Tendonitis is scar tissue. The tendon tore slightly, it did not break in half, only some of the fibers were broken. One way tendons tear is overuse in a repetitive motion (from tennis to typing). The tendons will also break from a single hit (a fall or a car accident). Sometimes both happen at the same time; while vacuuming, you fatigue your biceps tendon and may then unexpectedly hit 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 any particular action cause pain? With tendonitis, abstaining from that and similar activities reduces pain within a week or two, and the pain may go away completely 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 horse hair that is pulled into a 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 hit the strings with each stroke. Like the arch, the tendon fibers are parallel and, like cotton, the fibers of the scar tissue are directed randomly, with a glue substance between them. The scar tissue creates a lump. Although the lump is smaller than a grain of rice, it rubs against other tissues each time you move the joint. That hurts! What’s worse, the random direction of the fiber does not have the tensile strength of parallel fibers. Which means that no matter how long you rest from tendonitis, the next time you put in a 100% effort (swinging a racket at full strength or typing for ten hours), the scar tissue will tear again, just as bad as the first. time. .
The solution is to mechanically remove excess scar tissue.
A theory I learned at the Brian Utting School of Massage comes from British Dr. James Cyriax. Rubbing the 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 several weeks of “fiber rubbing”, the remaining intact scar tissue lies flat with the tendon. Because the fibers that remain intact are those 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 friction between fibers as strong as you can bear, with tears in the eyes. This would be done no more than two or three times a week, followed by ice. I used this method on many people, but found that they would not continue the treatment, it hurts too much. So instead of painfully rubbing, I now use an Ice Cup. Since I switched to ice treatment, I find that many more people continue their treatment at home.
Ice is like magic!
How to treat your own tendonitis:
Put water in your freezer now so it will be ready tomorrow morning. Freeze the water in a small cup of yogurt or 6 to 8 oz. paper cup. Tomorrow when the ice is ready, take it out of the cup and hold it with a hand towel to collect the drops. Do not use the flat surface, but rather the edge of the ice to cut perpendicularly through the tendon at the exact site of the small scar tissue injury. Cool an area no larger than the size of a dime.
Ice yourself no more than five minutes (Look at a clock or set a timer!) Or until numbness, whichever comes first. (You can check for numbness by removing the ice, dragging a finger lightly over the area to see if you can still feel it.) If you apply ice for more than five minutes, it will freeze; i have done it to myself and i think you dont want freezing. Ice only for five minutes. When you feel the sensation again in about five more minutes, you may freeze again. You can freeze up to six times for an hour while watching a TV show.
Yes, it must be a mug! An ice pack or gel pack will not work; the cold spreads over too large an area, and the small point that needs it does not cool enough, the melting water maintains 32 degrees. A cup of ice maintains a greater thermal mass the same as 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 shake if you cool a large area. You will hardly notice the cold if it only chills the size of a dime. You could even sit in a hot tub or warm bath while you ice your limb.
Ice at least once a day, until the pain is gone and your strength returns to 100%.
How does it work? Ice threatens to freeze cells to death. The body wants all cells to live, so it sends a lot of cool, warm 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 throughout the blood, so the more blood that can pass through the scar tissue, the more macrophages will “see” the scar tissue. That’s why we cool down just the size of a dime, to narrow the focus where all these macrophages will go and all this erosion will occur.
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 is not 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 as a vague and changing place.
If you can’t find the exact location, check out an anatomy book from the library. The likely locations for tendonitis pain are:
- front of the shoulder (subscapularis and / or biceps),
- upper part of the shoulder (supraspinatus),
- back of the shoulder (infraspinatus and / or triceps),
- wrist (upper insertion of the extensor fingers near the elbow),
- sit bone (hamstrings),
- sole of the foot (inner or outer curve of the plantar fascia of the heel)
- snout (pectineus)
- front of the hip (psoas or Tensor Fascia Latte)
- knee (just above or below the kneecap)
While looking at the pictures in the anatomy book, keep in mind that the most likely places for tendonitis are 1) where the tendon joins the bone and 2) where the reddish muscle turns into the yellowish tendon. One obstacle is that you feel pain “distal”, or further from the brain, than the actual injury. If all you have is a vague idea of the location, try pricking the nearest tendon and following it “upstream” until you find the source of the pain. In almost all cases, people do not realize that there is a small sore spot until we begin to puncture the tendons.
How do you know you 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, colder” to focus on the peak of pain. This is the scar tissue injury that will apply 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 were trained to feel where tendons meet with bones and muscles. Call a few and ask if they can help you find the exact location of a tendonitis injury. Go at least once and bring a permanent marker so they can put a point on the injury. This way you can find it again when you get home, to make your daily frosting at home. If the pain is somewhere that you cannot reach, such as the back of your shoulder, this point will help your spouse or friend ice up every day at home.
This article is not intended to provide you with a diagnosis, only a doctor can diagnose it. That being said, you won’t suffer any harm from freezing 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 improved when we addressed the scar tissue lesions on the bottom of the heel.
The purpose of pain is to help you learn to do something differently. How did this scar tissue come about in the first place? Icing the injury will make it go away, but you still need to change something in the way you do this activity so you don’t create a new injury.
My sincere intention is that you have the power to heal yourself from this nagging pain and make changes for a happier future. Happy frosting!