Flux Health Forum

Ongoing log of wife's treatment of tendinosis

It apparently happens to some people, not to others. If it happens, try spreading out smaller doses throughout the day.

BTW, this is a side effect of basically every food and medication at sufficient dose for any given person, so it more or less goes without saying I think. As an example, my limit for chocolate peanut butter ice cream is 2 pints in any 1 hour period. So, to get in my daily minimum of one gallon, I have to spread it out during the day. But apparently I tolerate GLY very well (as I mentioned in the link I pointed you to), so I can take at least 10 grams at one time. I have a close friend who seriously needs GLY, but unfortunately he can barely tolerate 1 gram at a time, so he takes something like 500 mg every 2 hours.

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Interesting, thanks!

Hey @Bob, I hope you aren’t really eating a gallon of chocolate peanut butter ice cream a day as we’d like to see you around minimum for another 40 years with your engineering excellence and honesty. :grinning: :rofl: :joy:

Well, OK, the ice cream was a joke, but as I age I really have lost my ability to eat/drink certain foods. For example, fresh squeezed fruit juices really harm me if I try to drink more than 1 or 2 ounces. On the other hand, I can handle dairy products without any apparent problem.

Without getting into the discussion of what is and is not good to drink, my point here is that as we age, it is pretty clear to me that we lose our ability to absorb and process certain types of nutrients. As an example, it has become very clear that older people are really deficient in GLY, just based on skin collagen content (other tissues too, but these are generally less well studied). As much as anything, it might involve a decreasing ability to absorb/transport/process this nutrient.

As in the example of my friend who can not tolerate large amounts of GLY as a supplement… why should that be any different than GLY in collagenous foods?" We may be getting some insight into the fact that for this person GLY is poorly handled digestively, and it only really shows up as a problem when he tries to take a few grams in a more pure form. But for smaller amounts in food this may just be an inability to absorb/transport/process GLY that does not show up as gastrointestinal distress, but the other digestive problem persists.

Of course we could argue that taking GLY in its natural form essentially as long-chains of collagen might make it less of a problem than taking pure GLY. But I think the issue here is pointing to something I have suspected for a long time: we simply do not absorb nutrients as well as we get older. Getting them in whole foods may or may not be the answer. Sure, no supplementation to a rich whole food diet may be the answer when you are 26 years old, but maybe not so much when you are 62.

I am sure this conjures a lot of hate in some people. But growing scientific evidence does show that we really need certain things as we age that we really can no longer get just from diet alone. I am of the opinion that GLY becomes one of these as we age.

Fermented foods seem to be an important part of the answer, but I also am gravitating toward the opinion that supplementation becomes more essential for many people as they age. I am much more inclined to think this way now.

So, I would be very interested to hear if anyone knows of or has experimented with ways to improve the ability to take supplements in bulk amounts, such as several grams of GLY per day, for people who are sensitive. The main way that I know of is to take smaller amounts spaced out throughout the day. Has anyone experimented with trying to combine bulk supplements such as GLY with other foods to aid absorption? Maybe simply combining it with muscle protein or Whey protein would help?

Fascinating info Bob, thanks! Getting back to my wife’s A9 protocol, is it possible that after 10 hours/day for 6 months her body developed tolerance and that she may benefit from resuming after a several week break?

Habituation is certainly possible. I did design the pulse patterns to minimize habituation. Mostly that seems to have worked, but still I think if is a good Idea to take an occasional break, or to change pulse patterns (if you have an M1 or C5), or to change the coil positions from time to time.

Just four A9s that I attached to her socks with velcro. I’ve got a C5 and the coil mat but it hasn’t been practical to use on her for long periods. Will restart the A9s mid-May and see what happens.

I think you are on to something. I also think something like GI MAP with Zonulin provides a lot of actionable insight when properly interpreted. High Zonulin, High Calprotectin, Low Elastase can be in part mitigated by supplements like sodium butyrate, tributyrin-x to lower zonulin and tighten protein junctions, pancreatic enzymes to ensure proper break down of food, among others. I have seen in our family what dysbiotic gut does to a young person on vitamin and mineral levels - entirely deficient across the board. Seems like Glycine is another key part to GI health which makes sense given collagen production is key. This may also explain why taking Perfect Amino has helped my gut health.

Its a topic of importance to health, with a great amount of human need but a paucity of solid information. That makes it crucial for broad and detailed study, but also ripe for fraudsters and charlatans. I need to think about some reliable guidelines for separating the nuggets of truth from the ocean of rubbish science on this topic.

UPDATE: This may be preliminary but my wife’s foot pain seems to have decreased substantially and we are only doing 3 things differently:

  1. NAC 2x/day
  2. 3 additional grams glycine/day (in addition to the 3 grams in Vital Proteins)
  3. Doubled her LDN dose to 4mg. This may be the most significant.
    Notes: LDN was originally used to put her RSD in remission. RSD caused her tendinosis originally. But now we’re thinking her slow healing and tendon pain is actually low-level RSD and that at this point, her tendinosis is triggering the RSD instead of vice versa. Also, NAC is a mandatory treatment in Finland for RSD. We shall see. Have not restarted A9 coils yet, want to see how this plays out.
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have you heard of or tried earthing? it has some very interesting positive effects for pain and inflammation reported by many people… very similar to how people have had great experience with pemf. quite amazing actually. worth investigating and trying out for your wife’s situation

Thanks for the suggestion but as I’ve said elsewhere, we tried an earthing mat for several months, 10 hours a day and it did absolutely nothing.

that’s a real bummer. I’ve been experimenting and what i can measure is interesting. body voltage drops to 0 vs 110mV (after i removed the resistor)… consistently my Garmin watch measured my avg stress level during sleep at 8-12 vs 22-26 without grounding… and that average seemed consistent once i got my setup consistent.

as for what the cumulative benefits can be seems to vary person to person like any natural therapy.

I’ve been doing 2 months now and sleep quality is good for stress but i have yet to notice solid, longer sleep, which is what I’m trying to include too… just weird.

no particular pain nor inflammation to address or test. maybe some leaky gut and related eczema that i recently properly recognized thru gut testing… but dunno if this earthing thing will help.

I’m earthing at 0mv consistently for maybe 5h a day but will try longer to see how that goes. :thinking:

i know earthing does affect numbers, but how it benefits/manifests is not clear nor same for everyone. i think what is measurable is heart rate (hr), hrv (hr variable - which is another value used to measure stress level) and is notably affected. i suspect the numbers that I’ve been reaching are equivalent to relaxation thru breathing or meditation exercises. what i like about it is the set and forget part of the usage.

lastly, these numbers became consistent only when there is good skin contact, consistent thru the night. i used my own copper top setup vs the mats they sell, but i would guess (?) the results should be similar with a purchased setup. the Garmin watch and a multimeter are what i use to measure results and effectiveness.

and yes, not trying to sell it, but just trying to share my experience so far

Well unfortunately I can now say conclusively after many months trying every A9 combination that they did little or nothing to improve my wife’s foot tendinosis. We stopped about a month ago. As I’ve said before, this is very disappointing as the A9s cured my plantar (permanently…I hope) and my rotator cuff pain every time it flairs up.

What may now be helping my wife is several hours a day using a combination infrared mat/and infrared lamp combined with gentle physical therapy. We shall see…

The way I think of PEMF is its use as an adjunct to other treatment strategies. Sometimes PEMF alone is not effective. In the case or tendon and ligament injuries, I am of the opinion that the best approach especially as people age is usually a combination of nutritional + biomechanical/kinesiological + PEMF. Here is my reasoning:

Nutrition:
As we age, most people become deficient in several amino acids that are considered “non-essential” because the body can make these… but not nearly enough as we age. So, recently, some people are calling these “quasi-essential” (or a similar term). Many people over the age of 50 have very low levels of glycine, for example. These low levels of glycine correlate very closely to the commonly observed thinned and weakened skin of the elderly. Recent research has suggested very strongly that supplementation with glycine can greatly improve skin health. We think this is also true for the less visible but equally important tissues such as tendons and ligaments because collagen is about 1/3 glycine. Further, as people age they progressively lose the ability to digest and absorb some nutrients. It’s not really possible to get enough glycine in your diet unless you eat a lot of skin and tendons. The arguments here have convinced me that tendon, ligament, and skin health for people over 50 requires dietary supplementation with glycine. This is just one example of the importance of nutrition for tendon repair.

Biomechanical/kinesiological:
Recent research has shown that the way that you brace and physically load a torn tendon or ligament can have a major impact on the ability of the structure to heal. Here is one example of this research:

Most braces are designed to minimize pain and/or provide stability for locomotion, but not optimized to actually promote healing.

My opinion: we are just at the beginning of this new approach to ligament and tendon repair, but the physical support of the tissue appears to be very important to enhance recovery.

PEMF:
In my opinion, the main benefit of PEMF is the reduction of pathologic inflammation, which then allows the tissue to begin and sustain the recovery process, so long as there is adequate nutritional substrate (collagen peptides, for example), and physical support and positioning to promote healing.


"Easy for you to say, Bob…"

OK, fair enough, everyone has an opinion. But I am usually pretty careful about voicing my opinions unless I am pretty sure that I am being helpful. In this case, I applied exactly the three points listed above to fix my shoulder impingement. Here is my experience with this:

A few months ago I started to have very severe shoulder impingement in my left shoulder. This is probably because I have always been a left-side sleeper. I had progressively lost a lot of shoulder strength and range of motion of my left arm, but for some reason it really flared up a few months ago.

The pain was extreme, and my left arm quickly became almost useless. I thought OK, no worries, ICES-PEMF will fix this right up. So, I went ahead and tried it… and tried it… and tried it. But the pain just got progressively worse and there was no relief. ICES-PEMF alone was clearly not enough, and may have actually been making things worse.

I was pretty desperate, but finally found one arm support/position that was not excruciatingly mind-numbingly painful, so I took the opportunity to think clearly about this severe problem to try to find a solution.

The first step was nutritional. I made sure to supplement adequate collagen peptides, especially glycine. That was easy. For me, this is a permanent life change, and I was well along the way to doing this already when shoulder impingement became a problem, so I just made sure I was doing enough. But note, nutrition alone was not enough to fix the tendon/ligament damage from shoulder impingement.

The hard step was the biomechanical/kinesiological part. First, I had to identify the problem and correct that behavior. In my case it was that I was side sleeping. I had to change that. There is plenty of information available about this, so I will refer you to that, but side sleeping was the causative problem, and I had to fix that problem first, because any other attempt without fixing the causative problem would be pointless and ineffective.

But for shoulder impingement there is another important biomechanical/kinesiological consideration: shoulder repositioning and shoulder muscle exercises. There are some pretty good YouTube videos describing the biomechanics of the muscles, tendons, ligaments, and bones involved, so I would refer you to those. Some explain the tissue biomechanics, while others suggest exercises. But the bottom line is that once you stop screwing yourself up (by side-sleeping in my case), you need to reposition the bones of your shoulder to relieve pressure on a tendon, then strengthen your stabilizing musculature and shoulder ligaments to hold things in place to prevent future problems.

My first approach was to use a rope to help me pull my left hand behind my back to improve range of motion and help reposition the bones of the shoulder. This was actually pretty helpful and gave me some relief. But in my case the best solution was to hang from a pull-up bar. Just hang as long as I could. Initially, this was nearly impossible and horrifically painful. Initially, I had to lift my left hand to the bar using my right hand. And there was no way I could actually “hang” my full body weight, so I just bent my knees to transfer as much of my weight as possible to my arms as I held on to the bar. I do this several times per day, trying to hold for 20 to 30 seconds each time. Just yesterday I finally was able to support my full weight with only my arms (yay!). If you don’t have daily access to a pull-up bar, they are relatively inexpensive. This is the one I bought from amazon:

This is a cheap one, but there are plenty of other ones with more bells-and-whistles. Just search amazon for “pullup bars for home door”.

I put it on the door to my closet in my bedroom, and now I hang several times per day. Hanging has been immensely helpful. The process was very painful, but now after a couple of months of work I am almost totally pain free from shoulder impingement.

PEMF:
As I said my initial use of ICES-PEMF was not at all helpful, and may have even been making it worse. I had (stupidly) out of desperation used a stack of coils from a C5 at full power… and it had zero beneficial effect after weeks of trying. As I tell everyone as related to power: “Too much is too much”. But I changed my strategy when my biomechanical/kinesiological interventions began working (which was almost immediate when I started them). I now wear an A9 during the day, with coils stacked, set to “M” (medium) power.

When I intelligently combined nutrition, biomechanical/kinesiological interventions, and PEMF, the shoulder impingement problem has almost entirely gone away, and now my shoulder and arm strength and range of movement is far better that it has been for many years.

Bottom line: Tendon and ligament injuries are among the most challenging to deal with effectively. Single treatments do not seem to work in some cases, and it is necessary to use combined nutrition, biomechanical/kinesiological interventions, and PEMF.

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Thanks for the detailed reply.

Yes, she’s doing the glycine at your suggestion. Will try increasing amount. Also collagen. Also going to be zooming with a new Dr. who is an acknowledged expert on tendinosis.

The pull up bar hang was actually the post-surgery rehab my surgeon told me to do for both of my rotator cuff surgeries. Btw, unless your shoulder is completely better, you might want to get an MRI. Hopefully unnecessary…

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My extra-long response was my attempt to collect and generalize my thoughts on tendon/ligament repair. Having direct experience with it and having done a lot of research on the topic, the best overall opinion I can offer is the challenging but remarkably effective approach I describe above.

More specifically for your question:
Have you been able to find anything in the “biomechanical/kinesiological” category related to your wife’s tendon problem? This would include both correcting the causative problem as well as positioning/physical bracing/exercises that could enhance recovery? This for me was the hard part, probably at least 99% of the work.

I am still in the recovery/strengthening process, but my shoulder is really much better even than it was years ago. The cynical voices in my head say “go ahead, get an MRI so they can tell you for sure that you have a problem that (once again) they can do nothing about”. But I might be missing something… do you have in mind a compelling reason to get an MRI?

Thanks, I appreciate it. My wife has seen 6 physical therapists since this all started in 1990. They were all terrible and made her worse except for the most recent one because they didn’t understand the RSD-tendinosis relationship. This last one tho is out of ideas. Btw, her first doctor in '90 braced her feet after the injury and THAT was what caused the RSD. He was an arrogant idiot. Took 16 doctors back then to diagnose it. We’ll be zooming with a tendinosis expert in a few weeks. Based on all the PT docs she’s had, my wife has put together her own exercise regimen based on all their regimens. Regardless, tendinosis means that the tendon cells are repairing/reproducing defectively. The only remaining therapy would be stem cells, except that would require injections at the RSD sites which will trigger an RSD flair up. Right now her RSD is held in check by low dose naltrexone. Also all the stem cell treatments in the U.S. are fat-cell derived and therefore weak, useless or corrupted. The best, Mesenchymal stem cells, are illegal in the U.S. for political/religious reasons. There is an air injector available and there is a viable stem cell treatment being developed in Canada but it is probably years away from U.S. deployment.

If your shoulder is better then forget the MRI. My surgeon said tho that if your shoulder is too painful to sleep on you prob should get an MRI because you prob have a tear. Note that a partial tear can be rehabbed but a full tear can’t be healed without surgery. Shoulder surgery really, really sucks. It worked, but I had severe damage and rehab took a full year for each shoulder. My right shoulder is fine but my left shoulder hurts occasionally when I overdo it, but so far doing 8hrs/day A9 on max/coils stacked plus laser plus DMSO takes care of it. Usually.

This is very difficult. You’ve clearly been working at it intelligently for a long time. In this particular case, considering the tendinosis, if you are able to try stem cells it will probably be very helpful to continue PEMF and probably IR light as an adjunct.

My shoulder is way better, thanks. It really feels like I am on a long but steady road to recovery, probably a partial tear which will slowly heal as I keep doing the right things (fingers crossed).

Yeah, if you’ve been improving then in my experience you’re fine…fake dr. that I am :wink: