Tendonitis: When Tennis Elbow Has You Down for the Game

A painful condition, tendonitis involves inflammation of the tendons—fibrous cords connecting muscles to bones. Commonly occurring in the knees, heels, shoulders, elbows, and wrists, tendonitis leads to swelling and discomfort when moving the affected body part.

A painful condition, tendonitis involves inflammation of the tendons—fibrous cords that connect muscles to bones. Commonly occurring in the knees, heels, shoulders, elbows, and wrists, tendonitis leads to swelling and discomfort when moving the affected body part.

You might know tendonitis by the following terms:

  • Jumper’s knee (patellar tendonitis)
  • Tennis elbow (lateral epicondylitis)
  • Golfer’s elbow (medial epicondylitis)
  • Pitcher’s shoulder or swimmer’s shoulder (rotator cuff tendonitis)

Tendonitis is also spelled tendinitis, so don’t let those variations confuse you. Whatever you call it, tendonitis causes pain and discomfort that can have a negative effect on quality of life. And while the condition usually improves on its own with rest, more severe cases may require physical therapy, medication, and even surgery to heal. Understanding the signs and symptoms of tendonitis is the first step in knowing when and if to seek medical attention.

Common Causes of Tendonitis

The most common causes of tendonitis are sudden injury and repetitive motions, such as from physical activities that put stress on the tendons. If proper technique isn’t followed, tendonitis or tendon rupture can occur.

Risk factors for tendonitis include age— it’s inevitable that as we age, our tendons become less pliable—occupation, and certain sports. Jobs that involve repetitive movements or forceful action, such as frequent overhead reaching, can cause irritation of a tendon. Sports injuries that cause tendinitis are common among tennis players, runners, golfers, swimmers, bowlers, baseball players, and basketball players.

Tennis Elbow and Tendonitis Symptoms

Wondering if you’re suffering from tennis elbow or just a mild cause of overexertion? Here are some of the primary signs and symptoms of tendinitis:

  • Pain that worsens with movement
  • A cracking or grating feeling around the bone
  • Swelling
  • A lump near the affected tendon

Despite the name, tennis elbow often occurs in people who have never picked up a racket. In fact, the condition may occur in anyone whose work or hobbies involve repetitive motions of the wrist and arm. To that end, tennis elbow is common in painters, plumbers, and carpenters as well. Older people are more likely to get tennis elbow, as tendons become less flexible with age.

If you’re suffering from persistent pain around your elbow that spreads into the forearm and wrist, or if you’ve noticed a bony bump on the outside of your elbow, don’t hesitate to seek medical attention. Left untreated, tendonitis can cause a more serious condition called tendon rupture, which often requires surgery to repair.

Tendonitis Diagnosis

Your health care provider will determine if you have tendonitis or a related condition by taking a medical history and conducting a physical examination that assesses range of motion and discomfort in the affected area. Be upfront with your work and physical activities, including any new sports you’re trying out, so the doctor can consider contributing risk factors.

Your physician may also order X-rays to rule out arthritis or a fracture and blood tests to rule out conditions such as rheumatoid arthritis. Your doctor may even go a step further and order an MRI scan (magnetic resonance imaging) to see changes in the tissue around the tendon.

The type of test used is greatly determined by the area affected. For instance, the Finkelstein test helps diagnose wrist tendonitis. Your doctor will bend your thumb, fingers, and wrist in a specific manner to see if the pain that results is tied to wrist tendonitis or another type of wrist injury.

Tendonitis Treatments

There’s no one cure for tendonitis. The goal of treatment is to reduce pain and inflammation while giving the body time to heal. Some of the most effective home remedies for the condition include:

  • Resting and avoiding activities that led to the injury
  • Applying an ice pack to the affected area for 20 minutes every couple hours
  • Using a compress or bandage on the affected area
  • Elevating the limb or injured body part
  • Taking over-the-counter medication, such as ibuprofen

It’s important to note that tendonitis can take 4 to 6 weeks to heal. However, more serious or long-lasting cases of tendonitis may require additional treatment. If rest and medication are doing little to alleviate your discomfort, you might want to see a doctor and/or physical therapist to discuss the following treatment options:

  • Steroid injections to reduce inflammation and pain
  • Shockwave therapy
  • Platelet rich plasma injections to encourage healing
  • Surgery to repair tendon ruptures and remove damaged tissue

Note that it could take 6 months for a tendon to heal completely after surgery.

A painful condition, tendonitis involves inflammation of the tendons

Achilles Tendonitis Treatment

Athletes and other people who spend a lot of time on their feet are at risk for a type of tendonitis affecting the Achilles tendon. With Achilles tendonitis, the large tendon that runs down the back of the leg becomes inflamed. As a result, patients may suffer stiffness, swelling, and pain that worsens with activity. Treatments for Achilles tendonitis vary based on the severity of the condition and may include:

  • Rest and avoiding repetitive motions
  • Stretching and muscle-strengthening exercises
  • Icing the area
  • Elevating the affected foot
  • Physical therapy
  • Taking anti-inflammatories
  • Wearing special shoes to take tension off the tendon

In severe cases, patients may require steroid injections or surgery to treat their Achilles tendonitis.

What Is the Difference Between Tendonitis and Tendinosis?

Tendonitis involves inflammation. When tendonitis is at play, you’ll see hallmark inflammatory signs such as warmth, swelling, redness, and pain. Take wrist tendonitis, for example. Wrist tendonitis involves inflammation of the wrist tendons and is caused by either a sudden injury or repetitive motions that cause the wrist tendons to rub against the bone. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen can help the pain as the tendonitis subsides over the course of several weeks.

Tendinosis, on the other hand, is chronic, which means continuous or recurring. It’s caused by a repetitive trauma or overuse injuries, and can take several months to heal. The main difference between tendonitis and tendinosis is that tendinosis is the the non-inflammatory degeneration of a tendon.

Amino Acids as a Tendonitis Cure

An increasing amount of research suggests that amino acids can boost musculoskeletal health and even help repair damage. When people engage in exercise, their muscles break down more rapidly, and additional protein is required to prevent minor injuries from becoming serious ones.

According to a 2018 article titled “Nutritional Research May Be Useful in Treating Tendon Injuries,” evidence suggests that certain amino acids, including leucine, arginine, and glutamine, can aid in tendon growth and healing. However, it’s always best to consume a balanced mixture of essential amino acids to ensure optimal health and wellness.

The article goes on to reveal that tendon surgery isn’t always successful, and many patients experience chronic pain even after treatment. More research is needed to determine if amino acids could be used in therapeutic approaches to tendon injuries and other problems.

Additionally, people can protect their long-term tendon health by avoiding exercises and activities that put undue stress on tendons. It’s also smart to mix up workout routines, take time to stretch and warm up, and use ergonomic equipment in the workplace.

Should I Take Amino Acids Pre-Workout?

The before, during, or after debate on amino acids for working out can leave you utterly confused as to when you should take your amino acid supplement. I’ll cover the details, but the quick and easy answer to the question should I take amino acids pre-workout is yes!

The before, during, or after debate on amino acids for working out can leave you utterly confused as to when you should take your amino acid supplement. I’ll cover the details, but the quick and easy answer to the question should I take amino acids pre-workout is yes! An amino acid pre-workout powder can help support muscle building, reduce the breakdown of muscle, increase blood flow to the muscle during your workout, and help prevent fatigue and boost performance.

Why Amino Acids Make Ideal Pre-Workout Supplements

You’re taking your sports nutrition goals seriously. You load your plate with whole foods and make sure to prioritize quality protein at every meal. Maybe you’re even incorporating protein powder or other dietary supplements into your regimen. You commit to each training session. You should be seeing major muscle growth gains and yet, you seem to be stuck.

The problem may be that you’re ignoring just how essential a role the fittingly named essential amino acids play when it comes to increasing your muscle mass. No matter how much time you put into weight training, if you fail to provide your muscles with the raw materials they need to grow, you won’t see the results you’re craving.

Key Facts About Amino Acids

You may have heard amino acids described as the building blocks of protein. That’s not a bad description, but it doesn’t entirely do justice to the importance of amino acids.

Not only do amino acids provide structural integrity to protein, but they’re also vital to the synthesis and metabolism of proteins, enzymes, hormones, and neurotransmitters. They regulate the activity of numerous metabolic pathways. They contribute to cognitive function. In short, amino acids are involved in just about everything that occurs inside the human body.

There are 20 amino acids present in the human body. Nine of those are called essential amino acids because unlike the others, your body cannot synthesize them de novo—in plain English, they can’t be made from scratch. Instead, it’s essential that you supply your body with these amino acids via the food you eat or supplements you take.

Researchers have categorized six of the other amino acids as conditionally essential. Under most circumstances, your body can produce these amino acids, but when you’re under extreme duress, that ability becomes compromised.

The remaining four amino acids get grouped together as nonessential. In some instances, you’ll see people refer to 11 nonessential amino acids—when they do so, they’re simply lumping in the 7 conditionally essential amino acids listed above. Your body absolutely needs the nonessential amino acids, but it also has the ability to synthesize them, so it’s nonessential that you get them from your diet.

The easy answer to the question should I take amino acids pre-workout is yes! An amino acid pre-workout powder can help support muscle building and boost performance.

When it comes to using amino acid supplements to facilitate muscle growth and muscle recovery, all the key players can be found on that list of the nine essential amino acids. Here are some key facts about what each of these amino acids does inside your body.

Phenylalanine 

The analgesic (pain-killing) and antidepressant properties of this amino acid typically spark the most excitement. It’s also a precursor to norepinephrine and dopamine, two of the feel-good brain chemicals. When it comes to sports nutrition, the primary benefit of phenylalanine is that due to its ability to raise norepinephrine and dopamine levels in your brain, it may lower your rate of perceived exertion during exercise, helping you stay in a positive headspace through even the most grueling endurance exercise workouts. Our bodies also need phenylalanine to produce metabolism-regulating thyroid hormones.

Valine

A true power player when it comes to muscle synthesis, valine is both an essential amino acid and a branched-chain amino acid (BCAA)—more on these later. One of valine’s main functions is preventing muscle breakdown. That means if you take valine prior to or during an exercise session, it can help decrease muscle damage, allowing you to recover faster. Valine also stimulates your central nervous systems and regulates blood sugar levels.

Threonine

This amino acid helps keep your connective tissues and muscles strong and elastic, in part because it’s a precursor for two other amino acids: serine and glycine. The benefits of glycine have received a lot of attention from researchers lately. Studies show it can encourage muscle growth as well as decrease muscle loss, among other desirable effects. Threonine can also shorten the time it takes your body to heal wounds and recover from injuries. Plus, it supports healthy fat metabolism and stops fat from building up in the liver.

Tryptophan

Another amino acid that serves as a precursor for a feel-good brain chemical—in this case, serotonin, which can help quell physical sensations of pain. That means boosting your tryptophan can increase your tolerance for pain during challenging workouts. The human body also needs tryptophan to manufacture vitamin B3, which ensures your blood sugar levels stay balanced, forestalls free radical damage, and stymies the accumulation of cholesterol.

Isoleucine

Like valine, isoleucine is both an essential amino acid and a branched-chain amino acid. It’s a crucial component of hemoglobin, the protein in your red blood cells that transports oxygen. Our bodies also use isoleucine for muscle repair, which means upping your isoleucine levels lets you bounce back faster from taxing workout sessions.

Methionine

The principal task of this amino acid is to assist your body with metabolizing fat. Plus, it provides your body with the sulfur it needs to produce glutathione, its most abundant antioxidant compound, as well as cysteine and taurine, two other amino acids that contain sulfur. Thanks to its lipotropic properties, methionine can safeguard your liver function by preventing the buildup of fats.

Histidine

This amino acid, which has some antioxidant properties itself, is a precursor to histamine and helps your body synthesize carnosine. This can directly impact your physical performance because histamine can flush the potentially damaging free radicals generated during exercise from your system, while caronsine keeps lactic acid from accumulating in your muscles.

Leucine

Along with valine and isoleucine, leucine is both an essential amino acid and a branched-chain amino acid. It’s the most abundant amino acid found in human muscle tissue. In addition to enhancing stamina and endurance as well as promoting muscle recovery, leucine initiates the process of protein synthesis and helps to maintain your body’s nitrogen balance and energy supplies.

Lysine

Research indicates that lysine can simulate the release of growth hormone, meaning it can offer vital support to your muscle-building efforts. Lysine also ensures you body properly absorbs calcium. Plus, it demonstrates significant antiviral properties and encourages the production of antibodies, making it a phenomenal immune system booster.

Understanding Branched-Chain Amino Acids

Scientific analysis shows that 35% of your muscle protein is composed of three essential amino acids: valine, isoleucine, and leucine. These are, as you may have noticed if you’ve been paying close attention, the infamous branched-chain amino acids (BCAAs). These amino acids get their name from their molecular structures, which have distinctive, branch-like shapes.

The popularity of BCAA supplements with athletes skyrocketed based on studies indicating that they can help to reduce physical fatigue, sharpen mental focus, decrease muscle breakdown, preserve muscle glycogen stores, stimulate muscle protein synthesis, prevent muscle soreness, and more.

Leucine, found in high concentrations in whey protein, is arguably the most important BCAA. But as I mentioned earlier, simply increasing your intake of dietary protein or even adding a whey protein supplement is not the most effective way to benefit from leucine or other amino acids. When taken in supplement form, amino acids can be digested and absorbed more quickly, which maximizes their impact.

As I’ve discussed in previous articles, taking BCAA supplements is also not the most effective way to increase muscle concentrations of these beneficial compounds. There’s no question that BCAAs facilitate muscle growth and optimize athletic performance, but when you take them on their own, they have a minimal impact.

That’s because in order for your body to build complete proteins, it requires all the essential amino acids—and in their appropriate concentrations. Taking a supplement that contains only BCAAs throws off your amino acid balance. Taking an essential amino acid (EAA) supplement that contains the appropriate ratios of all the amino acids needed for protein synthesis is a far better way to amplify your muscle-building results.

When Should I Take My Amino Acids?

Now that you have an increased understanding of how amino acids prevent protein breakdown, facilitate healthy weight loss, improve recovery, and increase energy levels, among other benefits pertinent to those engaged in various physical pursuits, let’s discuss the optimal timing for taking an amino acid supplement.

One of the main reasons to take amino acids for fitness is to build muscle. When you exercise, muscle breaks down in order to release amino acids for the energy the muscles need to contract. Some of the released amino acids are used to rebuild the lost muscle protein. But many of the amino acids are oxidized and cannot be used for muscle protein synthesis. That’s where taking amino acids pre-workout comes in. They help replace the amino acids that are oxidized when your muscle protein breaks down as you exercise.

Taking an amino acid pre-workout powder before resistance exercise is especially important to maintaining and building muscle mass. During resistance exercise blood flows to the muscles at an increased rate. When you ingest amino acids pre-workout, there are more essential amino acids available to strengthen and build muscle.

Taking amino acids before a cardiovascular workout, such as a high-intensity interval training (HIIT class), can help reduce fatigue by balancing the uptake of amino acids that are responsible for the production of the neurotransmitters serotonin and dopamine in the brain.

That said, taking amino acids after a workout (within an hour after exercise) gives your body a boost when it comes to replacing damaged muscle fibers with new muscle protein. Essential amino acids are also important for reducing inflammation, thereby accelerating workout recovery.

To maximize all the beneficial effects of amino acids, it’s best to take a high-quality essential amino acid blend both before and after exercise. If you’re carrying out a resistance-training regimen, you may also see benefits from taking amino acids during your training sessions. This approach to amino acid supplementation is optimal for improving muscle strength as well as accelerating recovery.

A Personal Reflection on Exercise for Older Adults

As we grow older, physical activity and strength training must be tempered with modifications to keep us both strong and safe. Exercise for older adults should be carefully structured, diligently performed, and supplemented with essential amino acids.

There’s no doubt about it: physical activity helps us age gracefully, increases longevity, and enhances quality of life. But as we grow older, physical activity and strength training must be tempered with modifications to keep us both strong and safe. Exercise for older adults should be carefully structured, diligently performed, and supplemented with essential amino acids.

New to Exercise? Here Are Some Tips!

If you haven’t exercised in years, you might benefit from some help from a certified exercise trainer to develop a program specifically designed for your capabilities and goals. You’ll see benefits from almost any type of exercise, so a trainer may not be necessary if you are otherwise healthy and mobile with good knowledge of the proper form for strength exercises. Just start cautiously and build up slowly. The key to making exercise part of your life is to do something you enjoy. From walking to swimming to tai chi…it all works!

Some of the best types of exercises are those which use your own body weight for resistance, which reduces the risk of injury while still being an effective way to build muscle strength and even muscle mass. Some examples are push-ups, including wall push-ups, resistance band exercises, balance exercises, chair squats, water aerobics, and even brisk walking. Combined with flexibility exercises, research shows these low-impact exercises contribute to better balance with a reduced risk of falls, improved overall physical health, and enhanced quality of life.

Regardless of what type of workouts or exercise program you engage in, it will be necessary to push yourself, both to create the exercise habit and to reach new performance and fitness gains. You are actually in a pretty enviable position, because you should see some rapid improvement as soon as you begin to train. The improvement will be especially dramatic if you couple your exercise with premium essential amino acid (EAA) supplements. And what better motivation to continue exercising than results you can see!

It’s also important to moderate your expectations. Please be aware that at some point you will plateau in your progress. This is a normal part of developing and sustaining fitness. When you hit a plateau, you just need to push harder and increase your activity levels to keep improving. Resist the urge to baby yourself! You are capable of more than you realize.

The key to success is consistency. You have to make exercise a nonnegotiable time of the day. Setting a schedule and sticking to it is the surest way to maintain the consistency that you need.

An Exercise Pro? I’ve Still Got Tips!

If you are an exercise aficionado, you’re starting with the tremendous advantage of being in much better shape than the average person your age. Even so, I’m guessing you still face challenges. The challenges are part physical and part psychological, and the two aspects may merge together indistinguishably. I can relate, as I fall into this group and have talked with many former athletes in the same situation.

When I was young, my athletic focus was basketball. I was even drafted by the Warriors into the NBA. When my basketball career ended, I took up distance running seriously. Although not a world-class runner, I nonetheless embraced the challenge of setting both short- and long-term goals, and I trained hard to reach those goals. Being a scientist, I approached training for marathons methodically. I carefully recorded every workout in detail, including distance, time, etc. I did interval workouts twice per week and recorded every split of every interval. I raced steadily from age 25 until last year at age 69 when I had my hip replaced.

As I got older, I faced the same challenges that all of my friends who ran faced. Injuries became more frequent and it took longer to recover, not just from injuries, but from workouts. What was most discouraging was that, regardless of my workouts, I inevitably got progressively slower over the years. At 65, I was still trying to do the same program as when I was younger, but with drastically less success. I was running quarter-mile intervals at a considerably slower pace than I could maintain for an entire 26-mile marathon when I was younger. Intellectually, I understood that the days of 65-second quarter-mile intervals were long in the rearview mirror, but psychologically, it was much harder to accept. I would look at the workouts in my running log that I used to do and feel overwhelmingly discouraged at the decline in my ability. I could understand why almost everyone I knew from years of running had given it up.

At some point, I decided that I would rather keep running at a slower pace and within my reduced capabilities than quit altogether. This is a realistic modification when it comes to exercise for older adults. I retired the old running logs and started a new one so I could train refreshed. I wish I could say that, all of a sudden, I saw the light and loved running again, but it doesn’t really work that way. I still get frustrated when I’m jogging and someone breezes by me like I’m standing still. Nonetheless, I have made enough peace with my current abilities that I keep plugging away every day. I now take naps after good workouts, as I recognize I don’t recover very fast anymore. I never question why I am still working out—it’s just what I do.

The moral of my personal story is to keep doing whatever activity or sport you love. As difficult as it may be, it’s productive to move past the dismay of needing to play from the forward tees on the golf course when you used to play from the tips, or the disappointment you feel because you can only play doubles in tennis now. The benefits of participation in activities you enjoy trump any of these psychologically “negative” aspects. The social aspect of joining workout classes in the gym or a golf group is a great hack for adjusting to retirement. You just need to let go of what you used to do, and be happy with what you can do now.

Supplements for Seniors

I have found that using an EAA supplement before and after exercise has benefited my training tremendously, especially when it comes to recovering faster. I take a pre-workout beverage that seems to give me energy to get started and sustains my effort throughout the workout. I also take a post-workout muscle support supplement that seems to reduce inflammation and improve my gains in strength.

I have seen firsthand how combining EAA supplements with exercise positively influences body composition. One of the advantages of my line of work as a researcher is that I have been able to measure my body composition on a regular basis for the past 45 years.

When I was young and training twice a day for competitions, I had about 4% body fat. I predictably gained fat and lost muscle with time, despite continued training. At 65, my body fat was 22% of my body weight. Two years ago, at age 69, I started combining EAA supplements with my normal exercise routine. Even with the surgical stress of a hip replacement, I have increased my lean body mass and reduced my fat mass to slightly less than 20%. It is remarkable to have your body composition moving in a positive direction when you are in your 70s! And I entirely credit the regular use of EAA supplements in conjunction with my habitual exercise routine for the improvements in both body composition and performance that I have experienced in the last couple of years. I hope I’ve inspired you to follow suit!

Exercise for older adults helps us age gracefully, increases longevity, and enhances quality of life.