Tendinosis - anyone had experience of this?

[Alan]

I've been having shoulder pain and reduced mobility in my left shoulder and it started just before we went on vacation in March to Europe and steadily got worse while we were away. I thought that 6 months of not exercising it with tennis, yoga, and the like would improve the situation but it got worse, to the point that I couldn't even bear sleeping on my left side.

On return last month I went to see the doc who thought, like me, it was tendonitis and I tried NSAID's and steroids before being referred to an orthopedic specialist.

After X-Rays showed bone spurs he sent me for an MRI and I got the results today. It shows bone spurs and lots of tendonosis, which is different from tendonitis, plus a labaral tear (see below).

Tendinosis vs Tendinitis

The suffix "itis" means inflammation; the term tendinitis should be reserved for tendon injuries that involve acute injuries accompanied by inflammation. The suffix "osis" implies a pathology of chronic degeneration without inflammation, so doctors prefer the term tendinosis for chronic tendon injuries of failed healing. Tendinosis is an accumulation over time of microscopic injuries that don't heal properly. Although inflammation can be involved in the initial stages of the injury, it is the inability of the tendon to heal that perpetuates the pain and disability.



The MRI also shows a labaral tear. (I play tennis most weeks with my left hand even though I am right handed. Good for the brain, but maybe a bad technique serving has not been good for the labrum)


I have an appointment next week with the Doc to discuss treatment options, but it doesn't look like it is going to be as simple as 10 years ago when I had surgery for bone ridges that were causing tendonitis.

Anyone else had tendinosis, and if so, what treatment helped?

 

[REWahoo]

Bummer. Hope your doc can help you find some relief.

 

[Alan]

Bummer. Hope your doc can help you find some relief.

Thanks, it's a bit of a downer because I was really expecting it to be tendonitis that would be easily fixable by surgery. In 2003 I had surgery and the shoulder felt wonderful within a couple of weeks. Same for the right shoulder a few months after that in 2004. Once the x-rays last week showed new bone spurs in a different location I was really pleased.

As Bette Midler said, "Growing old is not for sissies"

 

[citrine]

Sorry to hear that Alan....Aqua Exercise, Massage (Neuromuscular Therapy), and lots of light stretching will help. The tears will heal up on their own, but the worst thing you can do is baby the shoulder. If there is a chair yoga class near you, take that as well.

 

[Alan]

Sorry to hear that Alan....Aqua Exercise, Massage (Neuromuscular Therapy), and lots of light stretching will help. The tears will heal up on their own, but the worst thing you can do is baby the shoulder. If there is a chair yoga class near you, take that as well.

Good advice, thanks. I've been doing a ballet style workout class twice a week which is 90% lower body and has lots of stretching. The upper body stuff is very light with no weight bearing. Once a week I go to an aqua exercise class in the evening with my son for similar reasons.

 

[haha]

Alan, I know nothing about this condition, but I wish you the best of luck in dealing with it. Not only are you missing doing your accustomed activities at the intensity you are used to, but it can even begin to somewhat affect your self image.

Ha

 

[Alan]

Alan, I know nothing about this condition, but I wish you the best of luck in dealing with it. Not only are you missing doing your accustomed activities at the intensity you are used to, but it can even begin to somewhat affect your self image.

Ha

Thanks mate, I'm sure my issues are trifling compared to what you are going through with your hip.

 

[RE2Boys]

Was diagnosed with tendinosis of my Achilles tendon in June 2012 with inflammation. Tried physical therapy for a couple of months which consisted of stretching and calf strengthening exercises. Quit the therapy sessions and did the exercises on my own. Needless to say, stopped all running and could just walk and bicycle (stationary and road). The biggest help was wearing custom orthotics to relieve the strain on the tendon........and lots of time. In May 2013 was able to finally walk and hike with little discomfort and found I no longer needed the orthotics. Still not 100% but can do easy jogging with no hills. It's been a 15 month recovery and unfortunately I was very disappointed to find the doctor's can do very little. A friend tore his Achilles last November, had surgery, and is only now at 80% or so back to his activities. The Achilles has very poor blood supply so takes forever to heal.

Hope you have better treatment options

 

[Alan]

Was diagnosed with tendinosis of my Achilles tendon in June 2012 with inflammation. Tried physical therapy for a couple of months which consisted of stretching and calf strengthening exercises. Quit the therapy sessions and did the exercises on my own. Needless to say, stopped all running and could just walk and bicycle (stationary and road). The biggest help was wearing custom orthotics to relieve the strain on the tendon........and lots of time. In May 2013 was able to finally walk and hike with little discomfort and found I no longer needed the orthotics. Still not 100% but can do easy jogging with no hills. It's been a 15 month recovery and unfortunately I was very disappointed to find the doctor's can do very little. A friend tore his Achilles last November, had surgery, and is only now at 80% or so back to his activities. The Achilles has very poor blood supply so takes forever to heal. Hope you have better treatment options

That sounds almost exactly the process I went through 2 years ago with inflammation of the plantar faciia. No sooner do I seem to get one bit of the rusting bodywork patched up that another bit falls apart.

 

[Animorph]

I have chronic tendinosis in my bowling fingers and thumb. Started with just the middle finger. The doc then put it in a splint for something like 8 weeks. That was OK, but if I bowl it's back again. Now it's both fingers and the thumb. It's been a few months of "resting" it, without success yet.

Look it up on Google. There are a lot of competing solutions, but nothing that seems much better than resting it.

 

[Alan]

I have chronic tendinosis in my bowling fingers and thumb. Started with just the middle finger. The doc then put it in a splint for something like 8 weeks. That was OK, but if I bowl it's back again. Now it's both fingers and the thumb. It's been a few months of "resting" it, without success yet.

Look it up on Google. There are a lot of competing solutions, but nothing that seems much better than resting it.

Yes, I've seen that rest is the best treatment but I have been resting the shoulder for 6 months now, with none of the exercises that hurt. The problem is that day to day activities such as pulling on a shirt or coat hurts, and when I sleep I will often roll onto my left side during the night and wake up in lots of pain.

Best of luck with your fingers.

 

[W2R]

So sorry to read about your tendinosis, Alan. I have never had it and I have no words of wisdom on the topic. I just hope you recover as quickly as is reasonably possible.

As Bette Midler said, "Growing old is not for sissies"

That's for sure. But you are just a youngster. Just wait!

 

[Zantastic]

I've been struggling with posterior tibial tendinosis in my left foot for over two years. Cortisone shots and a walking boot were no help at all. Physical therapy, mostly consisting of stretching, helped some but I still have significant pain when walking. I just started to see a new podiatrist but I'm not all that hopeful.

Sorry I can't give you more encouraging news.

The best of luck to you.

 

[Rich_by_the_Bay]

Yes, I've seen that rest is the best treatment but I have been resting the shoulder for 6 months now, with none of the exercises that hurt. The problem is that day to day activities such as pulling on a shirt or coat hurts, and when I sleep I will often roll onto my left side during the night and wake up in lots of pain.

Best of luck with your fingers.

Alan, "-osis" is a very general suffix, uncommonly used in American medical jargon, of little specificity. My guess is that the tests and exam will show arthritic changes and calcification. IF your doc agrees, I'd be con$servative and try physical therapy, maybe a tich of ultrasound, range of motion exercises, etc.

Best wishes for a brief course.

 

[timeasterday]

Maybe try a doctor that does active release therapy. I've had a couple of chronic running injuries this year and never had much relief until I started seeing a chiro who does ART. She quickly found weaknesses and muscle imbalances that are the most likely causes of my pain.

 

[donheff]

Good luck Alan. I have a lot of empathy for you. I have a chronic tendency for my left shoulder to get painful if I stress it -- especially with over the head lifting exercises (which I now avoid). I attributed it to bursitis since my father used to complain about his, but who knows? When it flairs up it is a PITA. I worry that it will get really bad when I get older.

 

[chemist]

Was diagnosed with tendinosis of my Achilles tendon in June 2012 with inflammation. Tried physical therapy for a couple of months which consisted of stretching and calf strengthening exercises. Quit the therapy sessions and did the exercises on my own. Needless to say, stopped all running and could just walk and bicycle (stationary and road). The biggest help was wearing custom orthotics to relieve the strain on the tendon........and lots of time. In May 2013 was able to finally walk and hike with little discomfort and found I no longer needed the orthotics. Still not 100% but can do easy jogging with no hills. It's been a 15 month recovery and unfortunately I was very disappointed to find the doctor's can do very little. A friend tore his Achilles last November, had surgery, and is only now at 80% or so back to his activities. The Achilles has very poor blood supply so takes forever to heal.

Hope you have better treatment options

I have also suffered from tendinosis of the AT and it has really hampered my running. I did have some good results with shock wave therapy but once I started running again had more issues. Think I need to lose some weight and avoid running up hills. Problem is, with no running it is hard to control weight.

Shock wave therapy works well for AT and Plantar fascia but I am guessing the shoulder tendon is not so accessible?

 

[Bestwifeever]

.... After X-Rays showed bone spurs he sent me for an MRI and I got the results today. It shows bone spurs and lots of tendonosis, which is different from tendonitis, plus a labaral tear.... I have an appointment next week with the Doc to discuss treatment options, but it doesn't look like it is going to be as simple as 10 years ago when I had surgery for bone ridges....

I wonder if the same bone spur surgery and perhaps repairing the tear will help calm the tendonosis. I would think that would relieve the pain at any rate, as it helped you before. What about a second opinion after you meet with your doc next week, as you have the X-rays and MRI results already? So sorry you are in such pain and limited activity; it does seem your six months of resting your shoulder would have already accomplished any benefit from resting.

 

[Alan]

Thanks for all the support and advice folks. I see the specialist in a few days time to review treatment options so it was great to get some insight from you guys ahead of the meeting.

 

[Lsbcal]

Yes, I've seen that rest is the best treatment but I have been resting the shoulder for 6 months now, with none of the exercises that hurt. The problem is that day to day activities such as pulling on a shirt or coat hurts, and when I sleep I will often roll onto my left side during the night and wake up in lots of pain.
...

To me this seems key. I know it is very hard to give the injury full rest. You might want to ask the Doc if the issue is as simple as trying to find ways to avoid even this level of "re-injury".

Maybe doing something like putting a rolled up towel on your sore side could help in avoiding sleeping on it? I've tried this but it didn't help me a lot however my problem was probably different. Also you might want to check your pillow out (proper head position) and maybe even the bed. I've been helped in this regard but it takes trials and patience.

Just some thoughts. Hope you find a cure. Good luck!

 

[Alan]

To me this seems key. I know it is very hard to give the injury full rest. You might want to ask the Doc if the issue is as simple as trying to find ways to avoid even this level of "re-injury".

Maybe doing something like putting a rolled up towel on your sore side could help in avoiding sleeping on it? I've tried this but it didn't help me a lot however my problem was probably different. Also you might want to check your pillow out (proper head position) and maybe even the bed. I've been helped in this regard but it takes trials and patience.

Just some thoughts. Hope you find a cure. Good luck!

Thanks for the advice. One big advantage of getting home after months of sleeping on a whole variety of beds is that I love my tempurpedic mattress and pillow.

The rolled up towel is a good idea to try and stop the automatic rollover onto the left during the night. I'll give it a try.

Now that I know the injury is not simply tendonitis I will make extra effort to not raise the arm too high. I played tennis today, right handed, and it took a little getting used to throwing the ball in the air to serve just using a forearm/elbow movement but there was zero pain and I still had my most favorite workout

 

[Alan]

Update

After 10 days of physical therapy I can report that I am almost completely cured. (Only 3 actual sessions, plus doing the prescribed stretches twice every day).

The key was knowing that the incredibly painful prescribed stretches were the correct thing to do. Without a physio telling me that the pain was good, I would have thought I was doing more damage.

So pleased to have got better so quickly after so many months of pain, and not to need surgery.

No problems in giving up throwing actions, including tennis with that arm, to avoid aggravating the labral tear.

 

[REWahoo]

After 10 days of physical therapy I can report that I am almost completely cured.

That's really great news.

 

[W2R]

After 10 days of physical therapy I can report that I am almost completely cured. (Only 3 actual sessions, plus doing the prescribed stretches twice every day).

The key was knowing that the incredibly painful prescribed stretches were the correct thing to do. Without a physio telling me that the pain was good, I would have thought I was doing more damage.

So pleased to have got better so quickly after so many months of pain, and not to need surgery.

No problems in giving up throwing actions, including tennis with that arm, to avoid aggravating the labral tear.

Woo-hoo!!! So glad to hear this! Apparently you have many wonderful tennis games ahead of you.

 

[Bestwifeever]

If I get tendinosis will I be able to play tennis too?

Amazing that the treatment is so simple yet so effective. And painful, but over soon.