Tendonitis or Bursitis? Natural Treatment & Prevention Regardless of Which “Itis” You Have

“Itis” means inflammation usually as a result of trauma (such as a tendon strain) or infection. However inflammation can also occur from nutritional problems as well as local muscle and joint dysfunctions, and I’d say that this is much more common than actual trauma and infection. Think about how often a runner develops an injury to their foot or knee that suddenly creeps up on them and their physician diagnoses it as tendonitis. Or a tennis player or swimmer notices some shoulder pain that gets worse and worse and is eventually told they have bursitis. Although the suffix “itis” typically denotes a more acute problem, rather than one that has been occurring for a long time (chronic), many people are told they have some injury with inflammation months or years after it first appeared. A lot of people have chronic inflammation throughout their body that is affecting their life each and every day – resulting in symptoms such as fatigue, body aches, and accelerated ageing. Different types of inflammation sometime require different treatment even though they often accompany one another when an injury strikes.

 

TENDONITIS

Tendonitis is inflammation of a tendon, which is where a muscle connects to a bone. This is probably the biggest complaint that athletes have in regards to injuries. It is also one of the most used diagnoses, and perhaps sometimes incorrectly. For example, many physicians now think of Achilles tendonitis as Achilles tendonosis (also spelled tendinosis) – which is a chronic degenerative condition with some micro-tearing of the tissues without inflammation.  Resolving tendonitis (as well as a tendonosis) involves both local and global “systemic” treatment.

Trigger point therapies, as I explain and demonstrate in the Sock Doc videos, and meridian (acupressure/acupuncture) therapies can help tremendously with pain and inflammation reduction as well as healing the involved tissues.

Gait disturbances can cause tendonitis. Walking or running incorrectly due to muscle imbalances or joint dysfunctions caused by another injury or from wearing improper footwear can result in tendon problems. What you put on your feet will have a dramatic effect on your entire body – not just your feet. I have treated many people with shoulder tendonitis because of an improper gait – some because of poor shoes and some because of old injuries that were still unknowingly affecting them. Every swing forward of your arm when you walk or run must also be in sync with the muscles of your opposite-side leg. An old injury or surgery to your knee, for example, could still be affecting your gait causing an imbalance which results in the improper motion of your shoulder on the opposite side. Next thing you know, you have tendonitis in that shoulder.

Your adrenal glands, pancreas, and liver are the three major organs involved in tendonitis problems. The adrenal glands are your hormonal glands that deal with stress. They will secrete excess cortisol when there is too much dietary, physical, or emotional stress. Over time, the beneficial hormone DHEA, also made in the adrenal glands, will become depleted with persistent chronic stress, resulting in low sex hormone levels such as testosterone and estrogen, as those are made from DHEA. This constant cortisol burden will tax the liver, which must detoxify the hormone, and much of this is done via a process known as sulfation. When your body uses up sulfur, it has less available to heal injured tendons as well as your cartilage (joints) where they attach to. So chronic stress leads to chronic cortisol leads to chronic inflammation and the inability to heal. The increased cortisol also plays off the pancreas, creating a constant tug-of-war between the two organs (the pancreas and the adrenals) as they try to keep blood sugar levels from swinging out of control all day long as you work, exercise, and sleep. This, as discussed here, will create insulin and carbohydrate sensitivities, and in turn create even more inflammation.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed for many “itis” problems. Guess what? These will also deplete sulfur from your body because that’s how your liver detoxifies them, so overall healing is even further delayed. If you ever feel better from taking a NDAID it’s a sure sign that you have a fatty acid metabolism problem occurring in your body. If there was no fatty acid metabolism problem or imbalance, you’d see no benefit taking the drug. If there actually isn’t inflammation to be treated and you’re dealing with an “osis” rather than “itis” you may not see a NSAID benefit. However I’d say it’s very rare for a person to have a chronic injury that their body can’t heal and not have some degree of inflammation. More on fats, NSAIDs, and inflammation here.

Using ice can sometimes help with the pain and inflammation during the acute phase of the injury, but it should not be used for weeks and months. This may in fact just be numbing your pain temporarily during use but actually delaying the healing by constricting blood flow to the area and artificially reducing inflammation too much for the tendon to heal. You do need some inflammation to heal in the acute phase – not too much for too long, and not too little!

 

BURSITIS

You have hundreds of bursa all over your body which can be thought of as little bags of oil that help reduce friction between two joints moving in opposite directions as well as where muscles & tendons slide over bone. Bursitis, or inflammation of a bursa, is often described as “hot & stabbing” pain, and has some degree of swelling.  Bursitis can be caused by a local injury to a joint, such as the elbow or knee, as well as improper repetitive motion between muscles. For example, if your biceps muscle is not functioning properly (there is some muscle “weakness” – inhibition) then your triceps will work harder due to the opposing muscle inhibition of the biceps. This muscle imbalance will cause stress on the elbow and shoulder joints. If the bursa in the elbow were to become inflamed due to the chronic joint and muscular imbalances, you would have a diagnosis of olecranon bursitis. Trochanteric bursitis in the hip is also a very common spot for bursa problems. Swelling of the bursa behind the knee where the calf and hamstring muscles cross is also very common; this is called a Baker’s cyst.

Similar local therapies which help treat tendonitis also help with bursitis, but the nutrition aspects of bursitis is a bit different. Nutritionally, bursitis has to do with calcium, fats, and the acidity of your tissues. Here’s the common bursitis “nutritional” scenario: When you’re under too much stress of any kind, especially when there is trauma to the area, your body requires additional protein. This protein can come from your diet as well as muscle breakdown and even from the area around your actual bursa. The robbing of protein from the tissue and bursa creates a more alkaline medium in that area. Calcium is then deposited in the bursa as a result of the alkaline environment to help protect the bursa. Unfortunately, this creates pain and inflammation – bursitis.

Treating the bursitis involves not only dealing with the inflammation but also mobilizing the calcium out of the area by creating an acidic environment in the tissues. One of the best ways to acidify the tissues is to add 1-2 TB of vinegar to your diet every day, (many use apple cider vinegar), though sometimes more may be needed. Some people actually have bursitis because they are too alkaline in so many areas of their body due to low levels of stomach hydrochloric acid. Low stomach HCL also creates poor protein metabolism allowing more calcium to precipitate into the alkaline environment resulting in bursitis symptoms. In addition to acidifying the tissues to mobilize the calcium, sometimes essential fatty acids are needed to help fight the inflammation. Omega-3 fats such as flax oil and fish oil, and omega-6 fats such as black currant seed, borage, and especially unrefined sesame seed oil can be of use here. Other anti-inflammatories such as quercetin and turmeric can help too.

Don’t forget to deal with the root cause whether you have bursitis or tendonitis. Evaluate your stress levels, your training, your diet, and your overall lifestyle. Tendonitis and bursitis, unless the result of some traumatic accident, (you fell off your bike, for example), are warning signs that your health is sub-optimal.

Comments

  1. Question:

    Red wine has the same PH as vinegar (which is why it was so useful: no bugs can survive in it). How about a glass of red wine instead of a 1/2 Tb of vinegar?

  2. I’ve never been sold on the idea that changing the pH of our diet has any significant effect on the pH of our tissues or blood. Sure your urine or saliva may change due to what you eat but your blood certainly doesn’t and sinovial fluid?

    Vinegar may be an effective treatment but I guess I’m skeptical it has anything do do with. Hypoventilation as a treatment? :)

    Thoughts?

    • Hi Nick, I’m not here to sell you on any idea, but yes a lot more changes than just your urine and saliva. Look at the pH levels throughout your digestive tract, for example. Your saliva should be slightly alkaline, your stomach obviously very acid (HCL levels), your small intestine more alkaline again, and then towards a more acidic level in the large intestine. Too much fluctuation in any of these areas can cause health problems. Low HCL in the stomach many think of as only causing poor digestion, (not high levels like the antacid companies want you to believe), and colon pH too alkaline can result in bacteria and yeast overgrowth. Actually, low HCL in the stomach is a major reason for itchy skin, allergies, hives, and low energy too. I use a lot of HCL supplements in my office around allergy season and it helps tremendously. And vinegar is one of those “old wives tales” for itchy skin and hives – it works more times than not – so clearly there is some acidifying of tissues going on beyond just the saliva which swallows the vinegar. Much of the low stomach HCL levels can be attributed to a high carbohydrate and refined food diet. Jack LaLanne discussed this decades ago and it was part of the push behind his fruits and vege juicing > getting the body’s pH levels back to normal.

      Now your blood typically stays in that very narrow 7.35 to 7.45 range but this is due to constant buffering and homeostatic mechanisms. Eat a lot of sugar and other refined foods, or drink and smoke, or even exercise too intensely, then your body will start to shift that level towards more acid. No, it’s not going to drop to a truly acid level – but shift towards that way maybe from 7.45 to 7.40 – and then your body has to correct the change, pulling calcium and other electrolytes into the blood to do so. Your body wants to keep that blood pH constant, but it will do so at the expense of other tissues, changing their chemistry, their pH, and resulting in various symptoms.

      Finally, and I know you’re a scientist and I really respect your comments and it’s good for me to elaborate and clarify what I’m talking about here, so I appreciate the question. But think about how some people view the human body as you note in your question. Do you really think that a person’s diet can change the saliva and urine but nothing else? No way. Sure they’re the easiest to measure but a lot of stuff goes on between the time you put something in your mouth and hit the bathroom.

  3. I feel like I should clarify and say that I wasn’t trying to argue that tissue pH is invariant between different organs/systems in the body. On the contrary you can get pH gradients within a cell, tissue, organ, etc. I totally agree that every organ or system has an ideal pH (depending on the stimuli it’s interacting with) and un-healthy people will fall far away from this pH. I also agree that if a person’s diet changes the pH of their urine and saliva (just examples I picked, I’m sure there are more) that something else in the body could have changed. An alternate explanation is that this could just be a reflection of those fluids being used as a buffer so other tissues can remain closer to their ideal range via homeostatic mechanisms.

    2 TB of vinegar (at 5% acidity by volume) is like 2.5×10^-5 mol of acetic acid which has a pKa of ~5 if I remember correctly. That’s just not very many more hydronium ions added to the human body as a whole even if we are talking about a pH > 7 where it’s 99.9% deprotenated. Now I’m just giving you a hard time though because I could easily imagine a mechanism where the vinegar causes a very local drop in pH which triggers some sort of feedback response that produces the effect you desire. Jack LaLanne was way more ripped than I will ever be so perhaps I believe him :)

    I should add that you Steve are WAYYYY more of an expert here. I am just an armchair philosopher (at least when it comes to treating real people) whereas you have practical experience. I happen to enjoy this thinking about stuff like this and you actually fix people. In my opinion practical experience wins out when dealing with the human body because it is so damn complicated and ultimately all we can do is say what works but not exactly why it works (in many cases). I put a great deal of faith in “old wives tales”!

    It’s awesome to have someone like you who I know is really busy take the time to respond!

    • Thanks Nick, and great comments. Yeah I write these posts based off both my clinical observations & the science behind it. Almost always they correlate but sometimes it’s hard to see exactly why. The human body is so much more intricate than we may ever know & with systems constantly changing & adapting, it’s often very difficult to study the massess & apply those principles to the individual.

  4. Martha Peterson says:

    Hi,

    I found your website after reading your testimonial on MovNat. I appreciate how you include one’s gait and movement as a possible contributor when explaining tendonitis. I teach Hanna Somatic Education, which helps people improve their sensory motor system so they can eliminate chronic muscle pain that habituates due to improper gait, injuries, accidents and stress. I work daily with people whose diagnosis is tendonitis or bursitis (or sciatica, chronic back pain, TMD, etc), that, as you noted, came not from something inherently wrong with the area of pain, but from a full body pattern of muscular contraction and imbalance. Once they learned to release their chronically tight muscles, their tendonitis (or other muscular condition) went away – quite rapidly.
    Thanks for being a medical voice out there who understands that adapting to faulty movement can contribute to muscular pain.

  5. I have numbing in my left arm and hand. The doctor told me it was the Bursa gland and he gave me a cortisone shot directly into the area. This never took it away completely but helped. it is back now and i want to know what type of exercises or home treatments there are to stop the tingling and numbness in my arm and hand?

    • You should go seek a second opinion. Aside from a local hand problem, numbness in your hand is most often from a problem in your neck (disc) or shoulder blade area.

  6. Thanks Sock Doc for this post. I found it on the Barefoot Runners Society website. I have had Achilles pain for years. The pain is right on the tendon and under the tendon not on the heel attachment so I guess it could be bursitis. Just touching them causes pain.

    I play soccer and have always attributed the pain to the sprinting I do in that sport. I started barefoot/minimalist running last year and the pain almost went away. This year it is back I think due to increased mileage in running. I had a feeling that rubbing the actual tendon would be bad so I have avoided that, and I also avoided massaging the narrow part of the muscles, but now I see from your video that I should be massaging that area quite a bit. There is pain and soreness to the touch there.

    I also think I must have the chemical imbalances you discuss – mostly due to stress. I will try the vinegar technique (perhaps I will get relief from these late August allergies as well). I have also recently tried to increase my protein intake. How can I know for sure that I do have calcium build up in the bursa and need more acid in my tissues?

    I have read more and more about not stretching and am a convert to that philosophy (one thing I read that stretching also does is cause the muscles to fire and move slower – not something a runner/soccer player wants). However, I have found that after a couple of miles of easy running I do some lunge stretching and that helps the Achilles.
    Thanks,
    Nathan

    • Hi Nathan, there’s really no way to be certain if you have calcium deposits there, but if you acidify your tissues and the Ca is there, it should resolve that part of the problem. One sign of over-acidifying your system is you’ll start to yawn very frequently. Check out the Achilles Tendonitis video I have here on the site you haven’t already.

      • Well after only one day of rolling my calf muscles they are very sore and the right Achilles feels better (haven’t run yet though). I can imagine that if I am reorganizing muscle fibers in my calves they would be sore – I just hope I’m not actually doing real harm to them.

        I thought maybe I had too much acid in my system because I drink a lot of coffee (2-3 cups a day), but I don’t have the yawning problem.

        Thanks Soc Doc

        • Nice, that should help. A lot of people are too acidic from refined carbohydrates, bad fats, and excess caffeine in their diet – you won’t necessarily yawn a lot but could have other problems like inflammation, pain, fatigue, sleep problems, etc.

  7. Erik Lee Skjon says:

    Dear Soc Doc,

    I posted comments on your recent stretching post on the BRS page, and have one further concern. I seem to have some tendinitis in my left shoulder.

    Here’s the background: I’m currently getting back in shape after 7 years of doing little exercise while I was in Mozambique doing linguistic anthropological fieldwork, 2004 to May 2010. I began running sporadically over the last year, and then towards the end of May I took up barefoot running, and that’s going pretty well (I had previously run barefoot 20 years ago as part of my karate training in Japan).

    I’m also getting back into weights. My regimen seven years ago was one day weights, one day run, three days a week each, with one rest day per week. Right now I’m experimenting with running 5 days a week and weights on the off days, mostly chest and back exercises (I don’t generally do small muscles exercises). I’m intrigued by the Crossfit regimen, but I think I’ll stick with what I’m doing for at least a year before I try something else. I want to achieve a basic fitness level doing something I’m familiar with before I branch off into something new. In the past I’ve achieved pretty high levels of fitness. Besides practicing karate for three years in Japan twenty years ago, I’ve hiked in the Andes and Himalayas, bicycled for two years through Africa, the Middle East, and Europe, and other adventures. The goal now is simply to return to good fitness levels with a modest one-hour-a-day commitment.

    Ok, enough background, here’s my problem: for the first time in my life (I just turned 50), I’ve had a nagging injury. It began in Mozambique, after I had some masons make a primitive weight set out of concrete, paint pails, and ¾ inch plumbing pipes. After about a month I was starting to be able to push it a bit, and so I did that one exercise where you grab the bar narrowly and lift it up your collar bone (upright row?). That’s when something went click in my left shoulder. I only had two weight gradations (10 gallons of concrete on either side of the bar, and 20 gallons each side), and the lower gradation was too much weight for that particular motion. That was three or four years ago. Then this winter I did high reps for about a month and the mild pain went away, as I sought to condition the joint before adding too much weight. Then we had our second child and I got out of shape again for a few months and the mild shoulder pain came back. In June I took up weights again and tried to go up to higher weights too quickly and the shoulder pain persisted. Then, in August, after the shoulder pain had more or less subsided on its own, I returned to weights doing higher reps and the shoulder pain is gone again. So the plan is to just do higher reps for a few months more before I start to push it. I hate doing high reps, but it makes sense right now.

    My question then is: do you agree with this strategy? I sometimes wonder if this is tendonitis or a more serious injury that has never healed. It’s weird the way it comes and goes. Sometimes just sleeping with my left arm under my head can bring on a mild ache the next day. I saw an orthopedist in Mozambique, one of my wife’s uncles, and he wanted to treat it with three weekly injections into the joint with some kind of steroid. I had my older brother research the steroid (I’ve forgotten the name now), and he didn’t think it was a good idea, so I declined. Then I saw an internist here in Minnesota last year for a general check-up after getting back from Mozambique, and mentioned the shoulder. He thought it might tendinitis, and gave me some shoulder exercises to do to strengthen the joint. They’re more or less what I do anyway when weight training. That was before late December/January’s attempt to get back in shape. As I mentioned above, that period did see the pain go away, so I’m hopeful I can continue the progress I’m making right now sticking to high reps. I’m going to see the same doctor at the end of October, so if the pain has returned I’ll probably ask for a referral to an orthopedist. If that still doesn’t work, I think my older brother can probably recommend an acupuncturist. Any comments or recommendations you can make on my situation will be greatly appreciated.

    Thanks, Erik

    • Hi Erik, other than following the advice here in the post, which should help whatever the actual “itis” is, you may want to look for a rolfer or deep tissue massage therapist. They’re going to be most effective at doing deep tissue work, other than an applied kinesiologist, such as myself, but I don’t know any in MN. Then there’s the question as to whether you’re doing those exercises correctly. As you may have read from the MovNat posts here, I’m not a fan of doing isolated exercises, upright rows included. A referral to an ortho doc might be a good idea to have a MRI done to see if you actually tore something, but other than some drug or surgery, that is the extent as to what those docs can offer.

      • Erik Lee Skjon says:

        Thanks for your timely reply. I’m pretty sure I’m doing everything with good form. I’ve been doing weights on and off for 30 years, and had a excellent teacher in my older brother and next door neighbor (a gym owner) when I was first starting out. I’m pretty careful about my form and respecting my limitations (except of course in the incident described above.) I’m intrigued by the MovNat and Crossfit programs, but for the moment I’m sticking with what I know until I establish a good base fitness level. I spent a couple of hours yesterday looking over your sites and will continue to draw on them as resources. Thanks for making them available. As for your suggestions, I’ll definitely look into them. I know several people who probably know of some good local possibilities.

  8. Thank you doc for all the information about treatment on the Tendonitis or Bursitis article. Simple awesome.
    I am a marathon runner from Winnipeg-MB-Canada. I’ve been running barefoot for several months but because of winter, I’ve been back into some shod run on part of my runs. Last week I felt my Achilles aching (after 2 days aprox of last shod run and 7 days from last bare). Docs here tells me it is a posterior Tibialis Tendonitis in my left foot, gave me a boot to wear for 3 weeks and 3 months of no running … auch!

    Q: can I use a sky machine and / or a treadmill on a high incline but low speed as an alternative to running? I’m concern with loosing my level of running and fitness. May the use of these machines worsen my condition? I feel OK for now when I do for 15 up to 30′. The treadmill on the highest incline I’m not that sure though, I have some soreness in my calf but I don’t feel pain nor my tibialis is swollen after running on the treadmill or skying on the machine.

    What would you recommend for the fastest, quickest recovery ? Does your video about the Achilles Tendonitis apply? If so, how or where on the net could I find the best way of applying Trigger point therapy for the posterior Tibialis ?

    Does home grade ultrasound machines help ?

    thank you sir for this great website ! best

    • Thanks Daniel!
      First, if the shod run is the reason you developed the Achilles issue, you need to correct the footwear problem. Even if you’re already wearing a minimalist-type shoe, you may need a different type/style that is better for you.
      Sure you can use the ski machine or treadmill, or whatever does not cause you discomfort, so you can keep your fitness.
      Yes, what I show in the AT video may apply to you but if it really is posterior tib tendonitis then look at the Plantar Fasciitis Video instead. Even though you don’t have PF symptoms, it’ll still pertain to you since PF is a post tib problem. I show how and where to look for the trigger points there.
      Personally, I never use an ultrasound, of any type. I’m all hands-on approach!

  9. How long should it take before I should notice if the vinegar is helping my shoulder? How long do you think is too long to take it?

  10. Hi Sock Doc,

    For years I have had tenderness in my heels first thing in the morning, in attempt to rid myself of this mild inconvenience I consulted a podiatrist. I was fitted with orthotics which really made no difference at all to my symptoms. I continued to wear them for 4 or 5 years for no other reason I guess than a placebo affect as I was told I had flat feet and they rolled in during push off. As with competitive amateur athletes in their mid 30′s about 12 months ago I consulted another podiatrist in an attempt resolve the issue and to hopefully regain some pace. I was told that my old orthotics where ill fitted and my feet were still rolling in and that in my normal stance my achillies still bowed inwards. After a lot of expense and breaking in another pair if new orthotics may problem worsened to the extent now that I have chronic tendinitis in my right achillies. I have tried all traditional methods of treatment to date and the condition hasn’t deteriorated, but it certainly hasn’t improved either. A physio has also told me I have short calves but the strengthening and stretching regime I have been doing for months has made no difference.

    I spend a considerable amount of time in my office and at home walking barefoot and whilst I cannot run barefoot without pain I have no general soreness whilst walking. I have always had quite tight calves that are prone to sore spots and knots that require constant massage. I have been researching alternative methods of treatment for a while and am glad I stumbled across your site. Do you have any advice for me or a reference for a like minded person like yourself in Melbourne as I am at my witts end and think 36 is to young to end my sports career.

    • Hey Mat, yeah 36 way too young for this to be happening to you, any age for that matter. Although I don’t like hearing of your terrible experiences with orthotics and diagnoses like “fallen arches”, “flat feet”, and “short calves” it proves my point – most docs and therapists are great at giving a name to a problem (priding themselves in a diagnosis) and having no clue how to correct it other than to support or stretch which only cause other problems.

      I don’t know any docs in AUS, sorry – and I don’t even know many in the US who think like I do and spend them time with patients to get them well. My advice to you is to work your way into going barefoot more and more like I discuss (and just posted “Lose Your Shoes”) as well as making sure your diet is optimal (Paleo as I discuss) and your exercise is aerobic – Sock Doc Training Principles.

      Tight calves often occur with hyper-adrenal symptoms >>> too much stress in your life.

      SD

  11. ! im a runner who just got done reading born to run! Ive been wearing minimalist shoes with no heel cushioning or support at all for a couple of months and have developed some achilles pain.I started trying many things like buying “the stick” but it seems to keep coming back. I have another pair of running shoes with way more heal support to protect my achilles, i was wondering if you think i shud give minimal shoes another chance or go to shoes with more heel support? thank you

  12. Hi Sock Doc

    Another extremely beneficial article, thank you! I have recently added bromelain (2x day 500 mg) as an anti-inflammatory for my “retrocalcaneal bursitis/tendonsis”. i take it on an empty stomach. this product is sold as an aid to help protein digestion when taken with food. do you think it affects the HCL levels in the stomach in a positive way? i have always thought i need to keep my system more alkaline than acidic and try to eat more alkaline foods to achieve a higher PH on that scale. (concern here was bone health and stopping the calcium depletion from bone due to a more acidic PH – urine testing). the ‘blood thinning’ side effect of bromelain is completely inconvenient.

    i will try the apple cider vinegar for a few days to see if the soreness/hot spot/swelling on the back of my heel is lessened and will continue with the bromelain if it would be beneficial in this case.

    i will vacation in NC this summer and am tempted to give up 2 days at the beach to spend at your office!

    thanks again for your advice here and throughout the websites.

  13. Hi Dr. Gangemi!

    Thanks for the great article. I see that it’s intended more for people who have developed tendinitis and/or bursitis gradually. So, what about people who have injured their joint, and now have both conditions?

    I’m desperate because I’ve tried many things for my knee tendinitis and bursitis. I fell down in 2010, and hit the lower part of my knee tendon. A few months later I fell on my butt and bent the injured knee too far. I developed massive swelling after this second accident and was not able to seek frequent treatment after several months due to inability to pay for healthcare insurance. Anyhow, I tried chiropractic care, natural supplements, NSAID’s, a cortisone injection, and physical therapy. The only things that seemed to work to some extent were the cortisone and the PT. However, I’m not back to health. My ankle is now affected with swelling there as well. My orthopedics doctor jut says that it will heal in time but I can’t function as I used to and it’s 2012. I can’t work for long periods of time, I can’t enjoy myself at the park…it’s so frustrating that I’m starting to wonder if I’d ever be healthy again. Any advise? Thank you!

    Kat

    • Same applies for your situation. But as I sometimes say, there are instances where you just need the right doc or therapist to sort things out – address the injuries and compensatory patterns you’ve developed over the months/years – (such as your ankle). Look for a chiropractor who does specific muscle work and/or applied kinesiology; or perhaps a rolfer can help.

  14. Tabetha says:

    My husband had knee surgery 2 years ago. He had a torn ligament & that was repaired. A couple months ago, he thinks he overdid it at work climbing ladders all week & he had pain in the knee that’s getting worse. The doctor said it’s tendonitis and he may need cortisone shots. I was wondering if there were any other “natural” remedy to help the actual cause of the pain and not just the symptoms? He drinks coffee every day, smokes and drinks mostly Dr pepper. I know that’s all bad for him but I don’t think that’s ever going to change. I heard apple cider vinegar, baking soda and even borax helps. Not really sure on all this. I just hope to find something that may help with the healing.

    • Sorry – not to sound harsh but if someone has knee pain (or any pain) and they don’t want to change their diet then they can’t be helped. I’ve seen it enough to know that’s the case. Now if someone isn’t sure what to eat or not eat that’s one thing, but personally I’d never treat someone who would still drink any soda and not have a goal of cutting down the smokes. So what “you’re trying to find” is what he won’t stop.

  15. TENNIS ELBOW/ Tendonitis of my left forearm tendons. One year from now I was a Truck Driver and I hit my left funny bone (ulnar nerve) pretty hard against the top edge of inside door. I never had problems with any of my tendons before. I believe my tendonitis of forearm is due to a combination of two things. Repetitive muscle tension of my forearm at the truck steering wheel and the blow to my ulnar nerve. 2 weeks after I hit, my entire arm felt somewhat different. It felt tense and thought I had just hit my funny bone and it would get better with time. I didn’t tell my company until 2.5months later when I could barely use my left hand. MRI was done and showed a dark area at the tendons. The doctor said I had tennis elbow. I’m still tying to heal. I also have a slight case of Scoliosis. At my 4th and 5th vertebrae of my neck shows (in ex-ray) that I have curvature, slight gap between 4&5th, and very small about of calcification. What do you recommend? I eat only fruits&vegetables and I just did a liver last night. 10 days ago I did the Master Cleanse for 10 days and my arm numbness seamed to improve a lot. I think it was because of the high vitamin C of the lemons and no food. I also use DoTerra essential oils topically. I will be going to acupuncturist soon. I sometimes go to the chiropractor and just had a adjustment done. I can use my hand, but my entire arm and up to my left side of neck is numbness and stress out muscles. What is Your input??

    • The two SD video that need to be filmed next are for the shoulder and the elbow. Basically tennis elbow is a problem with your triceps muscles (back of your arm). Look for trigger points there – all the way from just above your elbow to the back of your shoulder (underneath your shoulder). I’d say 95% of the time that’s where the problem is. The other 5% — the trigger points are in the back of the forearm (the extensors – that’s the part facing up when you’re typing on a keyboard). Check it out.

      • I whole hearty say thank you! Your knowledge is very very helpful and this is something I haven’t tried yet. WOW you say 95% of the time for tennis elbow is coming from trigger points from just above elbow to back (behind) shoulder and underneath shoulder. This is VERY good to hear! I’m already agreeing with this 100%. I do have a Trigger Point Therapy book and will be hunting for the areas to message. THANK YOU “Sock Doc”! I really appreciate you and your wisdom.
        p.s. I will try to remember to come back here later to update myself upon this new found knowledge. Oh and I don’t get__?_The two SD video that need to be filmed are for the shoulder and the elbow.

  16. Hey Doc. Found you through Trail Runner Nation. Thanks for the podcasts and the site – very informative.

    I am a zero drop shoe runner, have been for a couple of years now, and recently completed my first 1/2 iron – not too shabby for a former 500lb fat guy…. Anyway, several days after the 1/2 I went for a short 4mile, slow speed run and about 3.5 in, my left knee developed some pain. Eventually it forced me to a walk. That night I woke up and could barely bend the knee or put weight on it. Wrapped it up and the more I moved it the following day the better it felt. I went to the Dr (I have a 1/2 marathon end of Oct) and she diagnosed it as bursitis. The pain is about .5-1″ down and about .5-1″ over from the knee on the outside. I thought that the bursa sacs were more under the knee than on the outside areas. Just wanted to get your thoughts on it. I don’t believe in NSAIDs so I’ve been wrapping it and taking my normal Bromelian, fish oil and gluco/condrit. I also drink green tea instead of coffee in the morning. Not a ton of swelling going on but there is a little. Thanks for everything Doc.

    Will

  17. Kathryn Browning says:

    Hi Sock Doc

    I first got tendonitis in my right shoulder and an MRI showed inflammation in the Bursa too.It took 2 years to get better. Now I have tendonitis in my left shoulder and elbow and neck pain from being on the computer too much I suspect. I am also having returned symptoms of tendonitis in my right shoulder. I had never had any kind of tendonitis until after receiving Cipro in the hospital for an intestinal infection a couple years ago. Now I have tendon and muscle pain all the time and many hard lumps in my muscles about the size of a dime. I don’t drink sodas alcohol or smoke. I try to eat a whole food organic diet as much as I can afford. I have been dealing with an abscessed tooth for at least a year because I can’t afford to get it pulled. Do you think the Cipro has caused me to have tendonitis? If so, how can I heal myself from the side effect of this poison?

  18. I was diagnosed with retrocalcaneal bursitis (ultrasound showed Achilles tendon and its insertion looked perfectly intact). Given the relatively isolated involvement of the bursa, the sports doc recommended a cortisone shot under ultrasound guidance so I got one.
    How long should I rest after the injection before I can resume exercise? I’m supposed to refrain from running for the next two weeks. But what type of cross-training is allowed?

  19. Hi Soc Doc,
    In a desperate attempt to get some answers to a chronic problem with hip bursitis and tendonitis, I found this site and the posts addressing this issue. I have been suffering with this issue for the past couple years and it keeps getting worse. I do not sleep at night because of the pain, it affects my ability to walk and excersise. I am about 50 lbs over weight which I know just adds to this problem. Last winter I fell twice and this condition became worse, an MRI shows calcification, tendon tears and inflamation. I was sent to a orthopedic doc who just gives me injectiions of cortizone only for it to return a month or two later. I found the information on our gait being an underlying problem with regards to this issue. I have an issue with my hips and as a result there is about a half inch difference in the length of my legs therefore making my gait off. I have addressed this issue with several doctors who’s advice varied and I do believe it is one of my underlying issues but, again do not know what direction to turn. My life is affected in such a negative way with this problem and I just so desperately need to find some relief and some anwers. If you could direct me I would be forever grateful, I just simply want my life back and to not hurt anymore. Any suggestions will be grately appreciated!

    Best Regards,
    Karen

    • Hi Karen, you can schedule a consult with me or as I often say to people – “Sometimes you just gotta be treated by a doc or therapist who looks at the entire body from a structural, nutritional, and emotional perspective and understands how everything is interrelated and attributing to a health issue or injury.” Although there’s not a lot of “us” out there, that’s your best bet. A good doc will be able to help you out and if not, at least explain why it you aren’t healing.

  20. Jacqueline says:

    Doc,
    I went to see my doctor because I was suffering from heartburn. The doctor said I have a Hiatus Hernia. I still don’t understand how that happened. The doctor said in order to avoid surgery I needed to stay away from acidic foods and fatty foods. I’ve been eating more veggies, fruits and I have reduced my grains. . I bought a NutriBullet and I’ve been juicing for two weeks now. I’m trying to do all I can to become more healthy and reduce my knee inflammation. I am concerned that if I have poor digestion than all my efforts are in vain.
    The apple cider vinegar sounds like it could be something that could help me with my knee inflammation. Do you think I could use the apple cider? Or do you have another suggestion? Any thoughts on what I can do to improve my digestion and in turn maximize the absorption of all the vitamins from my foods?

    Thank you Doc!

    • I treat hiatal hernias all the time in my office, so you might look for a doc who does the same. Typically they occur from digestive issues (low stomach acidity) or diaphragm problems. Staying away from acid foods and fatty foods isn’t the reason for this; at least I’ve never seen it and hell I’ve seen plenty and corrected them 100% of the time. Those foods may aggravate a problem that’s already there though. Get rid of grains 100%, caffeine too. Apple cider vinegar may help; worth a try.

  21. Jacqueline says:

    Hi Doc,

    Ok, I’ll give it a try. How and how often should I take it?

    Thanks so much for your quick response!

  22. Jacqueline says:

    Hi Doc,

    Again thank so much for help and all the great information you share with us.

    I’m trying to add flaxseeds to my veggie drinks. But I think I’m having a reaction…right after I drink my shake I feel hot on the back if my neck and I feel like my pressure has gone up. Doc, do you think is allergic reaction to the seeds? Should I try something else?

    Thank for your help!

    • Could be, but either way it’s hard for your body to digest those seeds. Gotta grind them up really well. Anybody can react to anything, regardless of what anyone says or is “documented”.

  23. Hey Doc,

    I was diagnosed with biceps tendonitis of the long head. Do you have any advice for getting rid of it? Are there any trigger points areas specific to this location? Also, are there any corrective stretches, exercises or postural changes I should make sure I am doing?

    Thanks

  24. Hi Soc Doc,

    Just found your website while I was searching for Achilles Bursitis/Retrocalcaneal Bursitis. Need some help understanding this new injury that I now suddenly have. A quick background: I been running in New Balance 759/880s (~12mm heel-to-toe drop) up until the end of last March, culminating with a marathon at that point. After that, I been experimenting with Vibrams and Merrells since then while working on a more mid-foot strike and never went back to the New Balances. I had patella tendinitis in the past and I never had any discomfort running in a lower drop shoe so I was sold! I ended up sticking with the Merrells (zero heel-to-drop) for longer distances and worked my way up to a half marathon that I completed back in Oct. Along the way, I had some calf discomfort and a serious bout of plantar fasciitis on my right foot. The calf discomfort became hard to run on so I had to stop running after the half marathon and decided that I needed a shoe with a slightly larger drop since my calfs were not strong enough just yet. I ended up going with the Brooks Pureflows and they felt great. That 4mm drop was my sweet spot! Been running in them for the past 10 weeks and just reached the 200 mile mark when I noticed a pain I never felt before at the back of the ankle by the heel. I read about your treatment recommendations and I am just starting them (i.e. apple cider vinegar and fish oil) but I want to know what the root cause of this new injury is so I can take measures in preventing it from occurring again (or getting worse). The only thing I can think of is that I started bringing back the long run every Saturday since buying the shoes and my once-a-week long run is typically 10-13 miles and perhaps I am going too far? I went up to 14 a couple of weekends ago by accident (got lost) but then went back down to 11 this past Saturday. I noticed the pain a couple of days ago when I woke up that morning. Other than that, my workout routine really hasn’t changed in the past couple of years (running 3 times a week, strength training with P90X 2 times a week, yoga maybe once a week or rest 2 times a week). Appreciate the help and your “no stretching” post was very insightful!

    r/
    Bryan

    • With those injuries the first thing that comes to mind is some overtraining. Have you read the Sock Doc Training Principles as well as “Healthy People = Barefoot People”? That’s what I’d suggest next.

  25. I just found your website….think I am having flare up of bursitis again in right hip….fell several years ago and doctor treated me for bursitis (extended right leg backwards)…..have had problems on and off but nothing until recently….started PT for upper back pain about a month ago….doctor said degenerative ….have been doing exercises for shoulders, upper and lower back and some hip ones….have arthritis in lower back and some in hips too..got up and put weight on right leg few weeks ago and had pain (where bursitis would flare up)…would grab when I would get up (sometimes) sore and tender in area…PT thought bursitis and put a patch with medicine on it…..symptoms got better. Continued exercises and few days ago flared up….pain, tender and sometimes grabbing…also sore to lay on at night…. I was laying on right side at night (because I hurt left shoulder and PT told me not to lay on left side)….have read this could cause flareup of bursitis….laying in one position at night. Usually sleep mostly on left side…supposed to help acid reflux too (which I have)…I have read about the apple cider vinegar..heat/ice and what else can I do to improve symptoms..I should have treated it more aggressively when it started but thought it would get better…she recommended taking anti inflammatory (it does help) but upsets stomach….it has also been painful in groin area occasionally but mostly outside of leg…I ordered some DMSO to apply to outside of leg……..could it be trochanteric bursitis…PT said it shouldn’t hurt in groin area (she said that would only be arthritis)but from what I have read it can…I am 63…should I continue exercises or rest.. the pain is worse when I get up from being seated, or from prolonged walking or climbing stairs…..other natural alternatives for the inflammation…..I usually ride an elliptical but haven’t for last month or so because of upper back pain….what causes it to be a grabbing pain occasionally?…do I need to work on certain muscles, etc. I don’t have as much flexibility in right leg/hip area as I do in left…did switch to bedroom with firmer mattress about 2 month ago (thought it would help upper back)…..thank you so much for all of your wonderful information! I am so glad I found your site…………..

  26. This is great information! I have been dealing with tendonitis in my hips (the sides, along my outer thighs) for over a year now, (and now some bursitis too). I have been to 2 doctors, an orthopedic surgeon, and a chiropractor and haven’t had any relief. The doctors just put me on anti-inflammatory medicine and tell me to ice it. None of it has helped even a little bit. I excercise regularly. I have stopped doing any lower-body moves, stopped pretty much all cardio with the exception of walking. I’m really getting desperate, I don’t know what else to do. I am only 30 years old and take good care of myself. Is there anything else I can be doing to heal? Thank you!

  27. I’ve had bursitis in both of my hips for 5 years and nothing seems to get it to go away, the pain isn’t always at a 10 but in the last two years I have become more of an athlete and now the pain is way more intense. As well as the PF I experience, which I am doing away with my $350 orthotics and just following your exercises instead. So are you saying that simply adding some apply cider vinegar to my diet will make it, the bursitis , go away?

  28. hay dr my name is gareeb im a med college student i have that pain in the left heel since 4 month and its not going away even getting worse i tend to play football 2 times a week and that preventing me now and its something really sucks … i went to a orthopedic dr and he diagnosed me as retrocalcaneal bursitis ..r and he prescribed anti inflammatory drugs , cold compress i wanted to ask u how long it takes before i return exercise normally again ?? .. its been 4 month now …
    P.S i had this condition first time last year and it took 3 month to go away and now its coming back again

    • You should look for a doc who can help you figure that out, and check out the Achilles Tendonitis Video here on the SD sit. Since the injury came back, you haven’t yet figured out the cause.

  29. Hi,
    I read your website on bursitis and thought it was informative. What would you suggest for someone like myself who has cystitis and needs an alkaline environment. An acid environment creates bladder problems for me. I can’t have any vinegar at all and have to have more calcium based foods to control my cystitis. (I tend to get bladder infections when my urine is too acidic) Any suggestions for helping my hip bursitis in lieu of this situation? Any and all comments would be appreciated. Thank you.

    Karen

    • That would require an individualized assessment to see why you have the cystitis.

      • Thank you for your response. They don’t seem to know why I keep getting bladder infections and have cystitis. Can you offer any suggestions on where I can go to find out further information on this problem. Any suggestions would be helpful. Thank you.