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Shoulder Injury and Rehab

HawaiianPride.

HawaiianPride.

Senior Member
Oct 21, 2010
152
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Since there are so many questions about tendonitis and tendonosis, here are some tips and general information!

Tendonitis is a very common injury that occurs in athletics. They usually occur as a result of doing too much. The more is better approach usually leads to many repetitive stress injuries, which only hampers training time and causes more frustration in the long run. The types that are that most prevalent are Achilles, patellar, medial and lateral elbow, biceps and rotator cuff tendonitis.

The primary reason tendonitis occurs as a result of excessive loading. The muscle is not able to handle the forces and stresses that are placed upon it, so this extra stress must go somewhere....which is the tendon. If the tendon can not handle this stress, the individual will experience pain and discomfort in that area. Other common symptoms of tendonitis are inflammation, tenderness and swelling.

Tendonitis can also occur as a result muscle weakness. This is usually remedied by specific muscle group strengthening. Another manner in which tendonitis can occur is through excessive torque at the area of tenderness, which is caused by weak musculature up and down the chain, tight musculature up and down the chain, or improper mechanics. This can all be remedied by strengthening, stretching and teaching proper mechanics and technique.

Tendonitis is a frustrating injury to deal with. Most athletes will continue to work through this and will end up causing more damage. If the tendon continues to be stressed and it can no longer handle this stress, the stress will travel to the bone. This can lead to stress fractures and other types of bone breaks. Sometimes this might not happen, but the pain will continue to stick around. Long term tendonitis is known as tendonosis. The same type of pain will be experienced by the athlete, but there is no inflammation.

Treating tendonosis should be different than treatment for tendonitis. Treatment for tendonitis can be accomplished through icing, stretching, rest, eccentric loading, electric stimulation, ultra-sound, and NSAIDs (non-steroidal anti-inflammatory drugs). The primary treatment for tendonosis is rest. It is important to evaluate the athlete for specific tightnesses and weaknesses that may contribute to the pain they are experiencing. This is often attributed to poor posture and repetitive stress.

Knowing the difference between tendonitis and tendonosis will help in giving the proper treatment to a faster recovery. It is important to realize what is actually causing the pain and to treat it properly. Look to treat the cause of the problem and not just relieve the symptoms. Once the cause can be found and treated, the pain will naturally subside. Always have your athletes report pain to a certified athletic trainer so they can provide the proper care. Training smarter will always last longer than training harder.
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2:The elbow is a complex intersection of three bones--the humerus in the upper arm and the ulna and radius of the forearm--that enables extension, flexion and rotation and facilitates the function of the hands. The muscles and tendons of the forearm, which insert at the elbow, serve to stabilize the wrist, and when they become inflamed through overuse, repetitive motion or poor form you get pain and limited range of motion (Tendonitis) As for long-lasting pain directly on the back of the elbow joint, that may be an indication of bursitis.

But most ordinary elbow problems stem from overuse. Two of the best-known and most-suffered ailments are lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer's elbow). The tennis type occurs when the extensor muscles in the forearm become inflamed on the outside of the elbow. Similarly, duffers often find that the muscles and tendons that flex their fingers and wrists become aggravated on the inner side of the elbow.

Don't think you can switch to volleyball and be safe. Any sport or activity that requires a strong grip, repeated or forceful movements, a clenched fist, or turning and twisting movements of the forearm muscles can be the culprit, whether you're lifting weights or painting the house.

Elbow injuries are often the result of poor form or repetitive bad habits, like twisting your wrists at the end of a triceps pull-down. In all honesty it's far better to protect your elbows with proper form while doing your main training than to rehab them before or after your workouts.

Your elbows are especially vulnerable if you try to do too much when starting a new exercise program, or if you accelerate the intensity of an existing routine too quickly. One of the most important rules of training is to give your body adequate time to recover between each workout. Not only does this help avoid over training it will help you avoid injury.

One thing to consider...is if your form is poor you could be making a minor injury worse. Be sure you assess your biomechanical factors well: Body alignment, pronation or supination of your feet, or even old injuries that were never properly rehabilitated can be weak links that should be addressed by someone who knows how to correct your form (which can be hard in a lot of gyms, becaue knowledgable people are often hard to find)

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Exercises to strengthen your forearms can be helpful, both to promote recovery and to prevent future problems. As you do the following exercises, pay attention to your form and the position of your wrists. Do three sets of each exercise, working up to 30 reps or muscle exhaustion. If you're injured, start with light weights (two or three pounds), and increase as your strength improves.

1. STANDING ARM CURL Stand holding a dumbbell at your side with your palm facing forward (1a). Bend the elbow and lift the weight to your shoulder (1b). Slowly lower to the starting position. Keep your wrist straight.

2. REVERSE ARM CURL Stand holding a dumbbell at your side with your palm facing backward (2a). Bend the elbow and lift the weight to your shoulder (2b). Slowly lower to the starting position. Again, keep your wrist straight.

3. WRIST CURL Stand holding a dumbbell at your side with your palm facing forward (3a). Flex your wrist forward (3b) and back to the starting position.

4. REVERSE WRIST CURL Stand holding a dumbbell at your side with your palm facing backward (4a). Flex your wrist up as far as it will go (4b) and return to the starting position.

5. ELBOW STRETCH #1 Extend your left arm straight out and parallel to the floor, with the elbow locked and your palm facing down. With your right hand, pull the fingers on your left hand down toward the floor, bending your wrist. (The arm doesn't move.) Hold for 15 to 20 seconds. Switch arms.

6. ELBOW STRETCH #2 Extend your left arm straight out and parallel to the floor, with the elbow locked and your palm facing up. With your right hand, pull your left hand back and the fingers toward the floor. Hold for 15 to 20 seconds. Switch arms.

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Have you ever heard the Term "Rice" in the gym? If so here is what it means...

RICE: rest, ice, compression and elevation

A little trick I learned from from AM...You take several dixie cups and fill them with water. Place them in your freezer and allow them to freeze. In the evenings while you're sitting around doing nothing...Take one of those dixie cups that you have in the freezer and use it to massage anything that hurts (Including forearms..elbows..triceps) on your body (with the ice directly against your skin)...As it melts..just peel down the dixie cup exposing more ice...Fairly simple but highly effective..

I HIGHLY recommend ice. And I've grown to be a believer in linament...and not just any linament...Horse linament

1. Proper form and avoid over training

2. Do prehab exercises like I listed above

3. Ice packs 10-20 minutes post workout..

4. Linament (preferably Horse linament) during and after workouts

5. Ice massages with good ol fashionedl frozen dixie cups of water
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3:Tendonitis and Tenosynovitis

--An inflammation of the tendon (tendonitis) and lining of the tendon sheath (tenosynovitis) characterized by pain on movement of the associated joint.

Causes and Incidence The etiology is often unknown, but individuals are thought to be more susceptible as degenerative changes occur in the vascularity of the tendons, causing a slower response to repetitive microtrauma. Repetitive movements, strain, or excessive, unaccustomed exercise may be causes. Underlying systemic disease (e.g., rheumatoid arthritis, gout, sclerosis, and disseminated gonococcal infections) may also be a cause. Middle-aged and older adults and athletes or individuals with occupations requiring repetitive motion are at greatest risk.

Disease Process Repetitive microtrauma damages the fibers in the common extensor tendon of the involved joint, causing extravasations of tissue fluid and setting up an inflammatory process. Over time, healing builds fibrous, inelastic tissue and scarring, which often bind the tendon and sheath together, limiting joint motion.

Symptoms The involved tendons usually show visible swelling; the joint may be tender and hot to the touch; motion of the joint causes pain.

Potential Complications Rupture of the tendon is a possible complication.

Diagnostic Tests The diagnosis is based on a history of repetitive motion or underlying disease and physical examination of the joint. Radiology may show calcium deposits in the tendon or tendon sheath.

Treatments

Surgery
Removal of calcium deposits in cases unresponsive to other treatment; release of fibroosseous tunnels associated with de Quervain's disease; tenosynovectomy for chronic inflammation associated with rheumatoid arthritis

Drugs
Oral or locally injected corticosteroids to relieve inflammation; analgesics/anti-inflammatory drugs to relieve pain

General
Moist heat compresses to joint; rest of joint with controlled progressive exercise program

Tendon , one of many white, glistening fibrous bands of tissue that attach muscle to bone. Except at points of attachment, tendons are tubular shaped in delicate fibroblastic connective tissue. Larger tendons have a thin inner dividing wall (septum), a few blood vessels, and specialized stereognostic nerves. Tendons are extremely strong and flexible, inelastic, and occur in various lengths and thickness.

Corticosteroid /kor'tikostir'oid/, any one of the hormones made in the outer layer of the adrenal gland (adrenal cortex). They influence or control key functions of the body, as making carbohydrates and proteins, working of the heart and lung systems, and functions of the muscles, kidneys, and other organs. The release of these hormones increases during stress, especially in anxiety and severe injury. Too much of these hormones in the body is linked with various disorders, as Cushing's syndrome. The skeletal muscles need the correct amount of corticosteroids to work normally. Corticosteroids can also be given to patients to help certain disorders, as swelling or failure of the glands to make enough for the body.
 
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