Tendonitis and Eccentric Movements

I know there are already a few articles on this topic, here included, but I was just wondering if anyone has had any recent success with using negatives to help w tendonitis. I have tried every supplement under the sun and nothing seems to really help.

I have what I guess would be elbow tendonitis, or triceps tendonitis. I cannot even train triceps at this point. I have read an article where for that it talked about doing negatives on one-arm cable pushdowns, but since it is in both, thought I could maybe try something like close grip push-ups to save time, although those will hurt a lot more than one-arm cable pushdowns. I also have those voodoo floss bands which I have yet to try.

I used eccentrics for forearm tendonitis (tennis elbow) last year with great success. I got the advice from a previous poster named grrrsauce and used a Flexbar from Thera-band. The science behind it seems strong.

Where did you feel the pain with the forearm tendonitis?

Well, I did 4 sets of close-grip push-ups, very slow negatives yesterday and so far my elbows are killing me more than ever. Not sure if that is normal or if I did something wrong. I weigh in the neighborhood of 280-ish, so there is a lot of weight being put on my elbow joints, maybe I should have done the one-arm cable pushdowns instead like I read about.

Eccentric loading of tissues with a tendinosis helps strengthen it, yeah, but you have to let the tissue heal too. Are you taking advil or anti-inflammatories? If it hasn’t helped so far, I would definitely start. Also, eccentric loading for tendinosis should be done with therabands or cables, not bodyweight exercises.

Anecdotally I had a triceps tendinosis starting after db pressing heavy for a while, so I made a counterforce strap with athletic tape to support it when I trained. I guess that gave it the time it needed to heal and it hasn’t bothered me since. Massaging the area can help too.

Eccentrics have really helped with my patella tendonitis and achilles tendonitis.

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paulypaul,

I have a lot of experience with using negatives to get rid of tendon pain and have helped many others with it.

Which article did you read and where?

Once I know that I can tell you if you should follow the advice or not and what exactly you should do to get pain free pretty fast.

[quote]paulypaul wrote:
Well, I did 4 sets of close-grip push-ups, very slow negatives yesterday and so far my elbows are killing me more than ever. Not sure if that is normal or if I did something wrong. I weigh in the neighborhood of 280-ish, so there is a lot of weight being put on my elbow joints, maybe I should have done the one-arm cable pushdowns instead like I read about.[/quote]

[quote]The Seeker wrote:
paulypaul,

I have a lot of experience with using negatives to get rid of tendon pain and have helped many others with it.

Which article did you read and where?

Once I know that I can tell you if you should follow the advice or not and what exactly you should do to get pain free pretty fast.

[quote]paulypaul wrote:
Well, I did 4 sets of close-grip push-ups, very slow negatives yesterday and so far my elbows are killing me more than ever. Not sure if that is normal or if I did something wrong. I weigh in the neighborhood of 280-ish, so there is a lot of weight being put on my elbow joints, maybe I should have done the one-arm cable pushdowns instead like I read about.[/quote][/quote]

Thank you for reaching out to me.

update: I had a second link on here from another source, but I guess they would not allow it because it was associated with another supplement company.

I am familiar with both articles you are talking about. The one here on T-Nation is the first time I ever heard of using eccentrics to eliminate inflammation.

The second article (which I’m sure is from the blog of a company that makes protein bars) is the best one I’ve seen that really explains the process specifically to end triceps tendonitis elbow pain.

I would recommend you use it to a “T” as it works very quickly - usually 90-100% improvement in about a week if you do it every day. I have also helped a few friends with this pretty common problem (some of whom had tried everything and two of which had the problems for years) and it worked very well for them as well.

In the past I had gotten cortisone shots and it helped immediately with the pain but left me very susceptible to re-injury.

Using the eccentric technique described in the article actually makes you more bullet-proof and protects against future injury.

It is one of the only truly “magic” fixes I have ever found in the Iron Game and it costs nothing except some time to learn and apply it.

Good luck!

[quote]paulypaul wrote:

[quote]The Seeker wrote:
paulypaul,

I have a lot of experience with using negatives to get rid of tendon pain and have helped many others with it.

Which article did you read and where?

Once I know that I can tell you if you should follow the advice or not and what exactly you should do to get pain free pretty fast.

[quote]paulypaul wrote:
Well, I did 4 sets of close-grip push-ups, very slow negatives yesterday and so far my elbows are killing me more than ever. Not sure if that is normal or if I did something wrong. I weigh in the neighborhood of 280-ish, so there is a lot of weight being put on my elbow joints, maybe I should have done the one-arm cable pushdowns instead like I read about.[/quote][/quote]

Thank you for reaching out to me.

update: I had a second link on here from another source, but I guess they would not allow it because it was associated with another supplement company.[/quote]

[quote]The Seeker wrote:
I am familiar with both articles you are talking about. The one here on T-Nation is the first time I ever heard of using eccentrics to eliminate inflammation.

The second article (which I’m sure is from the blog of a company that makes protein bars) is the best one I’ve seen that really explains the process specifically to end triceps tendonitis elbow pain.

I would recommend you use it to a “T” as it works very quickly - usually 90-100% improvement in about a week if you do it every day. I have also helped a few friends with this pretty common problem (some of whom had tried everything and two of which had the problems for years) and it worked very well for them as well.

In the past I had gotten cortisone shots and it helped immediately with the pain but left me very susceptible to re-injury.

Using the eccentric technique described in the article actually makes you more bullet-proof and protects against future injury.

It is one of the only truly “magic” fixes I have ever found in the Iron Game and it costs nothing except some time to learn and apply it.

Good luck!

[quote]paulypaul wrote:

[quote]The Seeker wrote:
paulypaul,

I have a lot of experience with using negatives to get rid of tendon pain and have helped many others with it.

Which article did you read and where?

Once I know that I can tell you if you should follow the advice or not and what exactly you should do to get pain free pretty fast.

[quote]paulypaul wrote:
Well, I did 4 sets of close-grip push-ups, very slow negatives yesterday and so far my elbows are killing me more than ever. Not sure if that is normal or if I did something wrong. I weigh in the neighborhood of 280-ish, so there is a lot of weight being put on my elbow joints, maybe I should have done the one-arm cable pushdowns instead like I read about.[/quote][/quote]

Thank you for reaching out to me.

update: I had a second link on here from another source, but I guess they would not allow it because it was associated with another supplement company.[/quote][/quote]

Thank you for the feedback. I am concerned about having used those close-grip push ups as negatives, 5 days later and my elbows are still hurting probably more than ever with no other resistance training. They hurt the most when I am in bed.

I do like what you said about this technique not costing anything, but it stinks how this is interfering with my upper body training, I have made some decent gains recently and now cannot train that good because of this problem. I don’t think there is much that can be done for the upper body without involving the elbows, unless I get one of those EMSs advertised in the old muscle mags lol.

The other poster said to not do the eccentric training until it is healed. Would you agree with that? I thought the article said to do the eccentric training in spite of the pain.

The problem you are having is caused by tricep fulcrum movements - things like skull crushers, overhead extensions and even close grip push ups. Anything that puts the triceps in a stretch position that uses the elbow as a fulcrum will cause problems for many people over time.

You’ll probably notice that you can do close grip (12-14" hand spacing as recommended by Charles Poliquin and not the super narrow grip as that becomes another fulcrum movement) and dips without pain but other movements will kill you.

I’d stop the close grip pushups, switch to the one arm cable pushdowns as the article recommends and remember one thing: AVOIDING THE SE OF THE TRICEPS WILL NOT WORK.

The whole reason the use of eccentrics is so amazing is that you are INCREASING the inflammation locally and by doing that, you will INCREASE healing. Once you are pain free, you’ll notice that your tris are MUCH more resistant to injury. Taking time off, cortisone shots, etc. will make you MORE injury prone.

The first set of 15 reps will feel like you are doing something wrong. The second set will feel pretty good and the third will make the tris feel very warmed up. If you are training tris, you’ll notice that they feel pretty good. I’d recommend only using the close grip bench, dips and higher rep pushdowns (with a straight bar not a rope) for the next two weeks.

After two weeks you should be feeling 100% or at least close. I always start my tricep training with either some form of dip or dip machine or close grip bench. That really seems to reduce problems for the people I’ve recommended it to as well.

Here’s the take home:

Laying off of a SOFT TISSUE injury doesn’t work - we’ve all tried it. INCREASING inflammation with eccentrics is the key. I have gotten rid of tricep, achilles and forearm tendonitis in myself and those and couple of other spots for people I’ve shown it to.

It’s hard for many to believe but in my years of truing it’s the only thing I’ve seen that is miraculous. I haven’t really found any other good options for getting rid of tendonitis.

[quote]paulypaul wrote:

[quote]The Seeker wrote:
I am familiar with both articles you are talking about. The one here on T-Nation is the first time I ever heard of using eccentrics to eliminate inflammation.

The second article (which I’m sure is from the blog of a company that makes protein bars) is the best one I’ve seen that really explains the process specifically to end triceps tendonitis elbow pain.

I would recommend you use it to a “T” as it works very quickly - usually 90-100% improvement in about a week if you do it every day. I have also helped a few friends with this pretty common problem (some of whom had tried everything and two of which had the problems for years) and it worked very well for them as well.

In the past I had gotten cortisone shots and it helped immediately with the pain but left me very susceptible to re-injury.

Using the eccentric technique described in the article actually makes you more bullet-proof and protects against future injury.

It is one of the only truly “magic” fixes I have ever found in the Iron Game and it costs nothing except some time to learn and apply it.

Good luck!

[quote]paulypaul wrote:

[quote]The Seeker wrote:
paulypaul,

I have a lot of experience with using negatives to get rid of tendon pain and have helped many others with it.

Which article did you read and where?

Once I know that I can tell you if you should follow the advice or not and what exactly you should do to get pain free pretty fast.

[quote]paulypaul wrote:
Well, I did 4 sets of close-grip push-ups, very slow negatives yesterday and so far my elbows are killing me more than ever. Not sure if that is normal or if I did something wrong. I weigh in the neighborhood of 280-ish, so there is a lot of weight being put on my elbow joints, maybe I should have done the one-arm cable pushdowns instead like I read about.[/quote][/quote]

Thank you for reaching out to me.

update: I had a second link on here from another source, but I guess they would not allow it because it was associated with another supplement company.[/quote][/quote]

Thank you for the feedback. I am concerned about having used those close-grip push ups as negatives, 5 days later and my elbows are still hurting probably more than ever with no other resistance training. They hurt the most when I am in bed.

I do like what you said about this technique not costing anything, but it stinks how this is interfering with my upper body training, I have made some decent gains recently and now cannot train that good because of this problem. I don’t think there is much that can be done for the upper body without involving the elbows, unless I get one of those EMSs advertised in the old muscle mags lol.

The other poster said to not do the eccentric training until it is healed. Would you agree with that? I thought the article said to do the eccentric training in spite of the pain.[/quote]

Would all this be applicable to acute as well as chronic tendonitis?

I think I’ve recently been coming down with it in the distal end of my right tricep so this thread could be relatively good timing for me.

[quote]238 wrote:
Would all this be applicable to acute as well as chronic tendonitis?

I think I’ve recently been coming down with it in the distal end of my right tricep so this thread could be relatively good timing for me.[/quote]

no its not applicable to acute tendonitis, acute injuries already have inflammation occurring, acute injuries are best handled with rest, some blood flow techniques, and activity modification

@ The Seeker, thanks a lot for your input. I had a golfer tendonitis and tried lots including rest.
I will fallow your protocol.

[quote]BHOLL wrote:
no its not applicable to acute tendonitis, acute injuries already have inflammation occurring, acute injuries are best handled with rest, some blood flow techniques, and activity modification[/quote]

Much appreciated, will work on those. Aside from ice and voodoo bands, any recommendations on blood flow?

Some great stuff here - Seeker, your post is awesome, thank you for the info. I like very much what you said about the tricep fulcrum movements, makes a lot of sense. The only thing that worries me is even the movements you mentioned, the 10" wide close grip bench and dips hurt me just as much. That could be because up until now I have been stubbornly pushing through pain. A typical tri workout is Close grip bench 10", overhead extensions, tricep pushdown with a straight bar with elbows somewhen flared and dips. The only fulcrum movement is overhead extensions, so pushing through that might have done some damage.

I even have pain when doing chest and other pushing movements. I have also noticed that I got a lot of irritation where the forearm flexor inserts into the elbow area, don’t know if that is still considered triceps tendonitis when there is pain on the foreamr side of the elbow vs. the upper arm side? Granted, it is still very close to the elbow.

Also, in reading about acute vs. chronice tendonitis, what is the difference there? I know acute means it has not been a problem for long I am assuming? I have had it for a long time, so I guess I am chronic.

This and avoid the movement that cause pain helped my triceps/elbow pain.

[quote]vdizenzo wrote:
Do high rep extensor work for your elbows. Tate presses incline or flat, rolling dbl tri extenstions, barbell ext, and jm’s. Now keep in mind these must be low intensity work. Lighter weight, relatively of course, with high sets and reps. Watch your tempo because when you get to the bottom of the exercise there will be a great stretch on the tricep right by the elbow.

Some people call that pain when it’s really just a crazy stretch. Don’t bounce weight, heave, or jerk it. Take it slow and controlled. Build up over time and your elbows will feel much better. Lastly, if you do have real pain at a point in the movement try and manipulate body positions to find different angles that may not hurt.

IMHO, pushdowns blow and are almost a waste of time. You just don’t get that stretch. I only find them useful to do light with weight or bands for a ton of reps to force blood in the area for recovery. My elbows are in great shape so I never really need to do those for recovery anyway.[/quote]

[quote]238 wrote:

[quote]BHOLL wrote:
no its not applicable to acute tendonitis, acute injuries already have inflammation occurring, acute injuries are best handled with rest, some blood flow techniques, and activity modification[/quote]

Much appreciated, will work on those. Aside from ice and voodoo bands, any recommendations on blood flow?[/quote]

don’t know what voo doo bands are, NSAIDS, ice, avoidance of exacerbating symptoms and any exercise in which you can cause severe burning and a pump in the relative area without increasing pain not limited to high rep sets, supersets, restricted blood flow training, resistance bands

[quote]paulypaul wrote:
Some great stuff here - Seeker, your post is awesome, thank you for the info. I like very much what you said about the tricep fulcrum movements, makes a lot of sense. The only thing that worries me is even the movements you mentioned, the 10" wide close grip bench and dips hurt me just as much. That could be because up until now I have been stubbornly pushing through pain. A typical tri workout is Close grip bench 10", overhead extensions, tricep pushdown with a straight bar with elbows somewhen flared and dips. The only fulcrum movement is overhead extensions, so pushing through that might have done some damage.

I even have pain when doing chest and other pushing movements. I have also noticed that I got a lot of irritation where the forearm flexor inserts into the elbow area, don’t know if that is still considered triceps tendonitis when there is pain on the foreamr side of the elbow vs. the upper arm side? Granted, it is still very close to the elbow.

Also, in reading about acute vs. chronice tendonitis, what is the difference there? I know acute means it has not been a problem for long I am assuming? I have had it for a long time, so I guess I am chronic. [/quote]

Acute stage, generally <2 months, infiltration of WBC’s present with active inflammation

Chronic> no active signs of inflammation or WBC’s, vascular hyperplasia in the tissue, poor collagen alignment in tissue, presence of substance P and cytokines

Elbow, joint, etc…
A way to avoid overuse potential problems is to use unrestricted mouvement pattern.
A standard bench or militairy press is more risky versus the similar exercise done with dumbbells.

Each time we pull, push, press using rings, attachements, device that allow free rotation at wrist, elbow, shoulder level it is a safer option versus a straight bar that impose a perfect replication at each repetition.
Chad Waterbury and many others agree on that subject and my shoulders are glad i tried it.
Years back many argued that machines had the same patern mouvement isssue but it also can happen with free weights.

Some shoulder structure prefer neutral grip.

About blood flow thera bands can be carried anywhere and used 5 times daily about a set each 2 hours to nourish the healing area(ultra light and frequent usually work better).