*Hey guys, a little disclaimer first: I am NOT a medical professional. I am just a dude who studied bodies, movements and sports injuries in college and now is a professional weightlifter. While I certainly think my advice is good, it cannot be construed as medical advice, nor should it replace talking to a physician. I cannot be held liable for any outcomes from the following article.
Weightlifting is certainly not the most dangerous sport in the world, but the repetitive movements with heavy weights, poor technique, and the penchant for stupid decisions makes injuries a frequent occurrence. Having just dealt with my first serious weightlifting injury, I thought it would be a good idea to discuss some of the main culprits that knock you out of training. We’ll go over how they happen, what to do when you notice the pain, when you should seek a doctor/PT/chiropractor, as well as a re-entry plan back into lifting. So let’s take a look at tendinitis, shall we?
Tendinitis is an inflammation of the tendons. Inflammation is a big word that covers a lot of different types of injury. Inflammation is your body’s response to an injury, injection, or foreign body. Acute inflammation is the redness, pain and swelling you get after a cut, while chronic inflammation is the body’s reaction to a long-term injury, illness, allergy or auto-immune condition. Acute inflammation means your body is actively fighting to heal a new injury or sickness, chronic inflammation usual signals that something is systemically messed up within your body.
Tendinitis, depending on the severity, falls into both of those categories. An injury to your tendons, generally in the shoulder, elbow, heels or wrist for athletes, will result in swelling, pain and loss of range of motion (ROM) within a few hours. The culprit here is usually catching a lift wrong, essentially “tweaking” something in the joint. If you don’t let this injury heal, and continue doing the same lifting, your tendinitis tends to become severe, and causes long-term inflammation in the tendons and tissue surrounding the injury, as well as fluid accumulation. Chronic tendinitis can also be a result of continually lifting without stretching, with all the lifts compounding and causing injury. In this case, it’s not necessarily one bad lift that causes pain, but weeks or months of training that can leave you with pain and swelling in a joint.
To combat inflammation, the direct actions you can take are 1) icing, 2) compression therapy, 3) splinting, and 4) NSAIDs. Ice the offending body part 10-20 minutes every 4 hours in the days following the injury. 2) Compress the joint using this Voodoo Flossing tutorial, or simply by wrapping an ace bandage tightly on the joint for a 2-3 minutes. This can also be repeated several times daily. 3) Rest is important, but if you can’t completely rest, get a brace or splint on at all times. This reduces mobility and gives your body time to heal. If your injury is in the lower body, a cane or crutches wouldn’t be a bad idea, and make sure you elevate the body part when sitting. 4) NSAIDs, or Non-Steroidal Anti-Inflammatory Drugs, are typically aspirin and ibuprofen. I usually take 3 or 4 of these in a dose, but I’m 300 lbs, so figure it out yourself or call a doctor.
If an injury is severe enough, or if you continue to lift on and use the joint in question, you can tear or rupture your tendons, which results in surgery. If you are doing the above for a few days and see no improvement, it’s time to head to the doctor. An orthopedic specialist is probably your best bet, and if you can find one who specializes in sports injuries or the body part in question, you’re well on your way to healing. Ask your coach, lifting buddies, chiropractor, sports trainer…someone will have a name to get you started. I called a few people, none of whom did wrists, and all recommended the same man to me, so my decision became pretty clear.
Once you get an appointment with your doctor, a few things can happen. First, he or she will listen to your story, so make sure you have notes of what happened, and when. Then the evaluation will occur, which will involve some testing, manipulation, and other semi-unpleasant examinations. Your doctor might order an x-ray to make sure there’s no dislocation or fracture. In severe cases, if a tear or rupture is a possibility, your doctor will want an MRI. Most insurance companies will make you jump through hoops to get one, so your doctor might try a few weeks of rest or PT before getting the MRI.
Depending on the results, the path to recovery will look like one of a few options: 1) rest, physical therapy, then a gradual return to lifting. 2) Corticosteroid injection into the joint, rest, physical therapy, (with a potential 2nd shot), and a gradual return to lifting. 3) Surgery to repair, remove or lengthen the tendons and remove the inflamed tissue in the joint, loads of physical therapy, then a very gradual return to weightlifting. Your injury, age, and usage of the joint will determine which path your doctor thinks you should take. Talk to your doctor honestly about your expectations and results. Get a second opinion if necessary, especially if the option is leaning towards surgery. Be realistic that this may take a few months to fully heal.
Once you decide which route to go, be sure to follow every single direction perfectly. DO NOT lift a day before you’re supposed to. As a very stubborn person, I know what it’s like to know better, or convince yourself that the itch to lift means you are healed. But you have to remember that these tendons do so much more than lifting: they help you work, they help you pick up your kids, they help you make a fool of yourself on the dance floor. Do not create a long-term injury for yourself because you couldn’t wait another week to pick up a bar. In the meantime, work with a coach to build a program that you can do. For a lot of upper body injuries, that will mean squatting. Whatever the plan is, clear it with your doctor (he might see problems you don’t), and above all, take it easy. Keep your return gradual, and be sure to stretch the joint before and after workouts, and keep up with icing and NSAIDs.
Good luck, and heal quickly!