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PaperclipPerfector  6mo ago (text post)   2707 thread views

Small-Scale Question Sunday for October 29, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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My scumbag achilles...

Tendons are weird. Stupid and weird. And nobody knows shit about how to fix them.

Early in the summer, I strained my achilles playing soccer. I am old and this has happened before many times. This time I decided to GO HAM on my achilles. I adopted a strict stretching and eccentric exercise protocol. The sort that physical therapists have recommended in the past. I was 100% consistent and spent about 20 minutes each day. I did this for MONTHS. Did my achilles get better? Kinda, sorta, not really.

So I stopped doing the program. And I kept playing soccer. And the achilles pain sort of just... went away. It's completely gone now.

The only thing that changed was I switched to a low carb diet. GPT-4 tells me there is no evidence that this related.

One day, science will figure tendons out. We're a long way from that now. In the mean time, for those with nagging sports injuries, I advise not wasting your money on doctors and PT unless someone else is paying for it.

Tendons.. nobody knows shit about how to fix them

Well the thing is simply that doctors are scientifically illiterate, unlike me. The most potent drug at repairing tendons is BPC-157 which is a peptide endogenously produced in the body. It is available OTC for a short term injections cycle, the most reputable website but a bit pricey is peptidesciences .com https://pubmed.ncbi.nlm.nih.gov/14554208/ BPC is quite popular on /r/peptides and has "saved" many, however it is a serious medication that shouldn't be taken without studying its tradeoffs (short term anhedonia risk, amphetamine blunting and increased angiogenesis (therefore increased lifespan if young, increased risk of metastasis if old)

Thanks. A podcaster I listened to also mentioned this peptide as a sort of miracle cure for his long term tendon problems.

Apparently, peptides like this can't be patented so there is no financial incentive to research them. It seems like a good opportunity for countries outside of the US/Europe to push the science forward.

Nobody will push the science forward the world will keep being nearly maximally inept, both this century and for the others to come. As you correctly say, the economic incentives are beyond malevolent but most importantly, the pharma enterprises are simply extremely mediocre and their complacency, like worlwide suffering will perpetuate. The insane mediocrity is simply a product of the extreme absence of education during the human's brain-formative years (so called critical periods). Only a few artifact outliers like me can contemplate the contemporary horror in its fullest depth.

I've also got some persistent leg sinew issues, and so far I've gotten all sorts of advice:

  • Rest
  • Physical Therapy
  • Shoe inserts and knee braces
  • "I guarantee you it will go away on its own within two months"

Needless to say, none of that worked.

The issues did go away whenever I exercised regularly. No exercises tailored to resolve or avoid my issues, just whatever I enjoyed most. Swimming, hiking, biking, fencing. Maybe it's all psychosomatic in the end? But then things happened and I ended up extremely sedentary for many months, and ah, there we go, it's all messed up again.

No idea what's actually going on, but doing sports that are actually fun sure helps.

The only thing that changed was I switched to a low carb diet. GPT-4 tells me there is no evidence that this related.

This probably depends on exactly what we mean by "no evidence". While I am not aware of any RCT-style evidence for this, there's quite a bit of anecdata and a plausible-enough mechanism that I wouldn't be all that surprised if many people experience less joint or tendon pain with lower inflammation diets. As ever in the world of sports and nutrition, I think there's a good chance that there's so much individual variability in responses and difficult to control for differences that you'd need an impractically large study to have enough power to figure out whether there's good empirical evidence for this sort of thing, but if it seems like it works individually, who cares?

For me it's an N of 1 so I can't really say. And my achilles pain has gone away in the past without diet changes.

But I just did some more searching, and it appears that a low carb diet could improve tendon health after all.

Specifically, there is a link between diabetes and tendon health. A high sugar diet leads to production of AGEs which cause tendon problems as well as other, more serious problems.

Perhaps a low-carb diet isn't necessary. But the standard American diet has so much sugar that something like 10% of the population is diabetic, and another 38% with pre-diabetes. I have to imagine that this could impact tendons.

GPT-4 let me down.

Yeah, like you said, these kind of injuries or pains just seem so absolutely flukey that it feels like pure guesswork trying to get rid of them or prevent them. Personally, I've had that with IT band issues in running. In principle, I know that these tend to be from weak glutes and/or hip flexors, but that still doesn't help me understand when and why it becomes a problem. I've rolled through training months with consistent 60-70 mile weeks and zero pain only to wind up on the shelf from much less, much lower intensity work later in the year. Why? Well, if I knew, I would do something about it.

My shoulder/delt has been fucked for 6 months this year, and I’ve waited and waited, and done PT and more PT, and gone to the gym and worked out around it… and I’m slowly but anxiously moving towards the conclusion that no one seems to know what’s going on mechanically and I may as well just lift the weights and push through the pain. So it’s nice to read your experience with this

My shoulder/delt has been fucked for 6 months this year, and I’ve waited and waited, and done PT and more PT, and gone to the gym and worked out around it… and I’m slowly but anxiously moving towards the conclusion that no one seems to know what’s going on mechanically and I may as well just lift the weights and push through the pain.

Don't push through the pain. Drop reps, drop weights, drop ROM until your exercise stops hurting. My left shoulder hates specific movements and every time I try to push through the pain, it only gets worse.

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