Following an overwhelming response to a previous topic covered, tendonitis in the knees, I have been asked several questions about treatment options for current and chronic tendonitis. In my last article, I covered proper training and exercise technique to hopefully prevent tendonitis in the knees. Unfortunately, most of us don’t like to take preventative measures and only seek treatment after it becomes a problem. Although I did briefly discuss traditional treatment practices for tendonitis, I have decided to address some of the “newer”, trendier, treatment options for various musculoskeletal ailments including, but not limited to, knee and other types of tendonitis. The first treatment option that I will cover in this article is low-level laser therapy.

For most endurance athletes that look to compete hard and run most of their races in the spring and summer, they are just starting to make plans for the fall and winter in preparation for peak performance next year. Unfortunately, what many forget to take into consideration is how to stay injury-free through these next several months so that they can continue to train with the intensity that they want in their workouts.
They spend hours calculating distances and time spent running, biking, and swimming, while continuing to work 50 hours at their job and trying to cram every last minute of training before the sun goes down. Many think they have it figured out, filled with proper rest and gradual progression of training intensity. Some even add a balanced nutritional diet with every gram of protein and complex carbohydrate accounted for over the day and week. Despite all of this, they still end up getting hurt. Why?

Q: I have been having a lot of pain on the inside of my lower leg right next to the bone. I have been Internet researching it and wanted to know what the difference is between shin splints and a stress fracture?
A: “Shin splints” is a generic term for the description of pain that is near the large lower leg bone, or the tibia. The pain is usually a result from overload on the tibia and inflammation of the soft tissue of the tibia, known as the periostium. There are several reasons why the periostium may become inflamed ranging from poor and improper footwear, engaging in sports with frequent stops and starts, and training for too long, or too hard, too quickly.

Q: I have been diagnosed with tendonitis in the knees and it is worse on one side then the other. It hurts during track practice and after meets, but I really want to finish the season and try and place at the state meet. Is there any “quick fix” that would help me alleviate some of this discomfort?
A: Unfortunately, as with any tendonitis, there is no “quick fix”, but I will offer some suggestions for immediate relief and then ideas of where to go from there.

Q: Since the start of the New Year, I have tried working with a personal trainer, a Pilates class, a Body Pump class, and a kettlebell class. None of these have shed any weight off my frame and I have actually added an inch to my waist. What is the answer to all these choices?

A: This is the time of year that I see many people get frustrated if their body isn’t responding the way they wanted or hoped it would to adding exercise. Unfortunately, it just isn’t as simple as add a few classes here, a session or two with a trainer there, and then “Voila!” transformed. No, it takes much more then that… It takes, what I call, the three C’s of weight loss (no we are not going shopping for a new diamond…).

Q. I am a long distance runner looking to add weights to my exercise routine. I have never added weights in the 6 years that I have been running and don’t know where to begin. Several of my teammates and past coaches don’t think that I should add weights. What are your thoughts and how should I proceed?
A. The situation that you find yourself in is a common conundrum that doesn’t have a definitive answer. Obviously, how your body responds to weight training will be the deciding factor in whether or not this is an effective option in your training routine.

Q. A reader from Durham emailed me, “My New Year’s resolution is to exercise more often. I just got a puppy as a gift and was wondering if you know when it is okay to include them on my morning runs?”
A. Obviously this question required some expertise in canine anatomy and physiology so I consulted with a local vet and friend of mine that trains at our facility. Dr. Richard Hawkins of Colony Park Animal Hospital writes: As a veterinarian, I am often asked the question “Is it okay to run with my puppy?” Today, with our more health conscious society, we are all looking for outlets for exercise. Running has always been something we have done to improve our cardiovascular health, and running with your dog can certainly make this a more enjoyable experience.

Q. A reader and friend from Saxaphaw, NC writes, “I am an endurance athlete that is trying to lose weight while still trying to get optimal performance during my races. We use these carbohydrate gel packs during long training sessions to get some energy, but most of these contain simple sugars that are high on the glycemic index and I was told that this is bad for weight loss and blood sugar regulation. How can I get energy for training but try and lose weight in the long run?”
A. Many athletes get involved with endurance sports like running, biking, and triathlons with weight loss as their initial motivation. As they get going and continue to train, most will run into the same dilemma that bothers you in your training. The physiology and chemistry behind the answer is universal, but the implementation may be different for each individual.

Q. What are your thoughts about plyometric training for young athletes?
A. If you ask any trainer this question you are bound to get varying responses from those that love plyometric training for all ages to those who think that it is way too advance for young athletes. I think that while some plyometric exercises may be a little challenging and inappropriate for children (i.e. Drop down box jumps from 3 feet), there are many that can enhance and improve body movement at a young age setting the stage for advanced development later in life.

Q. I am 42 years old and trying to delay total knee surgery as long as possible. I heard that glucosamine supplements help, is that true?
A. Glucosamine supplements have been around for a long time. Because of this, they are one of the most studied and reviewed non-prescription pills on the market. Even several prestigious orthopedic and medical journals have published some findings from controlled, double-blind, placebo studies. Most of these studies test the effectiveness of the supplement on knee cartilage density and, of course, reduction of painful symptoms.