In the average chiropractic practice, at least two tendinitis cases per month present themselves. In larger practices, of course, it is more. This means that over one hundred cases per year are literally slipping through the fingers of every chiropractor in America.

If you agree with me that spinal manipulation does nothing for tendinitis, you are already at a point where you know that this condition requires "something different" to achieve lasting results.

Please don't misunderstand me. I know that chiropractic attains marvelous results with many other conditions including neuritis. But in order to treat any condition, we must determine the nature of that disease. The nature of tendinitis is that it is brought on through over-use of the muscles and tendons (except in the elderly). The muscles become stiff and tight, then the tendons inflame and become sore (natures defense against further insult), whether acute or chronic. All this may have nothing to do with the spine. More recent thinking says that the tendons are not necessarily inflamed. Thus, the term tendinosis.

In my opinion the tendons are inflamed in most cases.

Don't assume that the patient has only one condition causing the pain because very often this is not true. First, determine how many other conditions that might exist in the shoulder, elbow, acetabular or heel area. Does he or she have a true neuritis, rotator cuff strain (or tear) shoulder joint separation, clavicular dislocation, pulled or torn muscles or tendons (as in severe strains), calcium deposit, heart problem, etc...

Once the nature of the disease has been determined and other health problems addressed, the treatment may begin.

The Treatment Plan is fully discussed on Dr. Holtman's Say, "Goodbye to Tendinitis" video (available to Dr's and patients).

The second of eight exercises features the patient in the standing postion, arm extended at shoulder level, out to the side. The arm is briskly thrust accross the front or the body, then back in the opposite direction to its fullest extent. Then back across the body again for and eight count total. I call this the "French Karate Chop.


Then there are the supplements. There are two. Now I realize that some chiropractors are adverse to supplements. So be it! But, if there was ever a golden opportunity to try supplements, this is it! There is a definite difference in the degree of results when using the supplements as opposed to not using them (about 40%-60% better results) depending on what the patient needs most.

Because of FDA rules regarding claims, I cannot say what the supplements are, but I can tell you what they do without mentioning the supplement. The main supplement contains three natural anti-inflammitoryes and one natural muscle relaxant. The second supplement is a natural muscle relaxant. But, isn't this better than drugs with their side affects?

I think you can see from this presentation that between the proper application of heat, cold, vibrator, and transverse friction massage, special range of motion exercises, and proper use of supplements, the patient must get well. Even so, it takes time.



Mode of Improvement:

You can expect definite improvement during the first two to three weeks, and from then on gradual improvement until completely well. The patient must be devoted to the system and its instructions, and even though it takes time, you can expect complete recovery.

I would like to present my most noteworthy case histories: Case #1 - D.O. (initials) He described himself as "skeptical". I first saw this patient on May 9, 1992. He said he had had tendinitis since September 1991. He described a #5 to #6 pain in his right elbow area (#1 being the least pain he has ever experienced in his lifetime and #10 being the worst). He said the pain in the left elbow area was only a #2 to #3.

Previous to seeing me he visited these doctors:

1. Family doctor - no results.

2. Another general practitioner in same clinic as family doctor - no results.

3. Chiropractor - no results.

4. Orthopedic specialist - no results.

5. Specialist referred patient to hospital for physical therapy - no results.

6. Back to same orthopedic. He suggested patient take off work for one month. Patient's employer said "no" to that.

So, the patient went to another medical group clinic for physical therapy (yet again) - no results. I should say at this point that this patient has a factory job where he really overuses his arms, greatly. I put this patient on the home-self treatment on May 9, 1992. He has gotten gradually better. I saw him on June 24 and he reported his right elbow was at a #2 pain level, down from #5 to #6. His left elbow was at a #2 level, down from #2 to #3. And he continues to overuse his arms with no time loss! Oct. 3, 1992 patient update: both elbow areas are down to a #1/2 pain. Almost cured! Patient update January 1993: The patient is pain free.

Case #2 - D.B., factory worker.

Tendinitis in both elbow areas severe since June 1988. A #7 pain in the right elbow and a #5 in the left. Picking up a cup of coffee, opening a door, trying to light a cigarette was very painful. She had been off work a total of three months from June 1988 to January 1991. She went on "light" work, then gradually worked her way back to her regular job. This exacerbated her condition. Between June 1988 and January 1993 this patient had consulted six medical doctors for her tendinitis. No beneficial results. I first saw her on January 20, 1993. Diagnosis: Tendinitis in both elbow areas. No complicating factors. I placed the patient on the professionally made video instructions and supplements. No chiropractic. The spine was fine, but the patient was "skeptical." She thought it was a waste of money (but didn't tell me). Later she said, "Was I wrong!!" In two weeks she was better, in five weeks she was 35% better. In three months there were many days that she felt no pain at all. On July 5, 1993 she reported only occasional, very mild pain, and she is continuing with the exercises.

Case #3 - L.J., Occupation: Physical Therapist.

She couldn't lift a fork to her mouth and couldn't raise her extended left arm to shoulder level. This went on for two years at a #9 left shoulder pain. In December 1988 she went to her first M.D. and received anti inflammatories, muscle relaxants and pain killers. This did not bring about relief. She also packed her left shoulder in ice every night just to get to sleep. She then went to a second M.D. where she received a more thorough exam. But two weeks later, the doctor relocated. Then she went to a chiropractor for five months with no beneficial results. Next she went to the first neurologist. He couldn't find anything neurologically wrong. He used ultra sound, biofeedback, anti depressants and tens treatment. This went on for one year. She reported some temporary relief from the tens treatment. The neurologist recommended a psychiatrist. She then gave up on all treatments for four months. At this time she entered physical therapy school. (This had been her dream since age six.) But because she was new to the school, she went to another M.D. and asked for a prescription to take physical therapy privately. She stayed with the physical therapy for one and one-half years both in and out of school. For a time she was taking some form of physical therapy three times a day. She attained some relief, but the shoulder continued painful because she was over using the left arm. She then went to an orthopedic surgeon. He sent her to another neurologist. He found nothing neurologically wrong. Back to the orthopedic surgeon who operated on the right shoulder to correct a rotator cuff tear. (After which she couldn't drive her car because of not only the right shoulder surgery but also because the left shoulder tendon was still very painful.) Gradually with therapy her right shoulder improved. She came to my office on October 22, 1991 for treatment of a left sciatic condition. During the course of the sciatic treatment, she mentioned the fact that she had left shoulder tendinitis. (She was still favoring the right shoulder, thereby overloading the left shoulder which was at a #9 pain.)

She said she was ready to try anything. She began the treatment on November 8, 1991. In three weeks she was 80% better. In six weeks she was pain free. Later she became lax with the program, on occasion and the shoulder became worse, but after resuming the program the pain cleared in three to four days. Today she is feeling fine! August 23, 1993.

Case #4 - Edward G. Holtman, D.C. (myself)

Seven years ago I would have given anything for a successful treatment for tendinitis, because I had tendinitis myself for six and one-half years. I had tendinitis so bad in both elbows and both shoulders (because of my work) that it was a strain to lift our female cat. And, when my wife and I went to a restaurant or shopping mall, I had her open all the doors for me to avoid straining my arms further. Because I knew chiropractic spinal manipulation only occasionally helps tendinitis, I took almost all types of physical therapy.

Q. Did that help?

A. Yes, but the help was only temporary. However, the relief was very welcome and I hung in there. I spent $2,000 over the six and one-half year period. I tried rolfing, but I really didn't give it a fair trial (only one visit). Because of the cost, I had to make a quick decision. I also had three cortisone shots over the last two years of my condition. They helped, but once again, only temporary relief. At this point I was desperate. I began to look into other fields of endeavor, because I thought I would have to quit the profession. But I received a flier from a vitamin company that said a certain supplement might help muscles. I reasoned that if it might help muscles, maybe it would also help tendons. And, happy day, that proved to be true! I took the supplement and began feeling better within two weeks! How did I settle on two supplements? Just by fate or luck. You know how you try things from vitamin companies before you give them to your patients. Well, I did that and found that two of the many I tried helped my tendinitis. (I know this was not scientific, but there is a scientific reason why they worked.)

Q. How are other health professionals going to believe that exercise helps tendinitis when they know that overuse is what brings it on?

A. My exercises are not work or muscle-building exercises. I will admit that seven and one-half years ago I experimented with two exercises and almost wrecked my right shoulder. So, I quit exercising altogether. Then about one and one-half years later I began doing the helpful exercises that appear on my video and they work very well in helping to relieve tight sore muscles and tendons. Today I feel fine and I'm working harder than ever (even though I'm 68 years old). I've been using my system in my practice for the past six years and the results have been fabulous! Interestingly, through this experience I realized that I had been missing between two and four tendinitis patients per month. (And so are most other health professionals.) Since I've had my video, I've kept a record of all the tendinitis cases I treated to keep track of the results. I have found that 90 percent are completely cured. Among the remaining 10 percent are patients who were misdiagnosed and those who did not follow instructions properly.



ONE CAUTION: The video special exercises and other home treatment advice must be used in combination with the supplements for the very best results. Do you see a trend here? This is it: Tendinitis victims will not achieve lasting results until some of the thinking and approaches of the past are replaced by new thinking and approaches. Give the body what it needs and it will respond!

Now a word about the elderly and why they develop tendinitis. The elderly usually are not employed in jobs that will overload the muscles and tendons. However, as we grow older, we lose muscle mass, muscle strength, muscle tone and muscle elasticity. Add to this probable poor circulation. The end result is muscle tightness and stiffness. This leads to tendinitis. (My theory is: Do something good for the muscles and you will be doing something good for the tendons.) The elderly respond exceptionally well to this treatment because they don't have to go back to a job where they are over-loading their muscles and tendons. Fellow Chiropractors, if you are not addressing the needs of your tendinitis patients, they will not only continue to suffer, but also they will "walk." Wouldn't you do the same? Beginning today, examine every patient that complains of "arm pain" for tendinitis in the elbow and shoulder areas. You will be surprised! Next assure them that, now, help really is available. No longer must the population suffer indefinitely from the effects of tendinitis! Expose them to the system. They will love you for it! But time is of the essence. Every month, two to four tendinitis patients are walking out of your office in pain. But, knowing what you now know, you can help them say "Good-bye to Tendinitis," and have them walking in, instead of walking out.

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