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Tendonitis Or Inflammation Of The Tendons

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When the tendon gets inflamed it is known as tendonitis, and when the tendons are being overused, It can lead to some small tears in the collagen that surronds the tendon which can cause some weakening of the tendon. It can also be associated with rheumatoid arthritis. There is generally a swelling in a region of micro damage or a partial tear is seen or it can even be felt by the doctor who will diagnose it by such means. The tendon is the tough fibrous tissue that connects the muscle to the bone and it helps in walking, jumping, lifting as well as moving in many different ways.
Not all Tendons are the same size and shape
You don’t want to do any harm to your tendons which come in many shapes as well as sizes – with some of the smallest tendons found in the fingers and there are other larger ones that help people to walk. The inflammation to the tendons can be caused by a number of different reasons which results in the action of pulling the muscle becoming quite irritating. Any problems that you have with the gliding motion of the tendons will end up resulting in pain while moving and this is called tendonitis.
Chronic overuse can be the most common cause of tendonitis and may frequently occur when individuals begin to exercise or increase the level of their exercises, and it will result in symptoms of tendonitis. It can also occur to your age, because with advancing years, the tendons tend to lose their elasticity as well as ability to glide as smoothly as they are used to doing. Elderly people will thus be more at risk of getting tendonitis, and the cause of such a condition does require more study and research in order to completely understand the real causes.
There could be other reasons such as anatomical reasons for getting tendonitis especially if the tendons don’t get a smooth glide path if this is the case then surgery to have the tendons realligned is the best way to stop the tendonitis. Tendonitis can be felt in the wrists, Achilles, kneecaps, as well as rotator cuff. When a person suffers from tendonitis, it may be advisable to get plenty of rest as well as protect the affected area, and one may also need to apply an ice pack. In addition, anti-inflammatory medicines, and cortisone injections are effective means of treating tendonitis.

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Winding Down After the Ski Season

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FROM an orthopaedic and sports medicine point of view the most useful thing a skier can do post season is to maintain fitness and treat any injuries.

Most of us who go skiing sustain minor injuries in various tumbles while on holiday and expect the residual discomfort/bruising/swelling to resolve itself. Fortunately, it does so in the vast majority of cases with most skiers treating themselves with a degree of neglect, rest, ice and anti-inflammatories.

This is probably entirely appropriate for the most part. However, there are a few common, persistent or nagging injuries that are best not ignored.

A common injury among skiers and snowboarders alike is a fall on to the shoulder or a fall involving the shoulder. This can produce a common condition of subacromial impingement syndrome (painful arc syndrome). This is a condition manifested by people experiencing pain when their arm is utilized up at around shoulder height or once they take their arm right up into full elevation the pain either disappears or subsides.

The pathology with this condition is of an injury to a tendon in the shoulder called the rotator cuff which becomes either partly torn or simply inflamed. In either case it swells and this swollen enlarged tendon gets caught as it runs through a bony ligamentous tunnel in the shoulder. The condition becomes a bit of a vicious circle in that the more the tendon is swollen the more it rubs and so on and so forth.

Fortunately, the condition is easy to treat either with a programme of physiotherapy and/or a course of up to three injections. If the condition is allowed to persist it usually deteriorates steadily and can lead to a complete tear in the tendon.

The second most common complaint you are wise not to ignore is that of ongoing symptoms of pain, swelling, clicking or giving way following a minor knee injury If you had sustained a major ligament injury to your knee while skiing you would certainly have known all about it and would probably have to be blood wagoned down and possibly flown home.

It is, however, possible to sustain relatively minor cartilage tears in the knee which can grumble on for months with symptoms as I have described above. If you have such knee symptoms after a minor skiing injury then I would recommend referral to a local orthopaedic surgeon with an interest in sports medicine. He or she is likely to investigate with an MRI scan to confirm the diagnosis and can either put your mind at rest by saying that there is no evidence of any cartilage injury and that your symptoms will settle, or that the scan may confirm the diagnosis, in which case arthroscopic surgery will cure you quite quickly

If you leave such meniscal tears without treatment the tears can extend and lead to secondary degenerative change.

In summary, therefore, any symptoms from minor injuries sustained while skiing that persist for more than six weeks should be taken seriously.

From an original article published in THE SKIER & SNOWBOARDER MAGAZINE, MARCH 2001

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Shipping the Problem Elsewhere

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I was reading a recent survey that said if given the choice, most people would rather get increased healthcare coverage than a pay raise. We in the industry know it’s a mess and that many people delay getting treatment for fear of depleting their savings. The current state of healthcare in America can literally be deadly.

Which is why I wasn’t surprised to read an article that stated many patients are now going overseas for their healthcare. Get a load of this:

“Carl Garrett of Leicester, N.C., will fly to a state-of-the-art New Delhi hospital in September for surgeries to remove gallstones and to fix an overworn rotator cuff. His employer, Blue Ridge Paper Products Inc. of Canton, N.C., will pay for it all, including airfare for Garrett and his fiancee. The company also will give Garrett a share of the expected savings, up to $10,000, when he returns. ”

That’s right! We’re not only shipping jobs overseas, we’re now shipping patients there, too! Of course, if this trend continues, we will essentially be sending jobs for medical professionals overseas by default.

I don’t know about you, but this embarrasses me deeply. I didn’t get into healthcare management to only help treat the people who were lucky enough to have coverage or could afford it. Ill health doesn’t discriminate, it potentially affects us all, and the longer we let the situation get out of hand, the more bizarre and defeating solutions will be found by companies and individuals who are fed up with the status quo.

I got a good response to a previous article about people going overseas for medical procedures because it costs less. If you don’t mind, I’d like to respond to some of the comments.

The first commenter said:

“…like you, (I) entered healthcare management (twenty years in hospital administration, consulting and eight managing medical practices)to help based on my non clinical skills. I worked largely in innercity hospitals and then transitioned to medical practice management. There I became more jaundiced with the attitudes of specialty physicians. Behind the scenes the focus of a surprising number of doctors was on paying patients, although periodically altrusim did shine through. I had to look carefully for the quiet ones who took care of patients and did not bluster at the closed door business meetings. When things got tough they would speak up, but only when really pushed. Rhetorically, I wonder why organized medicine, and our lofty management societies and associations don’t focus more on the caring side, the professional side, the hippocratic side.”

Here again, someone says it better than I can. Another reader makes a good point based on experience:

“Why would H/care be exempt from the global marketplace? Health care services are a product that is consumed by consumers (patients). Accordingly, patients will shop for services. Consumerism in health care has been a long time coming. For instance, my family went to Colombia to get dental work done for a fraction of what it would cost here, and we managed to add in a vacation. Now the one thing to consider, is what if there are complications, is the company going to fly the employee back to resolve the complication? (Probably not).”

Actually, I don’t blame the patients for taking advantage of better deals in other countries. Your trip to Colombia sounds like a marvelous combination of business and pleasure, although I wonder if your vacation wasn’t affected by the dental work! Still, you ask a great question at the end, and while I’d suppose it depends on the company and the agreement worked out in advance, another reader makes this excellent point:

“You got it right when you said ‘COMPLICATIONS’. Try suing the doctor overseas and see how far you get. The malpractice piece is a large part of our health care dollar.”

Then there was this comment by Lifeline Medical Associates President/CEO Jack Feltz that eloquently summed up the frustrations he experiences heading the largest provider of women’s healthcare in New Jersey:

“One of the biggest wastes of resources is practicing defensive medicine because of the medical liability crisis and lack of meaningful tort reform in New Jersey and elsewhere. Physicians, I believe tend to order more and more tests because they are frightened not to. If there is a bad outcome you can bet there will be an attorney and expert to say they should have ordered every test imaginable. This is tragic, making health care unaffordable. I would rather see these wasted dollars go towards cures for breast cancer, immunizing poor children, improving care and keeping healthcare in the hands of expert doctors and nurses in the U.S.A.”

I think you make an excellent point, Jack (may I call you “Jack?”). If only more CEO’s had your sense of compassion. I often forget the legal part of the equation because I am so frequently enmeshed in battles with insurance carriers. Or to again quote yet another reader who says it better than I can:

“Insurance carriers are problematic, and don’t pay or delay paying claims, and then don’t pay them according to the appropriate fee schedule. This means patients get billed eventually for services that should have been covered. Unhappy patients complain to employers about coverage. Employers decide to go elsewhere. This doesn’t reflect on American physicians, it reflects on American insurance carriers. ”

Exactly. Personally, I think the solution to our healthcare crisis will have to combine tort reform with insurance reform. Outsourcing illness is a symptom of a diseased system. In the end, our political representatives will have to summon the will to play doctor and cure this problem. As I noted in my previous post, their inaction on this issue is deadly.

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Innovative Acupuncture Technique Targets Joint Pain

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A unique form of acupuncture is found to relieve chronic joint pain. The technique works by pin-pointing the exact tissues that actually cause the dysfunction. The joint-specific acupuncture, developed by Dr. Ken Golden, is a perfect example of modifications that enable acupuncture to address pain even more effectively.

Acupuncture has been utilized to help heal people for thousands of years and through that time it has seen many modifications. Dr. Golden’s office, Symmergy Clinic has taken some traditional theory and combined it with western science to accomplish an application that specifically addresses joint pain. Although acupuncture is an art that has proven effective for thousands of years, simple adjustments can be found useful. “This joint-specific technique is simply another application of acupuncture… another way that acupuncture can help patients live without pain and do the things that they want, and should be able, to do,” says Dr. Golden.

Muscles determine the function of the joint that it spans, therefore this style of acupuncture targets the muscle tissue. By very carefully selecting the muscles that are too short and tight doctors can quickly lengthen them to allow the joint to function properly and without pain. This method works off of basic muscle-to-brain connectivity where the muscle is “tricked” into “thinking” that it is experiencing a sensation. As a result the portion of the brain controlling and coordinating muscle movements sends a signal for the muscle to release. The outcome is an increased length in muscle tissue and a decompression of the joint that it crosses.

“This concept of muscles controlling joints is very important” says Dr. Golden. “The muscles that move every joint in our bodies must have balance or symmetry in order to work properly. This is where the name “Symmergy” comes from: symmetry and synergy, if you have symmetrical muscle length you have synergistic joint function.”

Joint pain of all types such as, arthritis, bursitis, rotator cuff damage, and tendonitis, all begin with muscle asymmetry. “It does not matter if we’re talking about a knee, shoulder or neck” says Dr. Golden, “they all come from the same place and if you identify, treat and maintain the correct tissues the pain and inflammation can be controlled.”

This innovative technique has given patients with all ranges of discomfort, relief from their joint pain. “I’ve had patients that have endured three failed surgeries prior to having success with non-surgical treatment at Symmergy Clinic” says Dr. Golden. “The quicker we can treat a case the better chance of resolution we have. That being said, many of my patients have been through the ringer before seeking my care. Most of my patients do exceptionally well with treatment.”

To learn more about Symmergy Clinic and their treatments contact Dr Golden at 594.0004 or visit symmergy.com.

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It’s Time to Say Goodbye to Tendinitis Part II

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IT’S TIME TO HELP YOUR PATIENTS SAY”GOOD-BYE TO TENDINITIS” Part II Dr. Edward Holtman, D.C. 48+ Years Chiropractic/Tendinitis Treatment Specialist  

Mode of Improvement:You can expect definite improvement during the first two to three weeks, and from then on gradual improvement until completely well. The patient must be devoted to the system and its instructions, and even though it takes time, you can expect complete recovery.I would like to present my most noteworthy case histories: Case #1 – D.O. (initials) He described himself as “skeptical”. I first saw this patient on May 9, 1992. He said he had had tendinitis since September 1991. He described a #5 to #6 pain in his right elbow area (#1 being the least pain he has ever experienced in his lifetime and #10 being the worst). He said the pain in the left elbow area was only a #2 to #3.Previous to seeing me he visited these doctors:1. Family doctor – no results.2. Another general practitioner in same clinic as family doctor – no results.3. Chiropractor – no results.4. Orthopedic specialist – no results.5. Specialist referred patient to hospital for physical therapy – no results.6. Back to same orthopedic. He suggested patient take off work for one month. Patient’s employer said “no” to that.So, the patient went to another medical group clinic for physical therapy (yet again) – no results.

I should say at this point that this patient has a factory job where he really overuses his arms, greatly. I put this patient on the home-self treatment on May 9, 1992. He has gotten gradually better. I saw him on June 24 and he reported his right elbow was at a #2 pain level, down from #5 to #6. His left elbow was at a #2 level, down from #2 to #3. And he continues to overuse his arms with no time loss! Oct. 3, 1992 patient update: both elbow areas are down to a #1/2 pain. Almost cured! Patient update January 1993: The patient is pain free.Case #2 – D.B., factory worker.Tendinitis in both elbow areas severe since June 1988. A #7 pain in the right elbow and a #5 in the left. Picking up a cup of coffee, opening a door, trying to light a cigarette was very painful. She had been off work a total of three months from June 1988 to January 1991. She went on “light” work, then gradually worked her way back to her regular job. This exacerbated her condition. Between June 1988 and January 1993 this patient had consulted six medical doctors for her tendinitis. No beneficial results. I first saw her on January 20, 1993. Diagnosis: Tendinitis in both elbow areas. No complicating factors. I placed the patient on the professionally made video instructions and supplements. No chiropractic. The spine was fine, but the patient was “skeptical.” She thought it was a waste of money (but didn’t tell me). Later she said, “Was I wrong!!” In two weeks she was better, in five weeks she was 35% better.

In three months there were many days that she felt no pain at all. On July 5, 1993 she reported only occasional, very mild pain, and she is continuing with the exercises.Case #3 – L.J., Occupation: Physical Therapist.She couldn’t lift a fork to her mouth and couldn’t raise her extended left arm to shoulder level. This went on for two years at a #9 left shoulder pain. In December 1988 she went to her first M.D. and received anti inflammatories, muscle relaxants and pain killers. This did not bring about relief. She also packed her left shoulder in ice every night just to get to sleep. She then went to a second M.D. where she received a more thorough exam. But two weeks later, the doctor relocated. Then she went to a chiropractor for five months with no beneficial results. Next she went to the first neurologist. He couldn’t find anything neurologically wrong. He used ultra sound, biofeedback, anti depressants and tens treatment. This went on for one year. She reported some temporary relief from the tens treatment. The neurologist recommended a psychiatrist. She then gave up on all treatments for four months. At this time she entered physical therapy school. (This had been her dream since age six.) But because she was new to the school, she went to another M.D. and asked for a prescription to take physical therapy privately. She stayed with the physical therapy for one and one-half years both in and out of school. For a time she was taking some form of physical therapy three times a day. She attained some relief, but the shoulder continued painful because she was over using the left arm. She then went to an orthopedic surgeon. He sent her to another neurologist. He found nothing neurologically wrong. Back to the orthopedic surgeon who operated on the right shoulder to correct a rotator cuff tear. (After which she couldn’t drive her car because of not only the right shoulder surgery but also because the left shoulder tendon was still very painful.)

Gradually with therapy her right shoulder improved. She came to my office on October 22, 1991 for treatment of a left sciatic condition. During the course of the sciatic treatment, she mentioned the fact that she had left shoulder tendinitis. (She was still favoring the right shoulder, thereby overloading the left shoulder which was at a #9 pain.)She said she was ready to try anything. She began the treatment on November 8, 1991. In three weeks she was 80% better. In six weeks she was pain free. Later she became lax with the program, on occasion and the shoulder became worse, but after resuming the program the pain cleared in three to four days. Today she is feeling fine! August 23, 1993.Case #4 – Edward G. Holtman, D.C. (myself)Seven years ago I would have given anything for a successful treatment for tendinitis, because I had tendinitis myself for six and one-half years. I had tendinitis so bad in both elbows and both shoulders (because of my work) that it was a strain to lift our female cat. And, when my wife and I went to a restaurant or shopping mall, I had her open all the doors for me to avoid straining my arms further. Because I knew chiropractic spinal manipulation only occasionally helps tendinitis, I took almost all types of physical therapy. To

Be Continued… Part III

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