Tendinopathies: The bane of athletes and sedentary individuals alike
Tendinitis/tendinopathies account for 30–50% of sports injuries. Main locations:
- Achilles tendinopathy: very common in runners
- Shoulder (rotator cuff): supraspinatus, swimmer's shoulder
- Knee (patellar tendon): jumper's knee in volleyball and basketball players
- Elbow (epicondylitis): tennis elbow
- Hip (greater trochanter): ginger tendinitis of the gluteus medius
Pathophysiology and mechanisms of ginger
1. Inhibition of peritendinous prostaglandins
Peritendinous PGE2 and PGI2 sensitize nociceptors and create a pro-inflammatory environment detrimental to healing. Ginger inhibits COX-2 in tenocytes and peritendinous cells, reducing PGE2 production without inhibiting COX-1, which is necessary for healing.
2. Stimulation of tendon collagen by ginger
Tendons are composed of 85% type I collagen. In chronic tendinopathy, type I collagen is replaced by type III collagen (disorganized, less resistant). Ginger stimulates type I collagen production in tenocytes via activation of TGF-β1 and the transcription factor RUNX2, promoting matrix reorganization.
3. Reduction of pathological neovascularization
In chronic tendinopathy, pathological angiogenesis (formation of new vessels accompanied by sensory nerves) exacerbates chronic pain. Ginger inhibits VEGF (vascular endothelial growth factor) in the peritendinous tissue, reducing this painful neo-innervation.
Ginger protocol for tendinopathies
| Phase | Internal Dose | Topical Application | Duration |
|---|---|---|---|
| Acute (0–2 weeks) | 3 shots/day | Icing + Ginger EO 2×/day | 14 days |
| Subacute (2–8 weeks) | 2 shots/day | Cross-fiber massage + EO | 6 weeks |
| Chronic (>8 weeks) | 2 shots/day continuous | Tendon massage + eccentric exercises | 3–6 months |
FAQ
Is ginger compatible with eccentric exercises (Alfredson protocol)?
Yes, and it's the optimal combination. The Alfredson protocol (progressive eccentric exercises) is the gold standard for tendinopathy rehabilitation. Ginger reduces peritendinous inflammation during exercises, allowing for faster progression in the protocol. Take 1 INTI shot 1 hour before each eccentric exercise session.
Can ginger be applied directly to the painful tendon?
Yes, via a topical preparation. Mix: 1 tablespoon of coconut oil + 10 drops of ginger essential oil + a few drops of INTI shot. Apply with a light circular massage around the tendon (not directly on the most painful area if acute tendinitis). 2–3 times/day.
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To learn more, also read:
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