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Tips to treat tendonitis

Sometimes it’s hard to know if your ongoing, chronic pain is coming from your joints, muscles, ligaments, or tendons. It could be tendonitis. Learn more.

If you’ve ever trained for Physical Fitness (PFT) and Physical Readiness (PRT) tests, a long-distance race, or other exercise routines, you’ve likely experienced pain. It might be a common, chronic overuse injury known as tendonitis. The good news is there are things you can to do to help reduce your risk of tendonitis.

Tendons connect your muscles to your bones and help you move by “pulling” on the bones when your muscles contract. Damage or inflammation can occur from repetitive activities, motions, or sudden movements that put too much stress on your tendons. Knees, elbows, and wrists are all common areas of pain associated with tendonitis because they’re often used in repetitive movements.

Pay attention to your body. Warning signs can include pain, swelling, and loss of range of motion. Here are some tips to help prevent tendonitis.

  • Maintain a healthy diet and weight, and check out HPRC’s Nutrition section for helpful nutrition tips.
  • Pay attention to your posture and make sure that you use proper form, especially when lifting and moving heavy objects.
  • Maintain a well-rounded exercise routine, which includes muscular fitness, flexibility, mobility, and cardiovascular endurance.
  • Make sure to incorporate rest and cross-training days to let your body recover.

Already have tendonitis? Here are some tips to help you get back into your workout routine:

  • Alternate exercise to rest the affected area. Instead of running, try biking or swimming to rest possible patellar (knee) tendonitis. Visit HPRC’s RX3 Knee Pain section on knee exercises and other rehab resources.
  • Ice the affected area to reduce pain and swelling.
  • Ask your healthcare provider about physical therapy and anti-inflammatory medications, which also can provide some relief.

See your doctor right away if you experience fever, redness or warmth in the affected area, or pain in multiple locations.

Stop shin splints

Shin splints—sharp, sore, and/or throbbing pain that runs down the front of your shin—are common among those who exercise regularly. But how can you prevent them?

Shin splints can sideline you from your regular workouts, but there are things you can do to help relieve the pain and quickly resume your exercise routine. Shin splints—a common injury among athletes, particularly runners—refers to pain in the leg below the knee, usually on the medial (inside) part of your shin. This pain can be caused by micro-tears at the bone tissue, possibly caused by overuse or repetitive stress. The best way to prevent shin splints is: Don’t do too much, too soon.

Shin splints usually occur after sudden changes in exercise or physical activity, such as rapidly increasing your running mileage, boosting your workout frequency or intensity, or even varying changes in surface, such as running more hills. To help reduce your risk for shin splints, you can follow the 10% rule: Increase your workout no more than 10% per week. That applies to the number of miles you run and how often and how hard you work out.

Other factors that can influence your risk include worn-out shoes, over-pronation, and excessive stress on one leg from running on a cambered road (the curved, downward slope from the middle of a road to the edge for drainage). If you run an out-and-back route, while not always safest in street traffic, you can run on the same side of the road each way. Or use the sidewalk instead. If you often run on a track, switch the direction you run.

Shin splints will usually heal themselves with proper rest. Consider taking a break from your regular workout routine and cross train with lower-impact workouts such as swimming, pool running, or biking instead. Basic self-care treatments such as stretching, ice, and anti-inflammatories can help relieve pain. If the pain doesn’t improve with rest, or if the skin is hot and inflamed, see your doctor to make sure you don’t have a more serious injury such as a stress fracture or tendonitis.

Can exercise relieve chronic pain?

If you struggle with chronic pain, you might ask, “How can I exercise if I’m in pain?” or “Won’t exercise make it worse?” Read about exercising to reduce pain.

If you struggle with chronic pain, you might feel that exercise is futile: It hurts when you don't exercise and it hurts when you do. However, a properly structured exercise routine might help reduce some kinds of pain and keep other kinds from worsening.

It’s important to know the difference between chronic pain and injury-related pain. Acute pain—the body’s normal response to physical injury—usually can’t be relieved through exercise. In fact, exercise can worsen your acute pain, so it’s not recommended. But if injury has been ruled out and your pain lasts for more than 3 months, you might be able to partially manage or even reduce your chronic pain through exercise.

Still, exercise can help reduce pain in several ways. It mostly increases endorphins—the body's natural painkillers — which help block pain, enabling you to relax. Exercise also helps boost serotonin—a brain chemical partly responsible for mood and the perception of pain—reducing stress and improving mood. Pain increases stress, which then reduces serotonin. Since exercise increases serotonin, it also might bring relief from pain-induced depression.

If you’re thinking of adding exercise to your pain management plan, consider the following types: aerobic, strength, and flexibility. But make sure your exercise program is specifically tailored to your needs. Some exercises might be easier or more difficult to complete depending upon the type and location of your pain.

Visit HPRC’s Physical Fitness section for information about training, exercise, and injury prevention. And consult your healthcare provider before beginning any exercise routine and if you experience pain during or after exercise. 

Does “cupping” reduce pain?

HPRC Fitness Arena: Total Force Fitness
What is “cupping”? Is it effective at treating pain?

“Cupping” has received attention recently with discussion of Olympic athletes using the practice to relieve pain and improve performance. However, evidence for the effectiveness of cupping is mixed.

Cupping therapy is a traditional Chinese medical practice that is popular in Asia, the Middle East, and in some parts of Europe. During treatment, a cup is placed on the skin over muscles and a vacuum is created to remove the air inside the cup. The vacuum against the skin is thought to promote blood flow to the tissue underneath the cup, which might bring relief of pain and tension. Cupping typically leaves reddish to purple circles on the body where the cups were placed. The bruises can take several days to weeks to fade.

Cupping is generally considered safe but should always be performed by a qualified professional. One obvious side effect is the circular bruises. Patients also report feeling warmer during the treatment and sometimes sweat more. Cupping is not recommended if you are pregnant or menstruating, or if you have metastatic cancer or bone fracture. It shouldn’t be applied to injured skin. There’s an increase risk of complication when the duration of treatment lasts more then 20 minutes, and some patients have been burned during cupping therapy.

How effective is cupping? The jury is still out at this point. There haven’t been enough studies to say definitively how effective cupping is at reducing pain compared to other pain management techniques. More rigorous research is needed before cupping can be called an effective treatment for pain. Talk with your doctor or healthcare provider before adding cupping to your pain management plan.

Tackling chronic pain

Be empowered to do more about chronic pain with this article from HPRC and video from the Defense and Veterans Center for Integrative Pain Management.

Pain can take a toll on you physically and emotionally, but there are some steps you can take to cope with it. First, know if your pain is “acute” or “chronic.” Acute pain is temporary, often stemming from injuries that will heal completely. Chronic pain is ongoing, lasting for more than 3 months. It’s hard to know what to do about chronic pain. And it’s a big problem: At least 25% of people in the U.S. suffer from it.

If you have pain, it’s important to see a medical provider to rule out something life-threatening. However, most injuries heal physically as much as possible after 3–6 months, so residual pain has more to do with complex mind-body processes than a clear-cut physical problem. Learn more about a 5-step structured approach you can use to tackle chronic pain from the video below developed by the DoD/VA Joint Pain Education Project and the Defense and Veterans Center for Integrative Pain Management

What exactly is a “trigger point”?

What is a trigger point, and how can one be treated?

Does it ever feel like there’s a baseball in your calf? Or what about that tight spot under your should blade? This might be something called a trigger point, more commonly known as a “knot.” Even experts aren’t completely sure what they’re made of, but they seem to be caused by overuse and/or bad biomechanics (that is, bad posture).

Getting rid of these annoying knots usually involves massaging the heck out of them. If you can reach the knot, you can massage it yourself to try to loosen it up. Or you can use things like foam rollers or massage balls to help. If that still doesn’t work, you can talk to your doctor about other treatments such as ultrasound, physical therapy, dry needling, acupuncture, or injecting the knot with medicine.

Even with these treatments available, it’s important to first avoid actions that create trigger points, such as poor posture or exercising without warming up. Don’t confuse trigger points with the sore muscles which can occur after a workout (delayed onset muscle soreness). This kind of soreness is usually harder to pinpoint but will go away on its own after a couple days or less.

Also, make sure you’re exercising with proper form. Ask a certified personal trainer, if you’re not sure. Keep in mind that if your pain began with an accident or lasts after trying treatments at home, you should consult your physician or other healthcare provider. 

Got pain on your brain?

Pain is not just in your head, but your head plays a role. Holistic treatment that also addresses your mind may be your best bet in facing pain.

Pain can be unpredictable, uncontrollable, and unrelenting, so even the most resilient Warfighters can be vulnerable to it. Because of pain, you may experience symptoms of anxiety or depression; your mind may even exaggerate the intensity and awfulness of pain. Socially, you might experience criticism, rejection, and negative interactions with family, spouse, or peers. Even if interactions are generally positive, you may want to withdraw from people or difficult situations

Chronic pain, which lasts longer than three months and is unresponsive to treatment, can affect quality of life for many. At least 100 million adults in the U.S. suffer from chronic pain. Unfortunately, combat and other situations make Warfighters especially susceptible to experiencing injury and pain. One study of an infantry brigade found that three months after return from Afghanistan, 44% of the soldiers reported chronic pain.

The American Psychological Association has shared evidence that relief from pain is more likely when mind and body are both treated. The National Center for Complimentary and Alternative Medicine has also indicated that continued study of non-drug approaches to pain management is a priority.

The latest trend in treating pain is the “biopsychosocial model,” which focuses on exercise and sleep (not just meds and surgery) as important biological influences. Important psychological factors include thoughts, emotions, behaviors, and attention. And impactful social factors involve healthcare, family, and work. All of these factors can contribute to understanding and mitigating the impacts of pain.

The American Psychological Association shares concrete advice to manage pain, including these tips:

  • Distract yourself.
  • Stay active and exercise.
  • Know your limits.
  • Follow prescriptions carefully.
  • Make social connections.
  • Don’t lose hope.

Also be sure to check out HPRC’s mind-body techniques and resources for managing pain.

Got pain on your brain?

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
Pain is not just in your head, but your head plays a role. Holistic treatment that also addresses your mind may be your best bet in facing pain.

Pain can be unpredictable, uncontrollable, and unrelenting, so even the most resilient Warfighters can be vulnerable to it. Because of pain, you may experience symptoms of anxiety or depression; your mind may even exaggerate the intensity and awfulness of pain. Socially, you might experience criticism, rejection, and negative interactions with family, spouse, or peers. Even if interactions are generally positive, you may want to withdraw from people or difficult situations

Chronic pain, which lasts longer than three months and is unresponsive to treatment, can affect quality of life for many. At least 100 million adults in the U.S. suffer from chronic pain. Unfortunately, combat and other situations make Warfighters especially susceptible to experiencing injury and pain. One study of an infantry brigade found that three months after return from Afghanistan, 44% of the soldiers reported chronic pain.

The American Psychological Association has shared evidence that relief from pain is more likely when mind and body are both treated. The National Center for Complimentary and Alternative Medicine has also indicated that continued study of non-drug approaches to pain management is a priority.

The latest trend in treating pain is the “biopsychosocial model,” which focuses on exercise and sleep (not just meds and surgery) as important biological influences. Important psychological factors include thoughts, emotions, behaviors, and attention. And impactful social factors involve healthcare, family, and work. All of these factors can contribute to understanding and mitigating the impacts of pain.

The American Psychological Association shares concrete advice to manage pain, including these tips:

  • Distract yourself.
  • Stay active and exercise.
  • Know your limits.
  • Follow prescriptions carefully.
  • Make social connections.
  • Don’t lose hope.

Also be sure to check out HPRC’s mind-body techniques and resources for managing pain.

Relief for your aching back?

Epidural steroid injections can provide short-term relief for back and neck pain.

HPRC continues its series on Pain Management with an article on epidural steroid injections (ESIs), which involve injections of pain medication around the spinal nerve roots. They are done by qualified healthcare providers for short-term relief of back and neck pain. They also can help doctors diagnose some types of pain. Learn more in HPRC’s “Epidural Steroid Injections for Pain."

A mesmerizing strategy for pain

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
Hypnosis is a strategy that can be used for pain management.

Hypnosis is a trance-like state produced from a heightened sense of focus and concentration. Like other mind-body strategies, hypnosis can sometimes provide temporary pain relief for many pain conditions. Learn more about what hypnosis is, the research on what pain conditions it can help, things to be aware of, and its relevance to the military in HPRC’s “Hypnosis for Pain.”

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