Chiropractic / Musculoskeletal / Joint pain Q & A...

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  1. Going back to what Scott said about inflamation, Ive tried taking 50mg of Diclofenac sodium a few days in a row and it seems to have no effect.

    - Is it both elbows?

    It is, they both have the same symptoms but my right is worse.

    - Any particular time of day it happens the most?

    Nah, but deffinately after Ive been leaning on them at a desk, as I straighten them theres an almighty crack and a little disscomfort in both, if my palms are facing eachother theyre too crunchy to grind through, I have to pronate my hands to smoothen it out.

    - Have you traumatized your elbows at all? (car wreck, sports injury, fall etc.)

    I broke my right elbow, 6 years ago.

    But I also bashed both of them about a bit doing Thai boxing, and needless to say... throwing heavy weights arround, shamefully my form was sloppy for years before I bothered to take care (until I started having problems).

    - Do you have trouble with any other joints?

    well my left knee points inwards a little sometimes, Ive been told to walk and jog like so: from the heel down frist placing the weight on the outer edge and then evening it back round towards the ball of the foot as I follow through the stride (if that makes any sense to you): told to me by my Dad who learnt it in the South African Army back in his day. And I do hamstring stretches and ballance exercises with my foot turned out to 10 'O clock.

    Every morning when I get out of bed theres a pain in my shoulders just under my calvicles seemingly just above my caracoid process. For a while I thougth it was my pectoralis minor, I stretched and strenghtened it, then I thought it was my anterior delts, then I thought it was my traps, then I thought it was my subclavicular muscles, nothing seems to help, but it doesnt bother me anymore after about 5mins out of bed and it doesnt bother me during excercise so I just ignore it :S.

    - When did it start?

    it started about 3 years ago but its only got bad enough to think stop lifting about 6 months ago.

    If I dont make absolute sure my elbows and and wrists are lined up nicely during bench press and shoulder press I cant fully straighten them, thats when it gets a little sore if I try to push it to full lockout.


  2. Hey doc-

    I have always had elbows that get upset at me easily. I get pain on the medial aspect of both my elbows, and normally when I have elbow pain, my brachialis muscle shares in this pain. The pain is sharp, continuous, and only occurs after i overdo some sort of elbow flexion, and when I am at rest (in bed) it is the worst and gets a throbbing quality to it. When the pain occurs, so does a very eerie weakness in both my grip, brachialis and elbow extension/flexion. I take 10g fish oil daily as well as 2g cissus. I rode motorcycles for 14 years and have trained for about the same time. This most recent insult involved taking an atlas stone from ground to shoulder.

    Any ideas or advice?

    Regards
    •   
       


  3. EZ,
    If I understand your description correctly, you just described a positive test for tendonitis to the proximal biceps tendon. That's the tendon that slides through a groove real close to the shoulder. This sounds like overuse to me

  4. Quote Originally Posted by EasyEJL View Post
    I'm just putting this post in as a placeholder, so I remember to come back later and ask a question when I see it in my subscription list
    Easy my man! Welcome bra!

    Sounds like supraspinatus impingement. NEVER abduct and internally rotate your shoulder (dont raise your arm out to the side with your thumb down). This causes the small, fragile supraspinatus tendon to slide over the greater tubercle and under the acromium and can become frayed from doing so. The biceps long head can also be caught up this way.

    You may have some inflammation of the supraspinatus tendon, OR worst case, it may be kind of "chewed" up from years of overhead activity. My recommendation, without performing several tests in person, is to do some internal and external rotations with theraband, with your elbow against your side. This strengthens the other 3 rotator cuff muscles, which assist in "inferior translation" of the humeral head during shoulder abduction and flexion- keeps the supraspinatus tendon from being smashed between the two bones.
    Suffer now.. and live like a champion later.

  5. Quote Originally Posted by celc5 View Post
    EZ,
    If I understand your description correctly, you just described a positive test for tendonitis to the proximal biceps tendon. That's the tendon that slides through a groove real close to the shoulder. This sounds like overuse to me
    I agree, but that would be more of a nagging pain, what he is talking about has to have something to do with nerve pain, I mean minus actually tearing something, usually only nerve pain can cause that kind of instantaneous shock of extreme sharp pain, where is the tenderness to the touch again and does the pain shoot up or down your arm, or is the sharp pain pin-pointed?
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  6. Quote Originally Posted by bezoe View Post
    Easy my man! Welcome bra!

    Sounds like supraspinatus impingement. NEVER abduct and internally rotate your shoulder (dont raise your arm out to the side with your thumb down). This causes the small, fragile supraspinatus tendon to slide over the greater tubercle and under the acromium and can become frayed from doing so. The biceps long head can also be caught up this way.

    You may have some inflammation of the supraspinatus tendon, OR worst case, it may be kind of "chewed" up from years of overhead activity. My recommendation, without performing several tests in person, is to do some internal and external rotations with theraband, with your elbow against your side. This strengthens the other 3 rotator cuff muscles, which assist in "inferior translation" of the humeral head during shoulder abduction and flexion- keeps the supraspinatus tendon from being smashed between the two bones.
    I agree with this... another good thing is to do the exact same exercises described by Bezoe, but in water, it's summertime, next time you are in the pool, spend a few minutes running through a few of those movements against the resistance of the water!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  7. Quote Originally Posted by TheKanezzi View Post
    Hey doc-

    I have always had elbows that get upset at me easily. I get pain on the medial aspect of both my elbows, and normally when I have elbow pain, my brachialis muscle shares in this pain. The pain is sharp, continuous, and only occurs after i overdo some sort of elbow flexion, and when I am at rest (in bed) it is the worst and gets a throbbing quality to it. When the pain occurs, so does a very eerie weakness in both my grip, brachialis and elbow extension/flexion. I take 10g fish oil daily as well as 2g cissus. I rode motorcycles for 14 years and have trained for about the same time. This most recent insult involved taking an atlas stone from ground to shoulder.

    Any ideas or advice?

    Regards
    OK, a lot of this sounds like over-use syndrome. My best advice without being there to do a few muscle tests, etc. is for you to get some serious deep tissue massage, mainly in the flexors & extensors of your forearm, Brachioradialis being one of those muscles. Also there is the whole warm it up with heat before lifting and icing it down after to control the inflammatory response.

    Bezoe being the master PT guy may have some other alternatives as well, but if you were to come into my office. After some muscle testing & palpation of the affected area, as well as a few orthopedic tests, and x-rays, to make sure nothing more serious was going on, I would start treatment as such... Apply heat for 15-20mins... then deep tissue work on the flexors, extensors and rotator muscles in the forearm to break up an muscle adhesions and scar tissue that may have formed, then I would manipulate the joints in your wrist and elbow, then end it with some ice for 15-20mins. As your treatment progressed, I would add in some wrist and elbow exercises to strengthen & stretch those areas.
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  8. Quote Originally Posted by JohnBrinks View Post
    Going back to what Scott said about inflamation, Ive tried taking 50mg of Diclofenac sodium a few days in a row and it seems to have no effect.

    - Is it both elbows?

    It is, they both have the same symptoms but my right is worse.

    - Any particular time of day it happens the most?

    Nah, but deffinately after Ive been leaning on them at a desk, as I straighten them theres an almighty crack and a little disscomfort in both, if my palms are facing eachother theyre too crunchy to grind through, I have to pronate my hands to smoothen it out.

    - Have you traumatized your elbows at all? (car wreck, sports injury, fall etc.)

    I broke my right elbow, 6 years ago.

    But I also bashed both of them about a bit doing Thai boxing, and needless to say... throwing heavy weights arround, shamefully my form was sloppy for years before I bothered to take care (until I started having problems).

    - Do you have trouble with any other joints?

    well my left knee points inwards a little sometimes, Ive been told to walk and jog like so: from the heel down frist placing the weight on the outer edge and then evening it back round towards the ball of the foot as I follow through the stride (if that makes any sense to you): told to me by my Dad who learnt it in the South African Army back in his day. And I do hamstring stretches and ballance exercises with my foot turned out to 10 'O clock.

    Every morning when I get out of bed theres a pain in my shoulders just under my calvicles seemingly just above my caracoid process. For a while I thougth it was my pectoralis minor, I stretched and strenghtened it, then I thought it was my anterior delts, then I thought it was my traps, then I thought it was my subclavicular muscles, nothing seems to help, but it doesnt bother me anymore after about 5mins out of bed and it doesnt bother me during excercise so I just ignore it :S.

    - When did it start?

    it started about 3 years ago but its only got bad enough to think stop lifting about 6 months ago.

    If I dont make absolute sure my elbows and and wrists are lined up nicely during bench press and shoulder press I cant fully straighten them, thats when it gets a little sore if I try to push it to full lockout.
    Man, I'm feeling ya Bro! Still all in all it still sounds like what we call in the profession DJD (degenerative joint disease) or Osteoarthritis, which is a natural occurrence with guys like us, but usually later in life due to all the heavy lifting and injuries, etc.

    It is funny, but Prolotherapy http://en.wikipedia.org/wiki/Prolotherapy was mentioned on another one of my injury threads and from everything I have read about it and researched it looks promising and may be an alternative for you to follow up with, especially if it starts to become painful! Just a thought, I know your background, so research it, dig around a little, here are a few more links to look at....

    http://www.prolotherapy.org/

    http://www.dailystrength.org/treatments/Prolotherapy

    http://www.ncbi.nlm.nih.gov/pubmed/16162983
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  9. subb'd for info!
    DISCLAIMER: Anything that I post on this forum should not be taken as medical advice. Consult your doctor before starting new diets, supplements, training protocols, and/or if you have any concerns about your health.

  10. Quote Originally Posted by ScottyDoc View Post
    Man, I'm feeling ya Bro! Still all in all it still sounds like what we call in the profession DJD (degenerative joint disease) or Osteoarthritis, which is a natural occurrence with guys like us, but usually later in life due to all the heavy lifting and injuries, etc.

    It is funny, but Prolotherapy http://en.wikipedia.org/wiki/Prolotherapy was mentioned on another one of my injury threads and from everything I have read about it and researched it looks promising and may be an alternative for you to follow up with, especially if it starts to become painful! Just a thought, I know your background, so research it, dig around a little, here are a few more links to look at....

    http://www.prolotherapy.org/

    http://www.dailystrength.org/treatments/Prolotherapy

    http://www.ncbi.nlm.nih.gov/pubmed/16162983
    Im on it Bra!!
    I was raised on meat&potatoes, played in the dirt, got smacked when I missbehaved, School started in assembly(Drill), adressed teachers as Sir/Mr & Maam/Mrs/Miss, didnt knw wtf a Happy Meal was or reliable public transport-and I truned out just fine
    •   
       


  11. Brinks, I dont know my man. Nothing really stands out for me in your answers except the broken elbow, which wouldnt cause the contralateral side to develop symptoms.

    It may be some arthritic anomaly.. perhaps hereditary.

    Only other thing I can think of is that your joints, elbows specifically, could be hypermobile, and have consequently developed arthritis.

    My advice would be to walk into a PT clinic and get a free consultation. Get them to look at your elbows and see what they recommend.
    Suffer now.. and live like a champion later.

  12. Quote Originally Posted by TheKanezzi View Post
    Hey doc-

    I have always had elbows that get upset at me easily. I get pain on the medial aspect of both my elbows, and normally when I have elbow pain, my brachialis muscle shares in this pain. The pain is sharp, continuous, and only occurs after i overdo some sort of elbow flexion, and when I am at rest (in bed) it is the worst and gets a throbbing quality to it. When the pain occurs, so does a very eerie weakness in both my grip, brachialis and elbow extension/flexion. I take 10g fish oil daily as well as 2g cissus. I rode motorcycles for 14 years and have trained for about the same time. This most recent insult involved taking an atlas stone from ground to shoulder.

    Any ideas or advice?

    Regards
    Sounds to me like nerve involvement strictly because of the "sharp" description and the fact that weakness accompanies it. Possibly the musculocutaneous peripheral nerve, or, taking into account your recent incident, a C6 or C7 nerve root injury.

    Picking up a boulder would possibly push your head into a forceful lateral tilt and cause damage to the nerve roots in the cervical region.

    Not much I can recommend you do (several measures would need to be taken to alleviate this- IF its the problem). These are just my assumptions given your info provided.
    Suffer now.. and live like a champion later.
  13. Never enough
    EasyEJL's Avatar

    Quote Originally Posted by bezoe View Post
    Easy my man! Welcome bra!

    Sounds like supraspinatus impingement. NEVER abduct and internally rotate your shoulder (dont raise your arm out to the side with your thumb down). This causes the small, fragile supraspinatus tendon to slide over the greater tubercle and under the acromium and can become frayed from doing so. The biceps long head can also be caught up this way.

    You may have some inflammation of the supraspinatus tendon, OR worst case, it may be kind of "chewed" up from years of overhead activity. My recommendation, without performing several tests in person, is to do some internal and external rotations with theraband, with your elbow against your side. This strengthens the other 3 rotator cuff muscles, which assist in "inferior translation" of the humeral head during shoulder abduction and flexion- keeps the supraspinatus tendon from being smashed between the two bones.
    Ok so if I don't have therabands, but do have powerblocks dbs so adjustable dbs from 2.5-95lbs would it be ok to do these same exercises as laying down on the floor or bed and do the rotations vertically instead? Like



    and

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  14. Quote Originally Posted by GoHardOrGoHme View Post
    subb'd for info!
    Welcome, we are here to HELP!!! Like I said before, we have a really good team here!!!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  15. Quote Originally Posted by EasyEJL View Post
    Ok so if I don't have therabands, but do have powerblocks dbs so adjustable dbs from 2.5-95lbs would it be ok to do these same exercises as laying down on the floor or bed and do the rotations vertically instead? Like



    and

    Yes, but extremely light... I still like therabands and water better because of the constant and smooth resistance, also why I added to Bezoe's recommendation and added the whole while in the pool idea, smooth consistent resistance!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!
  16. Never enough
    EasyEJL's Avatar

    Yeah, I can do the water once a week maybe, but the therabands i'll have to buy somewhere. I may go check out walmart, seem to recall them having something similar (probably some really crappy knockoff)
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  17. Quote Originally Posted by EasyEJL View Post
    Yeah, I can do the water once a week maybe, but the therabands i'll have to buy somewhere. I may go check out walmart, seem to recall them having something similar (probably some really crappy knockoff)
    Maybe not, I mean surgical tubing is surgical tubing! I've even seen some at surgical tubing, no handles of course, being sold at HomeDepot or as I like to call it The Ho-Po! You can always just buy so many feet of it and use multiple bands if it is too weak with a single band, but if it is sold at Walmart with handles I'm sure it will both be cheap enough and sufficient for therapy, not like you are trying to use it to get a total workout or anything!
    Dr. Albert Scott Representative for FINAFLEX
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    Redefine Yourself..... REDEFINE EVERYTHING!
  18. Never enough
    EasyEJL's Avatar

    Quote Originally Posted by ScottyDoc View Post
    Maybe not, I mean surgical tubing is surgical tubing!
    this one is in stock locally, and under $7 so worth the risk

    http://www.walmart.com/ip/Gold-s-Gym...ndingMethod=rr
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  19. Quote Originally Posted by EasyEJL View Post
    this one is in stock locally, and under $7 so worth the risk

    http://www.walmart.com/ip/Gold-s-Gym...ndingMethod=rr
    Hey... Looks good to me Bro!
    Dr. Albert Scott Representative for FINAFLEX
    www.finaflex.com
    Redefine Yourself..... REDEFINE EVERYTHING!

  20. Thanks guys for the help. I can normally beat it by not using my arms much, lol, but I was hoping that there was an exercise that I could do to strengthen and prevent these occurances from happening.

    The list of things that could have damaged that region of my body are numerous so i hope that there isnt some sort of long standing, permenant damage to them. Im only 26!!

    Regards

  21. Quote Originally Posted by ScottyDoc View Post
    Maybe not, I mean surgical tubing is surgical tubing! I've even seen some at surgical tubing, no handles of course, being sold at HomeDepot or as I like to call it The Ho-Po! You can always just buy so many feet of it and use multiple bands if it is too weak with a single band, but if it is sold at Walmart with handles I'm sure it will both be cheap enough and sufficient for therapy, not like you are trying to use it to get a total workout or anything!
    agreed

    Quote Originally Posted by TheKanezzi View Post
    Thanks guys for the help. I can normally beat it by not using my arms much, lol, but I was hoping that there was an exercise that I could do to strengthen and prevent these occurances from happening.

    The list of things that could have damaged that region of my body are numerous so i hope that there isnt some sort of long standing, permenant damage to them. Im only 26!!

    Regards
    I hope they arent either bra. Since it sounds intermittent, I wouldnt think it would be any permanent damage. You may just need some stretching of the scalenes or some realignement of your cervical vertebrae. Again, I cant come to a conclusion without running alot more diagnostics.

    Nerves are pretty resiliant.. the peripheral nervous system can regenerate if the nerve cell body is intact. Maybe try a few nerve glides:



    Suffer now.. and live like a champion later.

  22. thanks bezoe, ya i kow that assessment is more art than science and it wont translate over the internet, lol. Ha, i tried those two movements and felt some bonafide fatigue with maybe 60-70% ROM.

    Yikes

  23. Quote Originally Posted by TheKanezzi View Post
    thanks bezoe, ya i kow that assessment is more art than science and it wont translate over the internet, lol. Ha, i tried those two movements and felt some bonafide fatigue with maybe 60-70% ROM.

    Yikes
    http://www.hy-q.com/cooper/pdf/NCS%2...ology%2007.pdf

    Nerve gliding (or mobilization) is a self-directed technique of breathing, positions, and movements to improve the mobility and decrease symptoms of an injured peripheral nerve?O Peripheral nerves are longer than (by up to several centimeters) the distance between any two points along the limb.4 All nerves glide to some degree to accommodate the change in length during joint motion in order to ensure that the nerve remains tension-free at all times.',20 Several factors can limit the ability of a nerve to glide such as trauma, surgery, posture, bone or soft tissue changes or anomalies, or adhesions. As is true with most other physical therapy interventions, patient instruction and education are key to obtain optimal results in the shortest time frame. The patient is instructed to prevent provoking the symptoms of numbness, tingling, or pain during the glide technique. The nerve glide is halted when resistance is first encountered prior to the production of symptoms. Caution is advised to prevent nerve irritability, when the nerve is quick to flare up and is slow to recover from symptoms. It is also important to advise on home care and daily activities that can mimic over-tension nerve gliding and produce irritability.

    So basically, you wanna avoid reproducing the symptoms. If a certain movement or position causes the pain and weakness to occur, abstain from doing it.
    Suffer now.. and live like a champion later.

  24. Quote Originally Posted by bezoe View Post
    Brinks, I dont know my man. Nothing really stands out for me in your answers except the broken elbow, which wouldnt cause the contralateral side to develop symptoms.

    It may be some arthritic anomaly.. perhaps hereditary.

    Only other thing I can think of is that your joints, elbows specifically, could be hypermobile, and have consequently developed arthritis.

    My advice would be to walk into a PT clinic and get a free consultation. Get them to look at your elbows and see what they recommend.
    Thanks again.
    I was raised on meat&potatoes, played in the dirt, got smacked when I missbehaved, School started in assembly(Drill), adressed teachers as Sir/Mr & Maam/Mrs/Miss, didnt knw wtf a Happy Meal was or reliable public transport-and I truned out just fine
  25. Never enough
    EasyEJL's Avatar

    The band has been helping, trying to do it more or less daily. But I noticed a new oddity in my shoulder issues today. Although the pain has been less on shoulder + chest days, it was pretty painful today in that same spot doing chinups. Any ideas as to why?
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  26. Quote Originally Posted by EasyEJL View Post
    The band has been helping, trying to do it more or less daily. But I noticed a new oddity in my shoulder issues today. Although the pain has been less on shoulder + chest days, it was pretty painful today in that same spot doing chinups. Any ideas as to why?
    can you refresh my memory bro. Where exactly is the spot?
    Suffer now.. and live like a champion later.
  27. Never enough
    EasyEJL's Avatar

    Quote Originally Posted by bezoe View Post
    can you refresh my memory bro. Where exactly is the spot?
    I guess its more an area, but its at the shoulder joint slightly below the center of the joint on the front side.
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  28. On the outside of the arm, under the armpit, front of arm? Is it somewhere you can palpate and reproduce pain?
    Suffer now.. and live like a champion later.

  29. Quote Originally Posted by bezoe View Post
    On the outside of the arm, under the armpit, front of arm? Is it somewhere you can palpate and reproduce pain?
    From what I remembered him saying it was more in the superior/anterior aspect of his shoulder, but based on the location, I'm surprised it didn't hurt before doing pull-ups (I forget did you say under-handed pull-ups or just close-grip pull-ups?). OK, I see you just said Chin-Ups, well what was your hand position? I think of chin-ups as under-handed & close grip!
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  30. Never enough
    EasyEJL's Avatar

    thats pretty close, maybe slightly above inside of armpit level. Its hard to get good pressure on it because its covered with the front delt + subscapularis, but is somewhat sensitive to touch
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