View Full Version : Tendinosis Advice

10-03-2006, 07:27 PM
Hello all

A few months ago I self-diagnosed myself with biceps tendinosis. I've been trying to find out as much as I can about the problem because, as anyone who has or has had tendinosis knows, it's an absolute pain in the ass! - it just won't heal!

Although it seems to be a very common problem I could find surprisingly few constructive threads about it here on BB.com - and only one article of note. I've posted here about my own problem, asking for advice myself a few months back, and I didn't get much response, so this time I thought I'd share a couple of good information resources that I found and see if any one has anything to add. If anything I write seems mistaken to anyone who also has experience of this trouble, please correct me - I'm hoping that we can share information and experiences here that might help tendonosis sufferers get over the injury.

First of all, on this site there is a pretty good article by Dr David Ryan:


In addition I found the following site very helpful with a lot of good easy-to-understand explanations about the injury, and tons of great links to further resources:


OK so now I'll describe my own experiences and things I've tried, and throw up a few questions that maybe someone out there can help with.

First of all the reason I wrote that I was "self-diagnosed" is because I have not consulted a doctor about my problem, and the reason for that is that I'm certain that any doctor here (I live in Japan) that could really be of any help to me is would just be too expensive for me. So I'm on my own.

The problem started about 6 months ago and seems to me (in retrospect) to be a classic case - I had just started training recently and my strength made very rapid initial increases (so-called newbie gains). The weight I was using for arm exercises increased by about one-third during that 6 month period.

I had no idea at the time, but this kind of rapid increase is a classic cause of tendon trouble because the dense tendon tissue develops at a far slower rate than that of the muscles. This leads to the situation whereby although your muscles can handle the increasing weight, the tendons can't keep up, and they get damaged.

I began to experience a persistent pain in the crook of my elbow (inner arm), and deep in my biceps. Unfortunately I was very slow to realize that this pain was not regular muscle fatigue pain (it was a gradually encroaching pain, unlike most other injuries I had experienced). So I foolishly trained over it and compounded the problem.

As I said, in my case the pain is on the inner crook of my elbow, and along the biceps, much like what the writer of this thread (that no-one replied to!) is experiencing:


I think I went overboard with heavy curls - especially preacher curls, and that's what really messed me up.

Anyway, after training over it (like an idiot) for a couple of months, it finally got so bad that I had to quit doing pulling and curling exercises altogether. I laid off those exercises for MONTHS, but my biceps just didn't get any better.

I've tried supplements - I megadosed glucosamine/chondroitin and Cissus for a few months (plus flax oil and glucosamine as well as the usual muli-vit and protein) - to no avail. These didn't help at all, and further reading has indicated that that is to be expected.

What I'm trying now is frequent exercising with very light weights (currently curling 4-5kg (don't laugh - it's not funny!)) in the hope that I can gradually build back up to my previous weights. This is more or less what Dr. Ryan advocates in his article. From what I've read rehabilitative exercise seems to be crucial - rather than pure rest.

I've also been trying some ice applications. Now, Dr Ryan, in his article says that ice is no good for tendinosis, but some other sources say otherwise. I'm finding that it SEEMS to help, but not so much that I can be 100% sure. I apply ice once or twice a day for about 15~30 minutes.

My condition is still pretty bad after about 6 months. Just recently I feel like it's shown some VERY slight signs of improvement with the light weight exercise and icing that I'm doing. It's too early to tell yet, but here's hoping.

OK, I hope some people have taken the time to read this and that maybe something I've mentioned is of help to someone, and that someone may have something to contribute.

I do have a few concrete questions - if anyone can offer any advice on these, it would be gratefully received:

1. On the tendinosis.org site, where they're talking about rehabilitative exercises they say "Studies have shown that loading a tendon parallel to its length helps the collagen fibers grow with better parallel alignment and speeds the healing process." - anyone got any idea what that means? I don't understand it.

2. In the same section they talk about "eccentric strengthening," this concept comes up quite a bit in articles on treating tendinosis. They describe it like this: "Some studies have shown that eccentric exercise is especially helpful for tendinosis. Eccentric exercise is when a muscle is forced to lengthen while it contracts because it is being used as a brake or to absorb energy while doing "negative work." I'm not sure I understand this. Does this mean, for example, that in my case where the bicep is sore, that doing triceps extensions and chest-press type exercises could be beneficial?

3. In Dr Ryan's article, he says that "60% pain" is acceptable when doing rehabilitative exercises. He also says that tendinosis "usually feels better after proper training." In my experience, my biceps are ussually pretty sore the day after I do my light rehab training. It does get better after a day or two though. I wonder if this is OK? Or if I'm doing them more harm than good. Any insight on this would be appreciated.

4. Application of "heat" is often said to be beneficial for tendinosis. I've never tried it, but I'm wondering, how exactly does one "apply heat" to an area? Ice I can understand - you strap on some ice! But heat? Any good suggestions?

5. Also, regarding the application of ice (I should probably just do a search for this...) how often and for how long at a timedo you think it ought to be applied?

6. Now, this may well be ridiculous, so I apologise in advance. Many articles on tendinosis suggest that electric stimulation therapy may be beneficial. Now I guess this is something that really ought to be administered by a trained professional, but as I said, I do not have that luxury. I do, however, have in my possession one of those stupid ab-zapper things that you see on infomercials and the like. What do you reckon? Is it worth a try?! Anyone?

OK that's about it then. I know this was a really long post, but I think that it might be relevant to quite a lot of people. Tendinosis seems to be a very common, but very misunderstood blight amongst people who train with weights. And like I said it is a very nasty and persistent injury - very hard to get rid of. So if any fellow sufferers are reading this, let try to help each other out. Any contribution at all, even on a very small point, would be most welcome.

Okay, I'm done.

10-03-2006, 09:51 PM
1 & 2: Eccentrics are just lengthening exercises. For example, instead of doing a bicep curl, you start with the weight curled and lower the weight slowly until your arm is straight.

I don't see how they would think this is good.... heavy weight with this will DESTROY your tendons especially if you have tendonitis. I hope they mean this with a light weight.

3: Biceps soreness is not related to the tendon at all. Don't worry about it. If you're getting it doing rehab exercises then you're obviously doing really high volumes of work, or putting too much stress on your biceps which is causing the tendonitis in the first place. I hope it is the former for you.

4: Heat is beneficial to increase blood flow to the area to speed up healing.

5: After any activity ice should be applied for about 10 minutes to keep any swelling and pain down.

6: Don't do it. That stuff isn't really effective at all. You're better off with sufficient rest, ice and glucosamine/chondroitin which you are doing.

10-04-2006, 05:46 PM
Thanks for the reply braindx. I think I agree with you re: the eccentrics thing (now that I know what it means). I'm certain that the sources that recommend this type of exercise are talking about doing it with an appropriate weight (i.e. light), but I don't really understand how doing exercises this way would be any easier on the tendon than regular curls or whatever - maybe I'm missing something.

Thanks for the advice re. icing etc. - I thought that ice would have to be applied for far longer than 10 minutes. About heat though - one thing I'm really wondering is what is good way to apply heat to an injury? hold it up to a radiator? or what?!

One thing I should perhaps have made clear in my original post is is that I am not talking about tendonitis here, but tendinosis. This is an important distinction. These are two distincly different injuries, and need to be dealt with in very different ways. The fact that tendinosis is very commonly mistaken for tendonitis is one of the problems in getting it properly treated. The articles that I linked to in my original post explain the difference.

Given the location (inner bicep tendon/deep within the bicep) and the nature (very long term, no real improvement from complete rest), I'm pretty sure it's tendonitits. Any further informed advice on this will be appreciated though.

10-04-2006, 08:04 PM
Merck's "RICE" section on injury says alternate about 10 minutes on and off for a while. Another article from USC university hospital says 15-20 min. Honestly, you just need to do it long enough until your body sufficiently cools down so it won't start pumping blood to the area and swelling after you take off the ice.


Heat packs are the best for applying heat to an injured area. NEVER after exercise. Only when you are resting.

Whoops, sorry about the tendonitis/tendonosis mistake. Prolotherapy is supposed to be good for tendonosis. Here's some information on the topic:


10-04-2006, 09:39 PM
if its tendonitis, you may want to take 200 or 400 mg (or as directed) of an anti-inflammatory med like ibuprofen/motrin

10-04-2006, 11:21 PM
if its tendonitis, you may want to take 200 or 400 mg (or as directed) of an anti-inflammatory med like ibuprofen/motrin
If it is tendonOSIS like he said, anti-inflammitory medicines will decrease blood flow to the connective tissue which will make it heal more slowly.

Don't worry though, I made the same mistake and didn't pass reading comprehension. :)

10-05-2006, 12:00 AM
Thanks for the links braindx - I've never heard of prolotherapy before. I doubt there's anywhere in my locale that I could receive such treatment anyway, but it was interestinf to read about it nonetheless.

And yes, it's tendINOSIS - although as I said before, this is a very common confusion. I wish I could go back and edit my original post to put in a note at the begining that I'm not talking about tendonitis, but I don't seem to be able to edit it. Oh well..

Thanks for the reply anyway rob, but as braindx said those kind of medications are generally held to be detrimental to tendinosis healing (although it seems they are often prescribed to tendinosis sufferers by incompetent doctors - so no, don't worry, because even trained professionals seem make exactly the same mistake!).

10-05-2006, 01:00 AM
Actually braindx, some things you said in your posts just threw something into sharp relief for me:

about icing:
"you just need to do it long enough until your body sufficiently cools down so it won't start pumping blood to the area and swelling after you take off the ice."

...and then...

"If it is tendonOSIS like he said, anti-inflammitory medicines will decrease blood flow to the connective tissue which will make it heal more slowly."

...Which is why, I suppose, icing is generally not advised for tendinosis. Hmm... I felt like it was helping me, but maybe I really shouldn't use ice.

10-05-2006, 04:08 AM
No, ice is good after exercise. It prevents swelling after any use. Swelling HINDERS blood flow to the affected area for long extended periods of time.

Heat on the affected areas will speed up bloow flow the area which is good, but not right after exercise as that will speed up swelling.

10-05-2006, 05:48 AM
Stick: you have come on here with an extremely well written and well thought out post, with numerous references...excellent!

however, I must quote this one part of it:

First of all the reason I wrote that I was "self-diagnosed" is because I have not consulted a doctor about my problem, and the reason for that is that I'm certain that any doctor here (I live in Japan) that could really be of any help to me is would just be too expensive for me. So I'm on my own.

and just say, that I think that is sad, really.....

10-05-2006, 06:10 AM
Tell me about it! Nobody thinks it's sadder than me! (not least because I wrote "is would"...). But it's true, and actually it was true when I lived in the UK too. I've always found that regular doctors are pretty useless when it comes to soft tissue injuries and suchlike. Once when I went to a doctor in the UK with a very severe muscle injury in my shoulder (which I never ever found out what it was), he told me "If only it was broken, then I could fix it, but with muscles and stuff there's not much I can do." After several experiences like that I just gave up consulting general practitioners about such injuries.

I can't afford to go to special sports doctor or a physical therapist, so I have figure things out for myself. Surely I can't be the only pauper in that predicament?!?

Edit: By the way, thanks for the clarification on that braidx - I think I'll probably persist with the ice for a while, because it does seem to be helping. By the by the way, are you a real biochemist, or a student of (given your young years) by any chance?

10-05-2006, 06:53 AM
Yeah, going to a sports doctor or physical therapist would be your best bet, if you could afford one that is. Meh. Oh well.

I'm in my final year. I've actually already finished ALL of my major courses, but I haven't done like my outside-of-my-major upper level classes yet. So I pretty much know as much as someone who graduates with a biochemistry degree knows. Well, I also know a lot about exercise, weightlifting and anatomy too, but that was self taught. :)

Justin Buchana
10-15-2008, 11:36 AM
Subscribed. I have elbow tendonosis....... but instead of trying to push through it I took a year off, just trying to let what ever the pain was heal. Just started back again trying to rehab it.

11-14-2009, 08:03 AM
Sorry to reply to an old post but i am in a similar position to you and the op and if you are still using this site i just wondered how it was going. Would be useful to know if you ever worked out how to heal it or if time did the trick. I also have self-diagnosed tendinosis and while trying to research stuff i found this thread.

I think mine is in something that connects the forearm to the bicep because i can't do any exercise that involves the bicep without pain in my forearm, this means there are almost no pull exercises i can do now. I have had it for over 10 months now and tried resting it which meant doing virtually no pull exercies during that time which means i can barely do more than a few pullups now. Also i don't really do much push stuff either now but even when i do up it i am scared i will just unbalance myself and cause further damage.
I don't think there is any point in resting it any more and unless i can find/work out some kind of way to rehab it then i guess it's there for life.

04-19-2011, 02:30 PM
Sorry for necro'ing an old thread, but I really did find the information and resources contained herein very helpful in the treatment of my bicep tendonosis. Hope you managed to get things back in to working order, Stickboy!

10-09-2013, 08:57 PM
I'd like to see if anybody (especially Stickyboy) has found a solution to their tendonosis. I've been struggling for almost a year now to find a solution to the tendonosis in my distal bicep tendon.

01-14-2014, 01:31 AM
I had an MRI on Friday and was diagnosed with Tendinosis (NOT TENDONITIS)
The injury is the tendon on the long head bicep that connects to my forearm. It's been troubling me for a few months now doing any sort of bicep curls and pullups.

After endless research on the internet i decided to go and see a physiotherapist and gladly he knew the difference between the two and gave me the right rehab for it.
Firstly he gave me 15 minutes of electrical stimulation. Then he gave me deep tissue massage followed by ultrasound which creates heat on the tendon.
From there he gave me eccentric exercises to do twice a day. What this means is negatives. If it becomes painful lighten the load.
So for the next few weeks all I am allowed to do is 3 sets of 12 reps eccentric movements twice daily meaning I use my good arm to lift the weight and use the bad arm to slowly lower the weight down to full extension doing concentration curls. As this becomes easier I increase the weight. Also keeping a heat cream around the area to keep the blood flow up to the tendon.

11-18-2014, 06:12 PM
I'd like to see if anybody (especially Stickyboy) has found a solution to their tendonosis. I've been struggling for almost a year now to find a solution to the tendonosis in my distal bicep tendon.

Hi Manchestertaylo:

I have had this for 6 months, both arms, zero positive change. I quit working out, quit lifting things at all. The only thing I do now is general household activity. I work in sales and type a lot, this could have some negative effects to my recovery, not 100% sure but I do know this is horrendous. No gym, no surfing, no activity at all or my arms flare up.

Have you made any progress?

04-30-2015, 01:52 PM
Another person with tendinosis here.

For me it's my right wrist (the ECU in particular). Been down and out for 1 month and counting :(

09-02-2016, 11:57 AM
[QUOTE=stoptendinosis;1313698111]Hi Manchestertaylo:

I have had this for 6 months, both arms, zero positive change.

I have it in my both arms too(biceps & forearms). Im 18 and i havent let it rest for a couple of years and now its gotten to the point where my arms became so weak that they get tired very easily and i can barely open a car or pattio dor, wash dishes just basicaly lifting or pulling is very difficult and doing normal things in life. I cant even lift my cat and he must weigh 10 pounds or so. Most of my strenght in my arms are slowly going away and its scary. I see nobody has the secret on how to fully heal this f*cking tendinosis thats stoping us all from doing normal daily activities and living our lives normaly. Im going to try physio therapy. I see that many people tried resting it and it hasnt done much, for me it just gets worst day by day even with rest. Please if you have the same problem like all of us and got it healed, tell us how. Feel free to reply to me if you have the same problem and how you are managing it and healing it.

I hope everybody heals from this horrible tendinosis state.

09-02-2016, 12:35 PM
Ice is good at reducing inflammation which is good for an acute injury but not so much with a chronic injury.
It is much like taking an NSaid it blunts the bodys response to heal. If you artificially reduce inflammation you reduce healing.
Heat therapy is much better for chronic problems

Train under 80% of your max for at least a full month every 4-5 months and let the tissue heal. connective tissue heals much slower than muscles and the nerves do. it can take a month or longer depending on the damage that has occurred

09-02-2016, 12:41 PM
Just in my current state as im writing this i can barely lift my arms thats how weak they have gotten. So yeah the damage is i think bery very bad. I dont know if i will ever recover. I don think that any type of treatments work but all i wanna try is physiotherapy. That that doesnt fix me or if it makes it worst than my life is going to go upside down.

09-02-2016, 04:53 PM
are you experiencing golfers elbow, at that tendon?