Tendonitis: Mobilize or not to Mobilize

I get questions like this a lot—“I have tendonitis in my elbow (wrist, ankle, or whatever).  Is it better to immobilize it or to keep it moving?”  It is true that for some injuries immobilization is a must, like for broken bones.  The bones need to be immobilized in order for them to mend back together.  However, in my opinion and from my own personal experience from having tendonitis (a repetitive use injury) in tendons around my thumb/wrist several months ago, I can assure you that gentle mobilization was a big help in healing myself up and getting back my full range of motion.  I coupled the mobilization techniques with massage, soaking in Epsom salts (see previous post Relieve Your Pain with a Soak), and Restorative Exercise techniques to mobilize and strengthen the muscles surrounding the joint.

Therefore, my recommendations are as follows if you have tendonitis or any other repetitive use injury:

  1. As with all my recommendations, check with your healthcare professional that the following recommendations would be beneficial for your situation. Once you have the okay from your healthcare professional, work closely with your Massage Therapist and Restorative Exercise Specialist (or Physical Therapist) before and during these recommendations to be sure you are doing them correctly and safely.
  2. Find a good Licensed Massage Therapist and see them one to two times a week in order to help the muscles relax so that stretching and strengthening will be much more effective. A bonus with massage therapy is that inflammation will also be reduced.  Between sessions, self-massage the area.  Your massage therapist should be able to instruct you on what to do.
  3. Find a Restorative Exercise Specialist or other corrective exercise professional like a Physical Therapist and go to them one to two times a week. The exercises and stretches you learn in these sessions should not be limited to those sessions alone.  You should do them as often as you can throughout the day.  Set time aside to get through all of the exercises 3-4 times per day.  Then, between those exercise sessions keep the muscles around the joint gently moving/stretching.  With my thumb/wrist tendonitis I was always stretching it—stretching my thumb, fingers, and wrist.  For example, when a client came in and I was talking with them, I would be stretching my hand under my desk.  I did not have to set time aside for this.  This is just one example of when I would do this.  It was an all-day activity.  I found that when I was not moving it, it stiffened up.  First thing in the morning was the worst, as it was not moving (not moving=immobilized) all night.  Therefore, before I got out of bed I self-massaged it and stretched it until I was able to move it as free as it was going to be at that stage of healing.  I also did a lot of strengthening exercises and kept challenging, in a very gentle way, my range of motion.  I was not satisfied until I achieved full range of motion, so this stretching and strengthening did go on for several months until it healed completely.  It is a slow process, but do have patience with your body because it will heal.  The stretches and exercises should be challenging yet gentle.  Your therapist should be able to help you define what is challenging yet gentle as opposed to what is too much.  Also, it is very important to listen to your body.  You should inherently know what is good for you versus bad.
  4. Soak every night before going to bed in order to reduce the inflammation. See my previous post Relieve Your Pain with a Soak.  I liked doing this before going to bed for a couple of reasons—(1) It relaxed my entire body–not just my arm–making sleeping easier.  (2) It reduced the inflammation and my thumb/wrist was allowed to rest and heal overnight.  This also allowed for some rest of the tendons without doing activities that would cause swelling, and I also woke up with less swelling than I would have if I did not soak before going to bed.
  5. Lastly, and most importantly—avoid any repetitive use injuries by varying up your activity and not doing the same thing in the same way all of the time.