Percentage of adults
45 to 64 who report joint
pain in the past 30 days
16 AARP THE MAGAZINE / AARP. ORG
our bodies don’t fully recognize that
an injury has taken place.
But if our bodies remain oblivious,
not so our brains, which can’t ignore
the pain. Amazingly, says Dimeff,
researchers still don’t know exactly
what causes this. One theory holds
that as scar tissue slowly builds up at
the injury site, tiny new blood vessels
allow pain-conducting nerve fibers to
proliferate. “Different experimental
techniques can choke off these tiny
vessels,” Dimeff says, “killing the
nerves they supply, often eliminating
the pain.”
And not all tendons are equally sus-
ceptible to tendinosis—a small hand-
ful account for most problems. These
include the rotator cuff (swimmer’s
shoulder), the patellar tendon (run-
ner’s knee), the tendo achilles (Achil-
les’ heel), the medial epicondyle (golf
elbow), and my own nemesis: the
lateral epicondyle (tennis elbow).
Different sports may have led to the
popular names for these conditions,
but they aren’t restricted to athletes.
Tennis elbow, for instance, can be
instigated by any repetitive motions
that stress certain muscles in the
forearm and wrist. Gardening, hoist-
ing trash bags, wringing out towels,
and even typing are frequent triggers.
Likewise, washing windows, painting
a ceiling, or other chores requiring
prolonged overhead use of the arms
can lead to swimmer’s shoulder as
easily as a Michael Phelps workout.
The physiological underpinnings
of tendinosis are still far from fully
understood, though age clearly plays
a role. “We rarely, if ever, diagnose it
in a 14- or 15-year-old,” says Dimeff.
“It’s usually not until the 20s and 30s
that we start to see these problems.”
By age 50 and older, most of us have
accumulated no shortage of wear
and tear and have become, as a result,
especially vulnerable.
Fortunately for today’s tendino-
sis sufferers, innovative treatments
designed to rally the body’s innate
healing reponse are now becoming
available at specialized orthopedic
clinics and sports medicine centers.
These include:
SHOCK-WAVE THERAPY Shock
waves are delivered via a handheld de-
vice placed directly against the injured
body part. “It literally feels and sounds
as if you’re getting hit by a jackham-
mer,” says Alfred Cianflocco, M.D.,
director of Primary Care Sports Health
at the Cleveland Clinic. Cianflocco
underwent the procedure after a bad
case of golfer’s elbow failed to respond
to ice, anti-inflammatory drugs, wrist
splints, and elbow straps. A typical
session can last about five minutes; the
more discomfort you endure in that
time, says Cianflocco, the better your
long-term results. Within weeks of his
own treatment, Cianflocco threw away
his elbow straps and returned to golf
and gardening pain-free.
NEEDLING In a procedure called
prolotherapy, a doctor uses a hypoder-
mic needle not to inject therapeutic
medicine but rather a “known
irritant,” from talc to dextrose, into
the injury site. The rationale stems
from the realization that one long-
time orthopedic staple—cortisone
shots—works not so much because
of the cortisone, which is an anti-
inflammatory hormone, but because of
the micro trauma caused by the needle
itself. Cortisone, it turns out, may help
relieve your pain, at least in the short
term, but it often weakens tendon tis-
sues in the process, making tendinosis
worse. Researchers have reported bet-
ter long-term results by simply poking
around with the needle. “This is called
dry needling,” explains Dimeff, “and
it’s another technique that causes a lit-
tle bit of tissue damage so the body will
wake up and respond to the injury.” By
adding safe but irritating compounds,
