Tendonitis

[Catrin]

I've tendinitis in my shoulder/arm from my pec minor/calcific shoulder problem, which isn't a surprise. What IS a surprise in this current flare (which is calming) is that most of the pain is at night when I am sleeping. Change that, TRYING to sleep. I am not sleeping on that arm, and the pain is quite diffuse. I understand that tendinitis does that - and am considering perhaps going to bed with some warmth on that shoulder/arm. Has anyone tried that/had good effect with it?

I wonder if the night pain is from a lack of movement and lower circulation from that, which has me wondering if warmth might help by increasing circulation to the area.

My dr. has offered injections, but I am resistant to the idea. I want to use such methods as sparingly as possible. This episode seems to be calming, and my gym work seems to help calm it down. My coach is currently having me do different things in group training than the others, and so far no pain during/afterwards. Until bed time that is, and it is worse after a rest day.

Any other tips?

[Owlie]

Do you get to sleep and the pain wakes you up, or is it just more intense at night and prevents you from getting to sleep?

All sorts of pain-y things, I think, get worse at night, and I think some of that is because you don't have other stuff to distract you. I'm sure there's a physiological reason as well.

My mom has tendinitis in her elbow and neck, and she puts a heating pad on the one on her neck (the elbow one isn't quite so bad) before bed, but doesn't actually sleep with it on.

[Catrin]

There is no pain during the day, at night it wakes me up or prevents me from getting there. I've read that shoulder related tendinitis/osis does this. At one point last night I got up and put a small foot warmer (little pillow with seed corn) in the microwave but for not as long as I do to warm my bed :) I don't know that it actually helped but it felt good. Within 5 minutes of rising and moving around the pain is pretty much gone for the day! I don't think I got 1 uninterrupted hour of sleep last night :( What pain there IS during the day is very minor, not so bad I can't move my arm.

I've GOT to solve this, and I think this has probably been the cause of my recent problems on the bike. I wonder if how many treatments acupuncture would take... My upcoming move in September really restricts extra expenditures.

[OakLeaf]

Lately I've been having trouble with some of the attachments on my proximal humerus too - not 100% sure which muscle it is - and I've gotten a lot of relief from kinesio taping across my chest.

I cut a strip in half, on me five blocks long (you're about my same size but you'll want to measure yourself the first time). I put my shoulder in full external rotation ... hitchhiker thumb, wrist supinated hard, elbow bent open, maybe 100-120°, and not too close to my ribs, then bring my thumb as far back as I can to pull the shoulder back. Then I tape across the upper chest under the clavicles. Anchor below the SC joint just on the opposite side of the sternum - so the anchors will cross each other when you're done - and tape with zero stretch on the tape all the way to the upper arm. I don't quite parallel the clavicles, but that might depend on how they sit on you - but at least you want to make sure you keep the tape over the muscle and don't tape on top of the clavicle. Just keep the tape as straight as I can all the way to the other end somewhere over the anterior or medial delt.

I was surprised how much relief this is giving me now, because over the winter, when my symptoms were mostly more central and my DOM showed me how to tape this way, it only seemed to help a little.

I do spend a few seconds arranging myself before I go to sleep. Chin tucked "just so" - I actually pick my head up in my hands so I can relax my neck while I place my head - a rolled hand towel under my neck to support the curve - a U-pillow with its legs on either side of my head to keep my head from rolling side to side when I sleep - and the last thing I do is externally rotate my shoulders, hard.

But then again, my symptoms pretty much disappear when I'm flat on my back. So none of this might have any relevance to your situation.

[Catrin]

Ooooh, THIS looks hopeful! I do use a cervical pillow for my neck. It DOES help a lot to be on my back - the problem is I don't stay there once I am asleep. After it is aggravated to a certain level then it doesn't seem to matter. It sounds like you are able to tape yourself? This is certainly worth a shot, and if it works that would be awesome. Do you remove in the morning or leave it on for a few days? I remember when my PT taped my scapula it stayed on for 3 days.

I HAVE found an acupuncture provider with a downtown location that has a sliding scale, and they do other alternative treatments as well. Their suburb locations are much more expensive. I will keep them in mind, but I don't know how to evaluate a potential provider of this type of alternative treatments. Here is their website (http://www.indyacu.com/) if someone with more knowledge in this area has a chance to look at it.

Hopefully the kinesio taping will work and I will find some after work tonight. It is clear I've got to do something or I will be limited to being a gym rat, no riding at all :( Nothing wrong with being a gym rat but I really want to be ABLE to ride longer distances without shoulder issues - with the TOC and PM syndrome going the position just must put things in the wrong position.

[OakLeaf]

Yes, I tape myself, it's not too hard in that area. It stays on four or five days, usually. Besides having the area completely clean and dry, kinesio tape will stay on better when you (1) round the ends before applying, (2) make sure there is zero stretch on the anchors, and (3) rub the tape briskly with the unwaxed side of the backing after applying, to generate heat and activate the glue. I can usually get another day or two out of it if I trim off the ends when they start to come up.

My skin can be sensitive there - if that's an issue for you, SpiderTech makes a tape for sensitive skin, but I've had to order that online (from theratape.com, really fast service) - I've never seen the SpiderTech Gentle in stores where I am.



Also, not sure what kind of cervical pillow you use, but FWIW I don't put mine underneath my neck. All the ones I've ever seen have been WAY too big for that. I just set it so it's like a chock for my head, and use a much smaller rolled hand towel to support my neck curve. YMMV.



I looked at the acupuncture practice website, not that I know much about it, but a couple of things did stand out. Erica Siegel trained at Pacific, which is the most highly regarded acupuncture college in the US. Marianne C. Chalmers-Talkovski's bio says she does motor point work, though she doesn't say where she trained in the technique and it doesn't necessarily sound like musculoskeletal issues are a big emphasis for her. But that does bring up another point about why I think acupuncture might be really beneficial to you, is that it is an integrative practice that could possibly address some of the underlying issues Crankin mentioned. So I guess if I were you looking at that practice, I'd try to get in with one of the women.

[Catrin]

That is good information Oakleaf, thanks! I will try to contact one of the women and see if I can schedule something downtown soon. Hopefully I can get some immediate relief from the tape but that is a stopgap measure. I know some of the local Crossfit boxes stocks tape, I will see what they might have in stock.

My cervical pillow has two sides. There is a larger side that I typically use to sleep on my side with (which is how I've slept for 53 years, hence the problem with staying there), the other side is much smaller and I use it when I try to sleep on my back.

Good point about acupuncture being able to address different things. We are a system of systems, and obviously I've lots of things going on which is why it has been so difficult to get this under control. The whiplash injury certainly has contributed, but also probably brought to light problems that had been hidden.

[Catrin]

If my neck hurts to the point I can't sleep, I arrange my memory foam pillows a little differently. I use two: the bottom in the standard, horizontal position, so perpindicular to the body, the second is parallel to the body, so it's a little like a recliner. Makes a huge difference. It might help with shoulder pain since everything stays alligned better.

hmmm, I will think about this, thank you. My neck is fine - but IT gets cranky if I change my pillow up too much. Experimentation is called for here as my sleep couldn't BE worse :( If I could do something to prevent me from rolling over on my side - and it doesn't matter which side - that would probably help. I still have my old regular pillows and tried laying them on both sides last night as a way to hopefully keep me from rolling over and of course it didn't stop me once I got to sleep.

[Catrin]

I've scheduled an initial acupuncture appointment for next Thursday with Erica. I am rather nervous, but if this helps it will be worth it. AND it is in my budget :) It is obvious that my body needs some help, and I just don't wish to go the injection route. There is still some ambiguity about where all of the pain is coming from, and those injections can't be good for the muscles/joints/tendons. I will report how things go next Thursday afternoon, until then I will go the taping route.

[Catrin]

Lately I've been having trouble with some of the attachments on my proximal humerus too - not 100% sure which muscle it is - and I've gotten a lot of relief from kinesio taping across my chest.

I cut a strip in half, on me five blocks long (you're about my same size but you'll want to measure yourself the first time). I put my shoulder in full external rotation ... hitchhiker thumb, wrist supinated hard, elbow bent open, maybe 100-120°, and not too close to my ribs, then bring my thumb as far back as I can to pull the shoulder back. Then I tape across the upper chest under the clavicles. Anchor below the SC joint just on the opposite side of the sternum - so the anchors will cross each other when you're done - and tape with zero stretch on the tape all the way to the upper arm. I don't quite parallel the clavicles, but that might depend on how they sit on you - but at least you want to make sure you keep the tape over the muscle and don't tape on top of the clavicle. Just keep the tape as straight as I can all the way to the other end somewhere over the anterior or medial delt..

I finally got a picture of this after reading it a couple of times - had to translate the words into a mental picture :) I am also considering taping that bicep as that is where much of the pain is. My dr. insists that isn't where the problem is located, but that is were a lot of the sharp shooting pain is referred - perhaps taping the bicep will help.

Last night I noted that at the worst of the pain if I forced myself to move my arm - keeping it VERY stiff with no bend at elbow or wrist - into a new position that it seemed to provide some relief.

Here is for SOME sleep tonight!

[OakLeaf]

16434 Not the neatest tape job I've ever done, but hope that gives you a better idea. Hope it helps, and good luck with the acupuncture!

[Catrin]

16434 Not the neatest tape job I've ever done, but hope that gives you a better idea. Hope it helps, and good luck with the acupuncture!

Thanks, and THAT IS what I had in mind :)

[Catrin]

Unsure if it was the tape or sleeping position - but I actually was able to SLEEP :) Taped chest and arm, and worked something out with a regular pillow on the bottom with my cervical pillow on the top that was like a mini-reclining position. Apparently I don't roll over then. There is still just a hint of something there but NOT like it was :)

Oak, I didn't put much stretch (if at all) on the chest tape - was that correct? My thought was if there was too much stretch it would cause me to round my shoulders and I certainly don't need any of THAT going on - too many years of incorrect computer posture is likely the primary culprit - at least for my pec minor.

[OakLeaf]

Yay! So glad you were able to sleep.

Zero stretch is correct. Good deal.

[MelC]

During the freezing state of my frozen shoulder nights were the worst. If my shoulder was rotated in the slightest or there was any pressure on it my whole arm throbbed. What I found worked the best was pillows propped behind my back while I lay on my side with bad shoulder up. The key however was using one of those bean bag travel cervical pillows. I would hook it over my waist and then rest my bad arm on top. This extended the shoulder a little bit, the same as it would be while standing, and held the arm in place as your forearm settled into the beanbag form.

[Catrin]

Sounds painful MelC! I tried a few different sleeping positions last night and still got some decent sleep. I don't LIKE the little reclined sleeping position - but it appears to be the most effective for now. I still don't know if the tape or sleeping position is providing the most relief but am NOT ready to remove the tape for an experiment!

[Catrin]

After a lot of consideration, I canceled the acupuncture and scheduled with a chiropractor who specializes in shoulders AND Active Release Techniques (ART). I think this stands more of a chance to effect real change - my own unexpert soft tissue/joint capsule work has had positive effects, so it seems reasonable to expect targeted work by a true specialist to help me reach my ultimate goal. At least I know where to go should I decide to try acupuncture at a later time. I just wish my insurance would cover some of this. The chiro I am seeing has tons of qualifications/experience in biomechanics and nerve entrapment. This sounds hopeful!

I know that ART isn't pleasant, but frankly I don't care about that - I can handle discomfort if it gets me where I need to be. BTW, the sleeping position appears to have more of an effect than the tape does, so that has been solved.

[Becky]

I enjoy my ART sessions. Sure, there are brief periods of pain, but the overall effect was relaxing, much like massages that I've had in the past. It helps that my chiro follows the ART with e-stim and ultrasound for further relaxation of the treated area.

Good luck!

[Catrin]

I enjoy my ART sessions. Sure, there are brief periods of pain, but the overall effect was relaxing, much like massages that I've had in the past. It helps that my chiro follows the ART with e-stim and ultrasound for further relaxation of the treated area.

Good luck!

This sounds hopeful, thanks!

[Catrin]

My bicep finally appears to be calming a bit after 2 weeks, though mid-arm pain is still affecting my internal rotation (this is starting to improve as well). I've an appointment with a chiro next Tuesday (moved it up) with a lot of expertise with nerve entrapment, bio-mechanics, neck and shoulder issues. He also worked with the Colts during the 2010 Superbowl and has an impressive CV and reputation. Sounds like I am in the right hands...please wish me luck on this! KT tape has become my friend...so thankful to Oak for mentioning it! I thought it wasn't helping that much, until I removed it...

[OakLeaf]

Hope he can help you out.

[Catrin]

Hope he can help you out.

So do I Oak, I've thrown so much money and effort at this neck/shoulder with little improvement... Thankfully his office has separate rates for people whose insurance won't cover chiropractic care and so many have told me they he is usually able to get people out of the door after just a few visits. There is an OMT Clinic opening up soon that my insurance WILL cover and they will offer sports med and acupuncture. I will get the chiro a chance before going to a clinic where the practitioners are fresh out of school - and they aren't open yet.

It IS encouraging that the mobility work I've done on my own (from the Supple Leopard book and the MobilityWOD website) has actually provided me more real, measurable benefits than months of traditional PT - so it seems apparent that soft tissue/fascia/joint capsule mobility is playing a significant role.