We Feel Your Pain

By Tamela Thomas, Wellness Manager

We've been in our beautiful facilities here on the 4th Floor for almost two years. How we've grown—we now staff two Physical Therapists, a full-time Nutritionist, a Naturopath, an Acupuncturist, an Ayurvedic Counselor, an Orthotics Specialist and an Executive Personal Coach.

And though our cup runneth over with a rich menu of services to take you to a higher level in several areas of your life, some of you are still walking around in pain! How can we talk to you about enriching your life when this pain is distracting you?

As you'll read in this month's article, there is no need to accept the constant pain of tendonitis. Stuart Eivers, DPT, OSC, tells us how this common nuisance can turn into a real problem if it is left unchecked.

If you still have questions or are interested in having Stuart evaluate a nagging pain for you, give us a call in the Wellness Center: 206.839.4780.

A little stretch can go a long way.

Preventing & Treating Tendonitis

By Stuart Eivers, Physical Therapist

"It's been a great summer. I have gotten a lot of projects done, exercised more, and been really active. The problem is I'm sore!"

Does this conversation sound familiar? To most of us, a Seattle summer can be described like that. When we become more active and do things that we don't normally do, whether it be working in the yard or running harder and longer, we put ourselves at risk for overuse injuries such as tendonitis.

What is tendonitis? 

First, tendons are the structures that connect a muscle to a bone. If you picture a muscle as a bag of protein strands, the tendon is the tied-off part at the end. Tendons are made up of connective tissue or collagen. When a muscle contracts, the protein strands shorten; this puts tension on the tendon as it moves the bone. Repeated and/or very strong contractions can cause injury.

Tendonitis is the inflammation of a tendon. Inflammation can occur with an injury or repeated stress to the tendon. If there is chronic inflammation or stress put on the tendon a more permanent condition of tendonosis can occur. Tendonosis can create pain through sensitization of the tendon to stretch. Either of these conditions can cause pain and disability.

Overuse injuries usually occur with repeated movements that overcome the tendon's capacity over time. Sports participation was once the major cause for this type of injury, but tendonitis of the wrist and elbow from computer use and the proliferation of other highly repetitive jobs have made work the new leading culprit. Therefore, correct posture and ergonomics play vital roles in preventing overuse injuries.

Strain injuries occur with a quick overload of the tendon. Examples consist of jumping (Achilles) or catching yourself during a fall. The force can be enough to strain or even rupture the tendon.

Prevention

Tendonitis affects millions of Americans each year. Some common types are lateral epicondylitis ("tennis elbow"), Achilles tendonitis, and rotator cuff (shoulder) tendonitis. It can happen to any tendon in the body.

Medical literature supports the use of stretching exercises to prevent tendonitis. I normally advise a comfortable, sustained stretch to the muscle group involved using breathing and relaxing (no counting) for about 20-30 seconds. You should always feel better and more "loose" after stretching, and be ready to start your activity.

It is important to warm up and cool down before and after exercise. A warm-up can be a vigorous stretching routine or light aerobic exercise for five minutes. A cool down can be a five-minute walk or gentle stretching after your activity.

Another, more advanced, way of training called "negatives," or eccentrics, can also prevent injury by specifically training connective tissue, including tendons. Be careful, however, as eccentric exercise can easily cause tendon injuries.

As with anything, if you are doing something you are not trained to do or have increased the intensity of your workout too much, you are at greater risk for injury. Any time you start or dramatically change your exercise program, it is a good idea to consult someone knowledgeable. The WAC's highly qualified Personal Trainers are one such resource.

Signs and treatment

A common sign of tendonitis is pain specific to the tendon with full stretch as well as muscle contraction. If you are convinced that you have an injury, you can treat yourself with stretching and rest. Ice and anti-inflammatory medicines are helpful as well.

Rest can be defined as complete or active. An active rest involves cross training or decreasing the intensity of activity. If rest and self-treatment don't seem to be working for you, it may be time to seek professional advice from a Physical Therapist.

To this end, we have a special service available to WAC Members who wish to have a licensed Physical Therapist review their problem—it's called an Injury Screening. During an Injury Screening, you will get a 15-minute assessment of the situation and advice about how to best care for the injury.

The assessment may refer you to adjunct services offered in the Wellness Center. For instance, acupuncture can be helpful in reducing pain and inflammation. Also, a Naturopathic Physician can identify natural ways to treat the condition and actions that will prevent it. A Biomechanical Tune-up can identify the injury and the biomechanics that lead to it. In Physical Therapy the injury is diagnosed and a treatment is prescribed to alleviate the symptoms. Treatment can involve manual therapy (massage and joint mobilization) and exercise to reduce the pain and inflammation, and offer advice on training and prevention.

As the Seattle summer wanes and we start nursing our injuries from putting in that raised garden bed or taking on water sports, we prepare ourselves for the coming season. The WAC itself usually sees an increase in athletic facility usage in September and October.

It is my hope that if you have an injury, whether it is tendonitis or something else that limits you in any way, you have it addressed by your team at the Wellness Center now. There is no reason to concede your active life because of a nagging or incapacitating injury. Tendonitis can be one of those conditions that can become chronic and decrease your quality of life. Otherwise, use the advice in this column to prevent injury and live your life fully.