Tendinitis

This is a common condition relating to pain in the tendon where it connects with the bone. The most frequent victim is the athlete over 30, as it often comes on after unaccustomed activity, or exercise performed without sufficient training or adequate equipment. However even D.I.Y. or gardening can bring it on.

It causes pain that is triggered or made worse by tensing, or even touching, the affected tendon. The areas most vulnerable to tendinitis are the shoulder, where it causes what we call 'frozen shoulder', the elbow ('tennis elbow'), the tendons of the kneecap, and the ankle, where it may cause an inflamed Achilles tendon.

If tendinitis comes on for no apparent reason, if it does not respond to treatment, or if it keeps recurring, you should control your levels of uric acid, and see if there might be some unsuspected source of dental irritation that is causing it. A full X-ray of the teeth should reveal any problem areas.

Important advice

• Be sure to warm up properly before starting any athletic activity
• Be careful to do some 'cooling-down' stretches when you have finished. No dancer or athlete finishes a performance or competition without stretching afterwards
• Always use the appropriate equipment
• Do not play tennis in jogging trainers (which do not provide the stability you need for lateral movements), or go for a run in tennis shoes (which are too heavy, and unsuitable for running)
• Avoid borrowing your friends' equipment - someone else's tennis racquet may be too tightly strung for you, for example, or the handle may be too big or too small

Dietary advice

Some doctors and sports trainers hold that it is an excess of acid that either causes, or at least supports, tendinitis and other pains and inflammations. It makes sense, then, to counterbalance your diet with alkaline foods (which will neutralize the acids), following the rules set out by naturopaths:

• You should avoid fatty meats (such as pork, mutton, and lamb), smoked or tinned fish, cheeses (the stronger their flavour, the more acid they contain), fried foods, crisps, seasoned and roasted nuts, cakes, spicy foods, vinegar, refined sugar, syrup, jam, chocolate, honey, coffee, tea, cocoa, and alcohol
• You should limit your consumption to no more than two servings per week of the following foods: eggs, lean meats, yoghurt, acidic vegetables (watercress, sorrel, rhubarb, tomatoes), citrus fruits (oranges, lemons, grape fruitJ, acidic fruits (gooseberries, black currants), fruit juice, and sweetened, prepared drinks
• You should eat plenty of fresh fish, raw and cooked vegetables, leafy greens, soya milk, cereals (for example, oats, muesli, whole-grain rice, rye bread, and tapioca), fresh, unroasted nuts (such as almonds and walnuts), low-fat fromage frais, bananas, pears, and alkaline mineral waters such as Badoit

This type of regimen should be followed for one month. If at the end of that time you notice an improvement, you can reintroduce the excluded foods from one of the groups twice a week. If the symptoms recur, resume the diet for a month.

Non-medicinal measures

• Rest is the rule, but you can still continue to exercise, as long as you avoid the movements that cause pain, prolong the inflammation and delay healing. As an example, tennis players can continue to practise, provided they avoid serves and backhands if those are the moves that cause pain
• Cold should be applied either by means of ice cubes (wrapped in a cloth to protect the skin), or ice-water packs. A 10 to 15-minute treatment is invaluable when used right after exercise, but remember that ice cubes from the freezer chill the skin more quickly than cold packs from the fridge

Acupuncture

This treatment is highly recommended for tendinitis.

Treatment Schedule: Three or four sessions, four to five days apart, may well be enough to bring about a noticeable improvement.

Mesotherapvy

This is the complement to acupuncture, involving tiny injections of very diluted remedies into the painful area. The solution is not injected directly into the tendon, and no cortisone is used, unlike most orthodox medical injections. There is no set number of sessions.

Treatment Schedule: Three sessions, one week apart, may be enough to end a bout of tendinitis that is still in its early stages.

Magnets (Magnet therapy)

The disadvantage of magnets is that their effectiveness is somewhat unpredictable. However, they are so simple and harmless to use that they are worth a try.

- Attach two or three small magnets to the affected area with adhesive tape or plasters and keep them on overnight

Manual therapy

These treatments (osteopathy, chiropractic, or vertebrotherapy) can sometimes identify an underlying structural problem, which they may be able to correct

Kinesitherapy and physiotherapy

Using 'deep transverse friction massage' (DTFM) is effective, if not exactly enjoyable. Massage can be supplemented by other physiotherapy techniques and resources, such as medical lasers.

Herbal remedies

Horsetail and white wiDow

Possible Prescription: Ask your herbalist to make up 30 capsules of 150mg of a blend of dried extract of horsetail and white willow for each NO.2 capsule (the size of the capsule that the herbalist will use for the ingredients). Take one capsule three times a day for ten days.

Horsetail

The non-flowering plant's active principles are contained in its long, fluted stem. It is especially rich in silica, which makes it the best-known plant remedy for mineral deficiencies.

White willow

Named for its silvery-white leaves, this tree's bark contains natural aspirin compounds. It is used both to bring down a fever and to treat rheumatic pains.

• Ask your herbalist to make up a 60ml bottle of white willow in a whole freshant suspension (this formulation's lid stabilization process restores the full natural therapeutic effect of the ant). Take half a teaspoonful in a little water twice a day
• Or 'Nature's Plus' Willow Bark; each capsule contains 500mg of White willow.
  - Available in containers of 30 capsules
  - Take one capsule daily

Plant essential oils

juniper, mint and wintergreen

Possible Prescription: Ask for a cream made up of the following ingredients:
1 gram of essential oil of juniper, 3 grams of essential oil of mint, 2 grams of essential oil of winter green, made up to 50 grams with carrier cream. This is to be applied two or three times per day for several days

Homeopathy

Arnlca and Ruta graveolens

- Four 5c tablets of one or both of these remedies to be sucked slowly like sweets two or three times a day for several weeks

Arnica montana

- Vegetable origin: the leopard's bane plant
- The specific homeopathic remedy for bruises and the after-effects of injuries

Ruta graveolens

- Vegetable origin: the sap of the rue plant, whose strong, unpleasant smell was believed to ward off the plague
- The specific homeopathic remedy for ligaments and tendons

• You could also try Arnica-Heell@ (Heel), containing Rhus toxicodendron D6, Arnica D3, Bryonia D4, Dulcamara D4...
  - Available in drop bottles containing 30 and 100ml
  - Ten drops three times daily
• You could add a topical ointment such as Weleda Arnica ointment:
  - Available in 25g tubes
  - To be applied three or four times daily.