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Old 09-17-2009, 06:29 AM   #1
Davi Cohen
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tendon inflammation prevention

My tendons are a mess! And I would love to hear your strategies and suggestions for preventing tendon inflammation.

I currently have a longitudinally torn posterior tibial tendon in my left ankle. I can feel some inflammation from time to time in my right post tib too.

I have been resting - with the exception of swimming three times, biking for transportation a bit, and walking under water once and a very small number of workouts (about one per week) not using my left leg - since August 25 and more broadly resting (i.e. initially was still training upper body, still being pretty active about town, teaching yoga in my bare feet, which was a terrible idea) since July 16. After a somewhat misguided prescription from an initial doctor's visit (to a doc clearly inexperienced in working with athletes), I have gone to see my regular dance specialist orthopod, returned to my usual super excellent PT, and things are on the mend in my foot.

I was on crutches for about 10 days and have been in an immobilization boot since August 26 or so.

***

What I noticed when I was continuing to train my upper body regularly at first - back in July/early Aug - was that I started to experience inflammation in the front of my right shoulder. I decided to steer clear of the rings for a while and the irritation vanished.

Yesterday I did my first meton/Crossfit workout since September 5 and not only was it very challenging from a conditioning POV, it has left me with an irritated biceps tendon and the most pronounced discomfort is right below the acromium/near the glenoid process. It's predominantly on the right side, though if I apply pressure to the left manually I can feel it there too.

This was also my first time back in a Crossfit gym in a while.

WU: 10 pistols (R), 10 1-legged pushups, 10 pullups X 3

3 rounds of 30 situps, 20 pullups, 10 ring dips
50 knees-to-elbows
1-2-3-4-3-2-1 HSPUs

Aha! And looking back at that, of course, I did a modified version of the group warmup without knowing (and before the coach had actually come up with) my own WOD. So I ended up doing 90 kipping PUs yesterday (I could have done without that many PUs in the warmup). Earlier this year I was cranking out 20-26 PUs per round on Lynne and I don't *think* I was having problems with my tendon (except I may have just been ignoring the signs).

***

I am ultra-sensitive right now to tendon problems. My torn ankle tendon just appeared seemingly without warning, but what I realize in retrospect is that I may have dismissed some of the early warning signs or just not been aware of them.

I do NOT want to send myself down the road to tendinosis in my right shoulder.

I am taking fish oil, glucosamine/etc joint supplements, and getting massage (though I would be grateful for some more info about self-massage of the biceps tendon). What kind of controlled strengthening exercises can I do to help with my biceps tendon? I experience this problem on the right side (dominant side) only.

Also, I eat a lot of nightshades these days. It's still eggplant and tomato season in NY and I love eggplant and beautiful heirloom tomatoes. Should I minimize or cut these out? This will shift anyway as the season changes (but first we have peppers! I love peppers too!).

Any other suggestions about general prevention of tendon problems?

I know Starrett has a series on soft tissue injuries - I should go take a peek at those videos in the journal.

Thanks!
D
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Old 09-17-2009, 06:34 AM   #2
Davi Cohen
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addendum

Just to be clear - the pain in my shoulder(s) isn't unbearable. It's what I'd call "normal soreness" after a challenging workout.

However: I had no soreness that I could detect - no pain, just a little "toughness" in my tendon - before my post tib tore. I am just paying closer attention to everything now.

And I want to do everything in my power to prevent the collagen fibers in my body from going their separate ways.
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Old 09-17-2009, 06:37 AM   #3
Davi Cohen
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optimal post WOD stretching

I think I would benefit from being more structured in my approach to post-WOD stretching too. Instead of just going by sensation (which can be muted/different in the immediate post-WOD period), I want some stretches that will aid in the recovery of the stress on my tendons (esp shoulder at the moment).
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Old 09-17-2009, 06:48 AM   #4
Davi Cohen
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Re: optimal post WOD stretching

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Originally Posted by Davi Cohen View Post
I think I would benefit from being more structured in my approach to post-WOD stretching too. Instead of just going by sensation (which can be muted/different in the immediate post-WOD period), I want some stretches that will aid in the recovery of the stress on my tendons (esp shoulder at the moment).
and often stretching an inflammed tendonous area is not the way to go

*** okay, enough of this monologue for now!
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Old 09-17-2009, 08:30 AM   #5
Mike Mallory
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Re: tendon inflammation prevention

quite a lot of info (admittedly I didn't get through it all).......Anyways, I usually see this in clients when their diet isnt up to par, poor protoplasm in general.

so....how is your diet?

If you're pretty sharp with those things, I would look into food allergies or other sources of inflammation, your gut, stress in general, and down the line. Those can add to poor recovery, and food allergies can slowly destroy you completely.

I know personally If i don't watch out for my own health as far as diet/stress, I'll start to feel it in the tendons/ligs first.
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Old 09-17-2009, 10:30 AM   #6
Steven Low
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Re: tendon inflammation prevention

Yeah, may be good to do an allergy test for some foods.

I know Garrett doesn't really like nightshades at all. So you may want to eliminate those and see if it helps.


Otherwise, honestly just looks like a lot of overuse. I mean, 90 pullups for warmup? That's extremely excessive IMO.

I would start doing more joint mobility work for warmup and maybe a couple exercises. Not exercises as a warmup.
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Old 09-17-2009, 11:36 AM   #7
Davi Cohen
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Re: tendon inflammation prevention

My diet has been paleo plus cashews for a year (and I ate some string beans the other day - yumyum).

Just to clarify - the warmup did not consist of 90 pull-ups.

The warmup, which included joint mobility stuff ALSO included 30 pullups.

But then my individual WOD, which was not Diane (everyone else's WOD) since I am not deadlifting right now due to my ankle, and which I did not know at the time of the warmup, included 60 more pullups.

Basically, the summary of my stuff posted above is this:

I tend to feel stress and soreness at the tendon attachments rather than in the belly of the muscles right now. This makes me think there may be something systemic happening with me or at the very least that I need to change something, in view of the recent tendon tear and the fact of minor inflammation popping up in both feet and shoulders.

I have not been tested for food allergies in several years (though I was previously and it was seriously among the most unpleasant experiences of my life - I was basically in low-grade anaphylaxis for 24 hours ). At the time I was allergic to a huge host of things but nowadays none of them seem to bug me - at least not in the same ways (itchy eyes, swollen throat, hives in the mouth and ears).

I'm going to keep reading/exploring.

Thanks for taking the time to respond - my initial post could certainly have been more succinct!
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Old 09-17-2009, 12:09 PM   #8
Bob Guere
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Re: tendon inflammation prevention

Fish Oil. Lots of fish oil.
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Old 09-17-2009, 12:20 PM   #9
Davi Cohen
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Re: tendon inflammation prevention

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Originally Posted by Bob Guere View Post
Fish Oil. Lots of fish oil.
Yup, already got that going on!

Though I've been meaning to switch from capsules to liquid.
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Old 09-17-2009, 12:35 PM   #10
Mike Mallory
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Re: tendon inflammation prevention

also, add glutamine to your diet, a LOT.

at least two tbsp per day.......Look up 'Great Lakes Gelatin' and buy a can; you can't get enough in the pill form
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