# Tendonosis and bursitis



## dream (Aug 6, 2012)

I have had some niggling shoulder sensations for the last couple of  months and Bench press seemed to set it off and can irritate it, now  overhead presses irritate it. I would say the pain is two out of 10, in  that it does not hurt but feels inflamed and sore if pressured hard enough touch. My  symptoms throughout the day it just that feeling of inflammation  although it does go away after a day if aggravated. I got an ultra sound  and this is hat they found....

*All rotator cuff tendons appear normal and intact. There is a small  amount of fluid seen in the left subdeltoid-subacromial bursa in the  area of the supraspinatus tendon. Small amount of fluid seen round mid  portion of left bicep tendon. No Doppler activity.

    Conclusions_
    Mild tendinosis of left bicep.
    Mild bursitis of the left subdeltoid-subacromial bursa.
    Normal sonographic appearance of right shoulder.*

  What passive ways can  help speed up the healing process, from my research applying ice to the tendons are actually flawed as it reduced blood flow. I am taking devils claw, should i stop it as again I have read anti-inflammatory slow down the healing process devils claw is natural so might be different?
Also does super cissus help strengthen the tendons rather then act as an anti-inflammatory?
How should I train regarding pressing exercises? I have read that resting it is actually counter productive and will make it weaker, I know I can't train normally but I should do negatives at a low weight to help strengthen the tendons?
Thanks


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## bjg (Aug 6, 2012)

your injury seems mild...ice will actually help , it does reduce blood flow temporarily then it will increase it as you take the ice off....but you can skip the ice. 
take  a week off, then restart working out avoiding circular motions, heavy presses, standing curls, and anything heavy or anything that hurts , concentrate on exercises that do not hurt and do them slowly and with light weight and good form.....NEVER use sudden movements or jerking the weight in any case ...after a week off start by working out every other day and see how it goes from there.


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## hypo_glycemic (Aug 6, 2012)

Or take some glucosamine HCL!


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## CowPimp (Aug 6, 2012)

hypo_glycemic said:


> Or take some glucosamine HCL!



That is unlikely to help.  It is suggested that this supplement helps with osteoarthritis, where the articular cartilage on the end of a long bone has worn away.  That is not the issue this gentlemen has.  Not to mention, that evidence is tenuous at best.

The only thing you can really do is avoid things that aggravate the issue.  From the sound of it, you have some shoulder impingement issues.  The subacromial bursae and long head biceps tendon are both structures running through that subacromial space.

For now, avoid any movements that irritate the shoulder problem.  Additionally, try to add some corrective exercises to prevent future irritation.  Try searching for the following terms:

Shoulder internal rotation deficit
Shoulder posterior capsule stiffness
Scapulohumeral stability
Scapulohumeral rhythm
Rotator cuff strengthening

Feel free to try some of the exercises suggested for these issues.  See if it helps.  You won't notice instant results, but over a period of weeks it may help.  If things persist or continue to get worse, then consider seeking out an orthopedist.

In the meantime, see if you can get away with pushup variations instead.  Sometimes closed chain movements create less of an issue for people with impingement related shoulder issues.


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## NVRBDR (Aug 6, 2012)

*This is something I am looking into, it reads great and it may help, but I am unsure if the claims are valid and accurate...*

ALFLUTOP - antirheumatic products 



ALFLUTOP? is a natural product with high efficacy therapeutical properties proved by tests and studies performed for over 18 years. 

ALFLUTOP?, conditioned as injectable solution, contains in 1 ml solution 10 mg bioactive concentrate (amino acids, low molecular mass Peptides, mucopolysaccharides, trace elements: Na, K, Ca, Mg, Fe, Cu, Zn), maximum 5 mg/ml phenol as preservative. 

ALFLUTOP? belongs to the group of chondroprotective products having anti-hyaluronidase, antiinflammatory and analgesic action: 


inhibits hyaluronidase excess; 
restores chondrocytes homeostasis in damaged tissues; 
stimulates regenerative processes at cartilage level; 
improves the synovial fluid and the afflicted cartilage quality; 
stimulates superoxide diase; 
inhibits occurrence of superoxide free radicals. 
The clinical trials have proved the efficacy of the product ALFLUTOP? in degenerative articular rheumatism, post-traumatic pathology and abarticular rheumatism. 

Advantages: 

lack of major complications; 
very well tolerated, even by the patients suffering from gastrointestinal, cardiovascular and metabolic diseases; 
a favourable ratio of costs and clinical efficacy. 
The clinical trials have also showed the therapeutical effect of ALFLUTOP? in the treatment of periarthritis, spondiloarthrosis, spinal disc injuries, ankylopoietic spondilitis, Reiter syndrome, rheumatoid polyarthritis. 

Clinical Medicine №6 2004 
Svetlova M. S., Ignatyev V. K. 

Use of alflutop in the treatment of patients with osteoarthrosis 

The efficiency of alflutop was studied in patients with osteoarthrosis (OA) of the knee or hip joints. The examinees (n = 24) received alflutop only intramuscularly (in coxarthrosis) or intramuscularly in combination with the intraarticular injection of the agent (in knee osteoarthrosis). Physical examinations were made in control periods: before and immediately, 3, 6, and 12 months after treatment. Arthrosonography was used as an objective method for controlling the efficacy of the drug. The studies have demonstrated that alflutop substantially relieves pain, improves the function of the diseased joints in patients with OA. Arthrosonography has shown that the drug exerts an antiinflammatory effect, retards the progression of a pathological process in the joint. Alflutop has been found to be more effective in knee OA than in hip OA, which is determined by that its combined use regimen may be used in knee OA. The necessity and high efficiency of repeated courses of alflutop therapy are shown. 


The effects generally last from 6 to 9 months before the therapy must be repeated. 

The amps are sterile water based and its very good tolerated by your body and no side effects. 

Directions for use: 

There are two methods for use: intramuscular (IM) & intra-articular (IA). IM injections are the easiest to deal with and allow the compound to absorb throughout your body to all necessary areas. 

It has to be injected I.M.(intra muscular) 1 amp every day for 3 weeks (21 days), you can take again them after 2 months. Fore some, with more serious joint problems, a couple of rounds need to be done to bring the joints up to speed. (21 daily IM injections, 1 amp per injection, rotate inject sites) 

The last clinical tests found that the amps can be injected 1-2 amps in affected parts of your articulation or damaged ligaments. This has to be done once at every 3 days during 3 weeks. It can be done again after 3 months. (THIS IS FOR ARTICULAR or DIRECT SITE INJECT THERAPY ONLY)


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## dream (Aug 6, 2012)

bjg said:


> your injury seems mild...ice will actually help , it does reduce blood flow temporarily then it will increase it as you take the ice off....but you can skip the ice.
> take  a week off, then restart working out avoiding circular motions, heavy presses, standing curls, and anything heavy or anything that hurts , concentrate on exercises that do not hurt and do them slowly and with light weight and good form.....NEVER use sudden movements or jerking the weight in any case ...after a week off start by working out every other day and see how it goes from there.



Funny thing is curls do not irritate the area, pressing exercises can irritate the area, my favorite exercise the chin ups can as well, but only right at the top of the movement, guess that's where my long head of my biceps come into play.


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## NextMan (Aug 6, 2012)

Tendons are very slow to heal due to poor blood flow there. ICE will definitely help. It stops only for a short time and blood will rush in soon after and expand the capillaries to allow more blood flow. This is how the capillaries work - contract and expand even normally.
And use Nitric Oxide transdermal patches (be careful about the strength of the patch). Read this on NO patches for tendinopathy...
Using nitric oxide to treat tendinopathy


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## bjg (Aug 7, 2012)

dream said:


> Funny thing is curls do not irritate the area, pressing exercises can irritate the area, my favorite exercise the chin ups can as well, but only right at the top of the movement, guess that's where my long head of my biceps come into play.


 not  really worried about the curl itself, but with standing curls you can have the tendency to lean back and put pressure on the biceps tendon where it attaches to the shoulder and also pressure on shoulder...in standing curls try to lean a bit to the front and curl slowly without moving your upper arms and elbows... better if you use the preacher bench.
everything should be light weight  and smooth ..no jerking ..especially at the beginning  of a lift


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## pjreiff (Aug 8, 2012)

I've recently become a huge believer in deep tissue massage and chiropractic care.  Had a nagging injury that would not go away so had a few sessions with a LMT and DC.  Had great success with this and would recommend giving it a shot.


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## bjg (Aug 8, 2012)

^^^ it can help but i would not do it in the early stages of an injury


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## Usealittle (Aug 8, 2012)

all you need is DMSO oil and uncoated aspirin with a mortar and pestle. crush up 2-3 325mg aspirin add in 1cc oil and mix, add to points of pain about 30-45 min before workout and your GTG. that what i had to do when i would put my bench shirt on.... only way i could get through the joint pain it gave me.

try it and reply back... im sure you will like the way it works for you.


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## dream (Aug 8, 2012)

Usealittle said:


> all you need is DMSO oil and uncoated aspirin with a mortar and pestle. crush up 2-3 325mg aspirin add in 1cc oil and mix, add to points of pain about 30-45 min before workout and your GTG. that what i had to do when i would put my bench shirt on.... only way i could get through the joint pain it gave me.
> 
> try it and reply back... im sure you will like the way it works for you.



but s that not getting around the problem rather then trying to fix it


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## NVRBDR (Aug 8, 2012)

Usealittle said:


> all you need is DMSO oil and uncoated aspirin with a mortar and pestle. crush up 2-3 325mg aspirin add in 1cc oil and mix, add to points of pain about 30-45 min before workout and your GTG. that what i had to do when i would put my bench shirt on.... only way i could get through the joint pain it gave me.
> 
> try it and reply back... im sure you will like the way it works for you.



and do what with it?


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## Usealittle (Aug 9, 2012)

dream said:


> but s that not getting around the problem rather then trying to fix it



you can use it anytime to help keep inflammation down... i used it for about 2months every 3days and now i dont have the problems anymore.... so it does help FIX the problem.



Jimmyusa said:


> and do what with it?



i said "add to points of pain"... ok, ill spell it out. use 2 fingers and rub it into skin. you will know its workin when it starts to dry... about 45min after applying.


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## NVRBDR (Aug 9, 2012)

Usealittle said:


> you can use it anytime to help keep inflammation down... i used it for about 2months every 3days and now i dont have the problems anymore.... so it does help FIX the problem.
> 
> 
> 
> i said "add to points of pain"... ok, ill spell it out. use 2 fingers and rub it into skin. you will know its workin when it starts to dry... about 45min after applying.



Ok, I wasnt sure, you may have injected it...that's  interesting. 
 My kids great grandma swears by rubbing olive oil on achy body parts for relief, forehead for headaches.


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## sassy69 (Aug 9, 2012)

I experienced my first inkling of points of pain in my shoulders / front delts circa 1991 doing that seated pec deck machine.  Over the years it has had tweaky moments but I had a particularly nagging point in 2008 when I decided to go get an MRI. Anyway, long story short, I had orthroscopic surgery to clean up frayed tendons, remove some arthritis and shave down the clavicle to open a little more room to reduce inflammation where things would impinge on it. I went thru PT and was starting prep for national level shows 1 month later. Had a great result until I retweaked it lifting too heavy 1 week out (i.e. depleted) from my last show in 2010. ITs been sorta fucked since and but hasn't been bad enough to go do more MRIs, etc. (At least not yet...)

But you basically have a very common issue w/ your rotator - its a complex joint that has lots of influences on it  both in daily life (thus promoting overuse and hard to just give it a break to heal) and also it handles forces at many different angles. If anything is irritated or has an imbalance (e.g. push / pull imbalance due to your general structure or your tendencies in your lifting form), it is hard to let it recoup. Also if its been irritated once, e.g. w/ tendonitis, it is really hard to get back to normal. Even taking time off never really gets you 'back to normal'. So given that you're already compromised at that joint, you should add regular warm up to your lifting routines as part of preventative maintenance. Basically - it was already discussed how there is limited blood flow thru that area, so simple but consistent warm ups will get the blood flowing and warm up the joint so your actual training is much better and doesn't further irritate what is already jacked up.

Please see this thread w/ my post in Post #14 - I have a couple links to Joe DeFranco's shoulder warm up, I do this RELIGIOUSLY before I do any upper body, It is very simple and is not intended to be so heavy or so many reps that its actually a workout in itself - just exercising all the angles to warm up everything before you go into your work out.

http://www.ironmagazineforums.com/training/156466-i-keep-injuring-myself.html

In terms of supps, etc. YES use ice. It will make a huge difference in your comfort levels while you're healing. I also believe if it hurts after training and then you decide you'd rather not work it for a nother week or two, the start / stop approach hinders your recovery. My opinion anyway - instead of beating on it, making it hurt more, stopping, starting up again, just slow and consistent w/ icing will get you to a stronger end result. 

Additionally:

Tumeric & Bromelain - great anti-inflammatories
Cissus - I've been using it - not sure if it does anything but trying it.
I've been using glucosamine/ chondroitin for years - not really sure that combo does much, but MSM with it has made a difference over time.

Nothing is going to "fix" it right away, So much of healing a rotator is just slow and consistent work w/ sufficient warm up & recovery.


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## dream (Aug 14, 2012)

sassy69 said:


> I experienced my first inkling of points of pain in my shoulders / front delts circa 1991 doing that seated pec deck machine.  Over the years it has had tweaky moments but I had a particularly nagging point in 2008 when I decided to go get an MRI. Anyway, long story short, I had orthroscopic surgery to clean up frayed tendons, remove some arthritis and shave down the clavicle to open a little more room to reduce inflammation where things would impinge on it. I went thru PT and was starting prep for national level shows 1 month later. Had a great result until I retweaked it lifting too heavy 1 week out (i.e. depleted) from my last show in 2010. ITs been sorta fucked since and but hasn't been bad enough to go do more MRIs, etc. (At least not yet...)
> 
> But you basically have a very common issue w/ your rotator - its a complex joint that has lots of influences on it  both in daily life (thus promoting overuse and hard to just give it a break to heal) and also it handles forces at many different angles. If anything is irritated or has an imbalance (e.g. push / pull imbalance due to your general structure or your tendencies in your lifting form), it is hard to let it recoup. Also if its been irritated once, e.g. w/ tendonitis, it is really hard to get back to normal. Even taking time off never really gets you 'back to normal'. So given that you're already compromised at that joint, you should add regular warm up to your lifting routines as part of preventative maintenance. Basically - it was already discussed how there is limited blood flow thru that area, so simple but consistent warm ups will get the blood flowing and warm up the joint so your actual training is much better and doesn't further irritate what is already jacked up.
> 
> ...



What about general rep ranges, what should I be doing? I am actually finding chinups at the top of the movement seem to aggravate the shoulder area or bicep tendon which makes sense since they are recruited highly at the top, should I stop that exercise for a few weeks?  I have read and heard inflammation is good in the sense that it is part of the healing process, I can carry on training as it is just an irritation not pain but I wonder what it could develop into, longevity is important to me.


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## Usealittle (Aug 14, 2012)

Jimmyusa said:


> Ok, I wasnt sure, you may have injected it...that's  interesting.
> My kids great grandma swears by rubbing olive oil on achy body parts for relief, forehead for headaches.



i workout with the joe de'marco of the OG westside barbell and hes 82 still benches 255 and uses garlic oil... he says 2-3 drops in the mouth and all his pains are gone. he also uses DSMO oil without asprin on sites.


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## bjg (Aug 14, 2012)

dream said:


> What about general rep ranges, what should I be doing? I am actually finding chinups at the top of the movement seem to aggravate the shoulder area or bicep tendon which makes sense since they are recruited highly at the top, should I stop that exercise for a few weeks?  I have read and heard inflammation is good in the sense that it is part of the healing process, I can carry on training as it is just an irritation not pain but I wonder what it could develop into, longevity is important to me.


stop working out upper body for a week then restart working out but:
1- do not go heavy 
2- do not jerk the weight or do sudden contractions
3- keep movement controlled and slow
4- avoid rotational uncontrolled movements
5- avoid any exercise that hurts including chin ups since you tend to use sudden contractions while doing chin ups
6- use light weight and about 10-15 reps even if you can do more.

after 3-4 weeks like that you can increase the level of your workout and the range of motions gradually.
trust me you will not lose anything during this recovery time, think of it as a maintenance period.
you may even gain from it.


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## dream (Aug 15, 2012)

bjg said:


> stop working out upper body for a week then restart working out but:
> 1- do not go heavy
> 2- do not jerk the weight or do sudden contractions
> 3- keep movement controlled and slow
> ...



Thanks bro good advice will be cutting now actually but sticking to the 10 rep range will be fine for me, done Military press the other day and that did not aggravate my shoulder but chin ups did, recruiting the long head of the biceps at the top I believe.


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