Why does ice make my tendonitis worse ?

August 31, 2012 at 04:55 PM · I am getting a bad case of tendonitis in the left wrist. I have found that applying ice makes it much worse and that heat improves things a lot. What does it tell you about the injury if ice makes it worse ?

I am doing stretches and applying Voltaren gel once per day. I have cut my practise down to 30 or 40 minutes per day until this problem is solved. I work as a cleaner so 'resting' the wrist is not really an option.

I have also bought a wrist strap with magnets sewn in. Has anybody actually had any experience with these ? It sounds a bit dodgy to me but I am willing to try anything and it only cost $15 !

What about acupuncture ? Has anybody tried that for treating tendonitis and how successful was it ?

Replies (9)

August 31, 2012 at 08:47 PM · I'm not sure it tells you much about the injury. I've been told to use ice on a new injury (three days old or less), heat on an older one. I've been told to use whichever I prefer, or to alternate. If heat makes it feel better, stick with heat. Heat combined with an anti-inflammatory (aspirin or ibuprofen) has helped clear up tennis elbow for me.

Acupuncture seems to be something that some people respond to better than others. If you don't mind spending the money, it could be worth a shot.

Now, for the big question: what are you doing to make this go away and stay away? Have you seen a hand doctor and/or physical therapist? Is your violin technique or length of practice sessions contributing to the problem? If you don't address the causes, you'll have a hard time getting rid of tendinitis for good.

September 1, 2012 at 04:59 AM · I have had the tendonitis on and off for over 20 years. It started when I was learning the guitar and still flares up even though I no longer learn that instrument. I usually practise the violin for about 90 minutes per day in two 45 minute sessions. I would love to practise more but I know what will happen if I do.

I know I am pressing the strings more than I should and I am making an effort to only use the bare minimum of pressure required as per the book 'Basics' by Simon Fischer. When I am concentrating on reading music I tense up and squeeze.....not good.

There are no doctors who specialise in this sort of thing in my town ; we are too small. I use Voltaren gel once per day but I am not sure how safe it is to use long term.

September 1, 2012 at 05:12 AM · Brian - have you ever considered a mind-body link as a cause? You may want to take a look at John Sarno's books - such as The Mindbody Prescription.

September 1, 2012 at 05:57 AM · Brian,

Ice reduces swollen and heat helps the blood flow so both methods are helpful at the right time. If the problems go on for 3-6 months or more, you've got a chronic tendonitis, then ice and heat won't solve the problem and you need to get professional help. I have had shoulder tendonitis for more than 6 months and am going through pretty intense physiotherapy (twice/week for more than two months now). If leave it untreated, my doctor said it'll become calcified tendonitis and will have weakness of muscles, chronic pain, limited motion and arthritis. Did your doctor say it's tendonitis and nothing else?

In the replies of my recent blog, Jeewon Kim provided a lot of really good material. Take a good look at all the great resources that he provided there. It's eye opening.

I was trained as a nurse in China and practiced acupuncture on my patients numerous times back when I was there. Acupuncture can be effective in stopping pain for some patients and not others. Personally, I don’t think it’s good enough to only deal with pain without getting to the root of the cause of the pain. And contrary to many teachers and violinists on this site would tell you, it is not good enough to change the way you play. Yes, you absolutely need to play with proper form and as little tension as possible, but each person is different and violinists are rarely also trained to deal with health issues, I’m sorry to be so blunt.

This is why I prefer to work with a doctor and a qualified physiotherapist instead when it comes to tendonitis, or anything health related. I get them take a good look at my structure, work on my tissues and get the education I need to move properly to prevent future similar injury. A physiotherapist should also teach you certain exercise to strengthen the muscles to support the wrist for the kind of activities you are doing.

Specifically, Google active release and look up the other discussion on the similar matter. Also read up on trigger points. But again,at least get checked with a physiotherapist (preferably someone knows a lot about sports injury) to see how serious the problem is.

Hope this helps and get better soon.


September 1, 2012 at 04:53 PM · Yixi : It is difficult to find a health specialist in my town who knows much about this sort of problem. The larger capital cities would certainly have plenty of such people but not in Cairns.

You are right about the acupuncture ; it will only mask the pain and is not the right way to go. I should already have thought of that.

I once had frozen shoulder (left side) for 3 months and that was only fixed when I happened to pass a Chinese massage shop in Townsville whose sign mentioned 'frozen shoulder'. After a very painful 30 minute session I came out with bruises all around the collar bone and neck area but things immediately felt better and over the next 2 weeks full movement was restored. All this for $30 and one massage ! Sometimes you just have to find the right person and the right treatment. It can seem like magic when this happens

I have had Myofacial Release Therapy for other problems in the past. It was quite helpful but no miracle cure. I might consider trying it again for this problem but it is not cheap.

Andrew : Yes, you are quite correct. I have to make a very big decision in the next few months and no matter which way I go somebody will not be happy. It is a very stressful situation.

September 1, 2012 at 06:39 PM · Hi Brian, I sprained my left wrist a few years back and had to work through it (I had to play a show the evening of the sprain.) The pain lasted well over a year, and I had recurring pain for a couple of years after that. I suppose it might have been uncanny timing, but I believe mobilizing finally got rid of it. Too bad I found out about it so late.

There's also another type of mobilizing which is more for your quality and clarity of movement, than easy repetition. If you're able, you might apply this to your actual playing, using slow, mindful, gentle motions, making adjustments and refinements (the sort of practice we're supposed to do a lot of on the fiddle anyway,) but always without going into any pain.

Don't discount trigger points in and around your shoulder too. Some of them refer pain all the way down your arm, triggering a sprain-like feeling sometimes in the elbow and wrist. You can try it yourself for free with resources like this and a tennis ball. A student recently strained his wrist with too much practice too soon and was able to resolve it himself in about two weeks of massaging trigger points and doing mobility exercises for his wrist (and reduced playing.)

Good luck!

September 2, 2012 at 04:47 AM · Jeewon : that is an interesting site about trigger points. I will look into that as it looks very promising.

September 2, 2012 at 12:11 PM · Hi Brian, a friend of mine has had similar ongoing problems with what seemed to be tendonitis and old injury sites and various muscles flaring up from time to time. She now follows a slightly restricted diet, having eliminated all foods from the nightshade family, namely tomatoes, potatoes, capsicum and eggplant. There are no more problems, but as soon as she eats tomato, for instance, the old trouble comes back within a day or two. If it isn't too hard, try this for a few weeks, just in case it helps. You have nothing to lose by giving it a shot.

September 2, 2012 at 05:52 PM · Speaking of diet, if you have any gluten sensitivity/intolerance, you could have developed 'leaky gut syndrome,' which can wreak havoc on your immune system and contribute to low grade chronic inflammation.

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