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Ligaments & tendons - repair & strengthen?

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  • Ligaments & tendons - repair & strengthen?

    I've had golfer's elbow for several months now. (Like tennis elbow but on the inside of the arm - medial epicondylitis) It flared up after doing some strength work with some homemade medicine balls. The muscles were fine but I hear it can take up to a year for ligaments and tendons to repair themselves. Any suggestions on ways to speed up the process?

    It seems to me that there is a lot of info on how to build stronger muscles but most of the injuries that keep us from those activities involve the supporting tissues. What is the latest on how to strengthen those first before we power up the muscle?

  • #2

    For the average fitness/sport enthusiast, most tendon & ligament injuries come from overuse through repetive motion. Tendons and ligaments strengthen the same way muscles do; through weight lifting. The difference is they take longer to adapt.

    If you give your connective tissue time to heal from your repetitive injury and take measures to prevent any return, you shouldn't have any problems with regular exercising and weight lifting. There's no studies that I know of to back this up, but I've read that isometrics are good for both muscles and connective tissue. Heavy weights will also tax the connective tissues and force them to adapt along with the muscles. Light weights tax the muscles MUCH more than the connective tissues and that is where many injuries/aggravations can occur.

    Connective tissue problems are big with powerlifters and bodybuilders b/c they build their muscular strength quickly without giving their connective tissue time to adapt. Again, this is rarely an issue for those who lift for health/fitness purposes.


    • #3

      How about a nutritional approach, dfethers?

      It's said whey is good for ligaments. I wonder about good bone broth, too. Obviously, you have to make either yourself rather than buy.


      • #4

        Looks like we have a catch-22 here.

        Clint says, "Heavy weights will also tax the connective tissues and force them to adapt along with the muscles. Light weights tax the muscles MUCH more than the connective tissues and that is where many injuries/aggravations can occur".

        So, if I use light weights, I won't build connective tissue strength? That seems counterintuitive to me. I would think that since muscles adapt more quickly than connective tissue, we should consider increasing weight only at the rate our ligaments and tendons can handle.

        The problem is I have no idea what that rate might be. Does anyone know of any studies that look at this? A topic for Mark, perhaps?



        • #5

          I guess I should have been clearer.

          The lighter weights can be lifted more often, and usually are, so that can lead to a repetitive use injury for the connective tissue. Your muscles can heal/adapt to the repetitive use but the tendons/ligaments tend not to.

          Example: A person goes into the gym to do his/her regular workout. It consists of the same 6-10 exercises and he/she does them for the prescribed "3 sets of 10". He/she does this 3-5x a week. The muscles adapt to the load and frequency quickly and, possible, even get stronger. He/she frequently adds more weight. The constant taxation, however, doesn't give the proper time for the connective tissue to adapt. The lighter weights don't really tax the connective tissue to get stronger. This is the formula most bodybuilders follow and their group suffers pectoral and bicep "tears" often.

          Heavy weights, on the other hand, are typically not lifted as often. When I write "heavy", I'm referring to 85-95% of one's 1RM. One should only do 2-3 exercises; 2-4 sets of 4-6 reps. Then, wait 2-4 days and repeat. Adding weight to your lifts comes at a slower rate and the lifting frequency is less. This gives the connective tissue time to adapt at a rate "closer" to that of one's muscle tissue.

          You're absolutely right to stay at a weight that you're tissue can handle, but it can also handle A LOT of weight before it "gives". This is assuming that your connective tissue hasn't been weakened/taxed by repetitive use wear. Think about the adrenalized mom's who lift cars off of their children with minimal damage to themselves.

          Listen to your body. If you're having pain or discomfort in a joint; back off a week. Come back slowly to gauge recovery. See a doctor if it persists. And don't rush progress.

          I hope I did better explaining myself this time. I tend to breeze through these things when I'm not careful!


          • #6

            Thanks Clint. Great explanation. I appreciate the advice. I'll just have to back off on some of the upper body work for now, and concentrate on those exercises I can do.



            • #7


              The best things I have found with my elbow issues (caused by pullups):

              Good masseuse who will cross friction massage the area and loosen all surrounding tissues.

              Ice cube massage directly on the area for two - three minutes. Every day. Whether the joint is hurting or not. You could do this more than once a day if desired.

              I have read the elbow issues can be related to good grip strength and weak extension strength. Take a resist-a-band, make a fist, wrap the band around your fist and then flex/open your hand/fingers. Do 2-3 sets of 15-20 reps these every day.

              Cross friction massage the irritated attachment area yourself then do the ice cube massage. Always end with the ice.

              Supplement with glucosamine/msm mix. I need 1500 mg glucosamine a day or I dont feel the effects.

              Add fish oil in significant amounts.

              If you are going to stop exercising the irritated joint don't come back as soon as you feel better. Give your joint extra time like another week or two or more.

              Good luck, I have had my elbow issues for quite a while despite quitting all exercise for months, but I have significantly reduced my pain with the extensions, ice and massage.


              PS google this : cetyl myristoleate - I have some on order and will let you know of the results


              • #8

                Thanks for the info Ward. My wife swears by the glucosamine so I should give it a try. I've also found that using a heat pad like the Magic Bag reduces the pain to almost zero as long as I don't overdo the exercise. The injury is still there, just not so bothersome.

                I'll try the cross massage and extension training as well and let you know how it works out.



                • #9

                  I gave myself that same injury when I first started doing chin ups and got a little carried away doing them all the time.

                  I discovered that switching from a hands-in (chin up) grip to a hands-out (pull up) grip made all the difference in the world; it doesn't put nearly as much strain on the soft tissues because you're using your back muscles more and the angle is different.

                  Similarly, avoid bicep curls like the plague. Besides the elbow strain, there are much better ways to use your exercise time.