injury they can be very stubborn and sometimes if surgery is not done then rehab only seeks to strenghen the part that is still attached to prevent further injury. This is very "one size fits all" and like the others said a pt is a really good idea. With that horse beat to death here are some generalities.

DON"T STRETCH COLD. In this case you can use heat before you stretch. Get a heating pad or hot water bottle. Something like that. You can also heat then massage or heat then stretch then massage.

Don't get hung up on the "old injury" angle. Since you didn't do active rehab (and I assume no first aid) then unless you see a doctor and get specific instructions you have no choice but to treat it as if this is the first stage of active rehab of a NEW injury, which would be maybe 2, 3, or even 4 days after the initial injury and the swelling and inflammation had subsided after you used rest, ice, etc.

Here is the part of the first post of the injury thread that is relevant:

The most effective treatment at this stage is the use of heat and massage, but including light, gentle static and passive stretching exercises after your heat and massage treatment will help to dramatically speed up the recovery process.

Firstly, you must keep active! Don't listen to anyone who tells you to do nothing. Now is the time to start active rehabilitation. Most of the swelling will have subsided after the first 48 to 72 hours and you are now ready to start light activity.

Light activity will not only promotes blood circulation, but it will also activates the lymphatic system. The lymphatic system is vital in clearing the body of toxins and waste products, which can accumulate in the body following a sports injury. Activity is the only way to activate the lymphatic system.

Before we move on, a quick word of warning. Never, Never, Never do any activity that hurts the injured area. Of course you may feel some discomfort, but NEVER, NEVER push yourself to the point where you're feeling pain. Listen to your body. Don't over do it at this stage of the recovery, you've come too far to blow it now.

To complete your recovery and remove most of the unwanted scar tissue, you now need to start two vital treatments. The first is commonly used by physical therapists (or physiotherapists), and it primarily involves increasing the blood supply to the injured area. The aim is to increase the amount of oxygen and nutrients to the damaged tissues.

Physical Therapists accomplish this aim by using a number of activities to stimulate the injured area. The most common methods used are ultrasound and heat.

Ultrasound, or TENS (Transcutaneous Electrical Nerve Stimulation) simply uses a light electrical pulse to stimulate the affected area. While heat, in the form of a ray lamp or hot water bottle, is very effective in stimulating blood flow to the damaged tissues.

Secondly, to remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will be able to do that.

Either find someone who can massage the effected area for you, or if the injury is accessible, massage the damaged tissues yourself. Doing this yourself has the advantage of knowing just how hard and deep you need to massage.

To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you're able to use deep, firm strokes. The more you massage the effected area the harder and deeper you will be able to push.

Use deep, firm strokes, moving in the direction of the muscle fibres. Concentrate your effort at the direct point of injury, and use your thumbs to get in as deep as possible to break down the scar tissue.

So what is static and passive stretching?

Static stretching is performed by placing the body into a position whereby the muscle (or group of muscles) to be stretched is under tension. Both the opposing muscle group and the muscles to be stretched are relaxed. Then slowly and cautiously the body is moved to increase the tension of the stretched muscle group. At this point the position is held or maintained to allow the muscles to lengthen.

Passive stretching is very similar to static stretching; however another person or apparatus is used to help further stretch the muscles. Due to the greater force applied to the muscles, this form of stretching is slightly more hazardous. Therefore it is very important that any apparatus used is both solid and stable. When using a partner it is imperative that no jerky or bouncing force is applied to the stretched muscle. So, choose your partner carefully, they must be responsible for your safety while stretching.

The important point to remember during this phase of the rehabilitation process is light, gentle stretching. Never, never, never do any activity that hurts injured area. Of course you may feel some discomfort, but never push yourself to the point where you're feeling pain. Be very careful with any activity you do. Pain is the warning sign; don't ignore it.

The Next 2 to 5 Weeks

The aim of this phase of your rehabilitation will be to regain all the fitness components that were lost as a result of the injury. Regaining your flexibility, strength, power, muscular endurance, balance, and co-ordination will be the primary focus.

Without this phase of the rehabilitation, there is no hope of completely and permanently making a full recovery from your injury. A quote from a great book called "Sporting injuries" by Peter Dornan & Richard Dunn will help to reinforce the value of this phase of the rehabilitation process.

"The injury symptoms will permanently disappear only after the patient has undergone a very specific exercise program, deliberately designed to stretch and strengthen and regain all parameters of fitness of the damaged structure or structures. Further, it is suggested that when a specific stretching program is followed, thus more permanently reorganizing the scar fibers and allowing the circulation to become normal, the painful symptoms will disappear permanently."

So what type of stretching is best to use during this phase? Stick with the static and passive stretching exercises described above, but also include PNF Stretching.

PNF stretching, or Proprioceptive Neuromuscular Facilitation, is a more advanced form of flexibility training that involves both the stretching and contraction of the muscle group being targeted.

PNF stretching was originally developed as a form of rehabilitation and to that effect it is very effective. It is also excellent for targeting specific muscle groups, and as well as increasing flexibility, (and range of movement) it also improves muscular strength.


If you're interested, you can learn more about PNF stretching here.

Last edited by EricT; 09-18-2006 at 06:42 AM.
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  #7  
Old 09-18-2006, 08:36 AM
EricT EricT is offline
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It occurs to me that you never said where the pain was specifically. Bicep problems can be associated also with rotator cuff/ impingement problems which is all the more reason to see a pro.
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Old 09-19-2006, 12:11 AM
arthur arthur is offline
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Cool

I have pain in the biceps tendon which connects the bicep to the forearm. Also I can stretch my arms easily.


And thanks Eric {I don't how many times now}.

Eric, I think you are really fond of helping people.
Here is some info. I found which might be useful in your endeavour & in the forum - www.ifafitness.com - check out the free pdf guides.
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  #9  
Old 09-19-2006, 09:57 AM
EricT EricT is offline
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Quote:
Originally Posted by arthur
Also I can stretch my arms easily.
Meaning no pain when you stretch? That's prob good. I'd stretch anyway but definitely massage.

Thanks, Arthur, but I seem to piss people off as often as I help them .
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