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Lost Mojo: an Impinged Rotator Cuff and now, “Pine Mouth” – What Else?

Talk about piling on. I’ve been having long bouts of aching, stabbing pain in my right shoulder — since mid December, about a month now — and the intensity is not really getting any better. The pain shifts, from the trapezius to the rear of the deltoid, suggesting to me, at least, that I might be dealing with nerve issues as much as actual torn ligament or muscle. But well see. Thanks to a couple of commenters, I now have a self-directed course to pursue. Eric Lapine, and then Michael in a couple of comments really gave me some stuff to check out. Here, and here.

Last Thursday I went to the gym and did some light pulls in various ways and that seemed to help. Even if I do air rows and really get into collapsing the scapula, I get relief (I’ve learned to do this in bed, even).

Ibuprofen reminds me that I actually should love the drug companies. Had I not taken 800mg a bit ago, I would not even be writing this post. But I still hurt and I have to say that I’m just hating all of this.

Anyway, in that second link above, Michael makes reference to Tim Ferriss’ The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman. Well, I once shared lunch with Tim & Dr. Mike Eades in San Francisco and while Tim is impressive as hell, I don’t know about the super-human stuff. On the other hand, I got where I am with 60 pounds of fat loss largely by self experimentation, so who am I to question? To each his own experiments. And I do like how Tim is promoting very decent dietary guidelines…

…Now this is about 24 hours later. I just couldn’t finish the post. Yesterday was one of the worst days in a month. But I did make an appointment with Janzen & Janzen, mentioned by Tim in his book, and was present & accounted for by 8:40 am at their offices, only 10 minutes away. Mike Janzen and one of his physical therapists spent a good 2 hours with me: to both get the medical history, trying diagnose exactly what was going on (which involved quite a bit of manipulation in itself), and then an excruciating ART treatment, first by the assistant and then by Mike. …A hundred & sixty bucks. I was surprised at how modest the charge was, considering the time spent by two professionals. And since we won’t have the workup for subsequent treatments, it’ll be a lot less.

The result is that now I have more of a dull, constant pain, and not the sharp, agonizing pain that had me fantasizing about either cutting off my own arm, or having a .40 caliber for dinner. I go in again on Friday. In addition, he gave me a lot of ergonomic tips for such things as typing, mousing, and so on, that were really causing a lot of pain.

~~~

Now here’s something I’ve been waiting two years to blog about because I finally found out what the problem was. Ever heard of "Pine Mouth?"

This began in the spring, almost two years ago. We were attending a wedding. There was lots of food. But, I was also drinking and didn’t notice anything immediately. The next morning I went out to a local cafe and ordered a nice ribeye steak & eggs. And then I sent it back because it tasted awful; bitter, metallic. It made me lose my appetite for steak so I asked them to bring bacon instead. Still, I had the awful flavor, but just chalked it up to the "bad meat."

And then I had dinner later that day, and everything tasted the same: awful, bitter, metallic. And so it went; for days and days, perhaps a week or so. It finally cleared, and then happened again some weeks later. I did plenty of Googling but could never zero in because there were no clear set of symptoms matched with any possible cause I could find.

…Until two nights ago, when it happened again; and I immediately guessed the cause: pine nuts. I understand why this never occurred to me as a cause before, because I cooked with Trader Joe’s pine nuts quite a bit at the time. Along my paleo path I have almost completely stopped eating nuts, just naturally. Every now and then, maybe every couple of months. But no pine nuts in a long time. But the other day I was shopping and I grabbed a bag (toasted pine nuts). Then I thought they might go well in a loin of lamb I braised the other night. Wham! Immediately. First bite. And it still persists. Now that I had a likely cause it was simple to immediately find out what was going on: ‘Pine Mouth’: How Pine Nuts Can Ruin Tastebuds for Weeks. I find this of particular interest:

Another hypothesis — one that is becoming increasingly accepted — is that certain non-edible varieties of pine nuts are being passed off in the marketplace as the edible variety, Munk says. Some researchers have implicated China in exporting these non-edible pine nuts.

It’s interesting because I grew up eating pine nuts a lot. My grandparents would pick them, and I went along a time or two, on the road between Reno and Virginia City. They would lightly roast them, just enough so the thin shells world become brittle, and they were easy to crack, but the flesh inside was still soft, though firm. I used to like to just break that soft meat and then pull, and see if I could get the inner stem to remain intact.

So, I’m interested in a couple of things. first and foremost is if any of the brainiacs out there have any speculations about all of this. Second, if anyone has a good source for pine nuts, preferably in the shell. I have to delve into this.

[/file/ too weird]

Go ahead and alert your Facebook Friends and Twitter followers to my misery, if you like.

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More

70 Comments

  1. Jason Sandeman on January 19, 2011 at 18:54

    I have had the infernal Pine Mouth a few times in my career. Working in a Pasta Factory where we made our own pesto is a great way, or even pine nut tart. LOL
    It has gotten to the point now where I am not too fussy on the things anymore. I would def not trust anything pine nut related coming from China, that’s for sure! Lucky for me we have a nice Little Italy here!
    I hope things get better with the arm man, sounds excrutiating!
    Richard, I am working on a Beef stock video you might be interested to drool over on your recovery time!

  2. J S on January 19, 2011 at 22:15

    Hey, one thing you might want to check out for your shoulder pain is self-administred trigger point massage (or massage by a trigger point specialized massage therapist) . Trigger points are kinds of “knots” which form in our muscles due to injury/stress/overuse/etc. and sometimes the solution for a very troublesome problem can be really simple if you know where to look. There’s this (quite inexpensive) book on amazon.com which explains the whole package better than I do:

    • Jim Arkus on January 20, 2011 at 05:21

      +1 for this! I hurt a muscle in my neck doing chinups on Thanksgiving and was also about ready to eat a gun. But “Beyond Brawn,” a book that Martin Berkhan highly recommends, had a chapter about trigger point therapy so I gave it a shot and ordered this book. Pain went away immediately and I promptly fell asleep for 9 straight hours. Absolutely amazing.



  3. Emily Deans MD on January 19, 2011 at 18:15

    Wow – that pine mouth thing is alarming! There’s a good article at the daily mail here: http://www.dailymail.co.uk/health/article-1184261/Pine-mouth-puzzle-Why-nuts-leave-bitter-taste.html

    I’m used to thinking of a metallic taste as being due to poisoning (selenium, lead, mercury, copper) but apparently some offending Chinese pine nuts were investigated and they were not adulterated with heavy metals. The sleeping medicine lunesta causes the same symptom in a good percentage of those who try it, and as far as I know, no one knows why. Chocolate is supposed to help. Would love to hear some other thoughts on this topic! Glad your shoulder is feeling a bit better.

  4. Gazelle on January 19, 2011 at 18:19

    I also suffered from pine mouth recently! And it wasn’t my first time! You would think I would have learned my lesson after one bad experience, but no. I too googled around and came upon the theory that new pseudo-pine nuts on the market are to blame. The bad taste lasted over a week. It was awful and I will never ever eat pine nuts again.

    I think wild pignolis, like the ones you can find in the southwest that the ancient peeps there used to eat, might be rounder than the fake ones, which are thin and narrow.

    • Richard Nikoley on January 19, 2011 at 18:29

      Funny you should mention that, Gazelle, cause I have said and thought for many years, what are these skinny, puny things. The ones we got as kids were FAT & plump.



  5. Luc on January 19, 2011 at 18:39

    After more than a week with metallic taste in my mouth and without ever having heard something like it before, I suspected to be seriously sick and started to be very worried. Fortunately googling for “metallic taste” brought me some answers after a while. Strangely enough I was the only one of our dinner party of six who had this terrible taste int he mouth. The problems also did not start immediately but a few days after this dinner.

    • Richard Nikoley on January 19, 2011 at 18:53

      Yea, Luc, it is very likely that this was not cased by the food at that wedding, but something I fixed some time before. I was using pine nuts frequently.



  6. Nancy R. on January 19, 2011 at 18:51

    Wow. Just wow. I’ve had this happen to me a couple of times in the past, and like you and Gazelle, googled and came up with the pine nut theory. Nobody I know has had this happen to them, only me. It’s good to see others have had a similar experience because it just makes me feel less bizarre.

    Anyway, for what it’s worth, only the pine nuts from China have caused this reaction in me. I have found some Italian pine nuts at the Piedmont Grocery in Oakland and I have been fine with those. And yes, those Italian pine nuts look much different from the Chinese pine nuts. They taste a million times better too.

    A quick google turned this up: http://www.nutsonline.com/nuts/pinenuts/ I’m sure there will be other online purveyors dealing in true pine nuts. I haven’t needed to search since I found those Italian beauties nearby, but it will good to know if you have luck with an online company.

  7. Len on January 19, 2011 at 19:08

    I got pine mouth from the same exact product — TJ’s toasted pine nuts — after years of having eaten pine nuts with no problems whatsoever. Leads me to believe it’s an issue with their source.

    Truly a miserable condition for someone who loves food…EVERYTHING had that awful metallic taste. Everyone I ate with for those few days thought I was crazy (“What are you talking about? The guac doesn’t taste like pennies at all.”)

    Since then, I’ve been buying them raw from the bulk bins at WF (in SF, I imagine all of the Bay Area WF’s have the same source), and toasting them myself, and haven’t had any issues.

  8. Unamused Mouse on January 19, 2011 at 19:08

    We added pine nuts to some of our baking awhile back but I found that unless they’re chopped so fine that they’re hidden amongst other nuts/substance, I hate the damned things. They just don’t taste good to me.

  9. Tim Starr on January 19, 2011 at 19:16

    I’ve occasionally had a bad reaction to pine nuts, too, although I like them when I don’t react badly to them.

    I had a bad shoulder for a long time, but not since I made my own clubbell out of plumbing pipe & started working out w/ it. Best physical therapy for the shoulders ever!

  10. Mountain KillerAbs Evan on January 19, 2011 at 19:18

    Hey Richard,

    Great to hear you’re doing ART. To keep from regressing after treatment, though, might I recommend trying out Dynamic Neuromuscular Stabilization? I started seeing a Dr. Rintala in San Diego, after reading “Prehab: Injury-Proofing the Body” in 4-Hour Body. We start each session off with ART and chiropractic manipulation, but the real cool stuff are the DNS exercises we do. It re-teaches your body to move in ways it’s meant to, i.e. with an engaged core and left-right balance. Very paleo if you ask me.

  11. Kurt G Harris MD on January 19, 2011 at 19:22

    The pine nuts thing is really alarming. Gotta love those plants trying to defend their offspring!

    “Favor Food that is Defenseless When Dead”

    Very sorry to hear about your shoulder girdle pain. Are you under any (perhaps unacknowledged) stress lately? I am a big believer in John Sarno’s conception of TMS. I actually have a quite a lot of clinical experience with this. One clue which many are amazed to hear is that psychogenic or psychosomatic pain is often WORSE than that associated with cervical herniated discs, fractures or tumors!

    Your comment “sharp, agonizing pain that had me fantasizing about either cutting off my own arm, or having a .40 caliber for dinner” is typical in patients with TMS type pain.

    You can also contact me off-blog if you like….

    • Rod on January 20, 2011 at 08:13

      The whole Tms, myofascial pain syndrome and triggerpoint approach is fascinating and in my experience, much more useful clinically than some of our old paradims. A highly recommened summary of this is in a ebook by Paul Ingrahman of saveyourself.ca. His website contains a plethora of information for free and a series of ebooks. The trigger point ebook is excellent. Highly recommended for anyone suffering from chronic musculoskeletal issues that seem somewhat mysterious. Sarno doesnt call them triggerpoints but his finger is pointing in that direction. Even smart guys like Dr Harris would get something out of book.
      Rod



    • Kurt G Harris MD on January 20, 2011 at 10:05

      I’ve treated many patients in severe TMS pain successfully, including myself. Chris Highcock has some good blog posts about this. Besides Sarno, another very good book on this is Back Sense by Siegel. Thanks for the tips, Rod.



    • Emily Deans MD on January 21, 2011 at 15:16

      Siegal did a grand rounds at my residency program – he’s a great guy. I actually worked on a book with Dr. Arthur Barsky who is a world expert on somatic symptoms and pain syndromes – it’s called “Feeling Better” and has some strategies for dealing with chronic pain. Richard, if you want a copy, I have a few extra around and I’d be glad to send you one. Just ignore the nutrition chapter which is more “Body for Life” which I followed back in the day…



    • Richard Nikoley on February 1, 2011 at 18:22

      Emily

      Thanks so much and sorry to take so long to answer but it was writhing pain during the time this came in

      Much better now, at least during the day. Don’t know if you’ve seen some of my updates but zeroing in on a nerve issue in my neck. MRI tomorrow. In the meantime, Vicodin, baby!

      I have so much to read in my stack, so let me zero in on the root potential cause first. And thanks.



  12. Greg on January 19, 2011 at 19:24

    Heh- me too! It was incredibly vexing- sorry, but there is no valid reason for bacon to taste bad under any circumstane; I had no idea how this was possible.

    It wasn’t until I was in the car with our production assistant and she started complaining about my {our} symptoms that I figured it out, but only because it happened to my sister a year ago.

    Trader Joes pine nuts, 1bag, 1 bad. Costco pine nuts- years of purchase, no issues, though they haven’t had them for quite a spell.

    My metal mouth lasted 10 days and took 2-3 to kick in. Have fun and don’t waste any time or effort on stellar meals- it’ll all be for naught.

  13. Ari on January 19, 2011 at 19:24

    About the shoulder: you can also check out the Mobility WOD here: http://mobilitywod.blogspot.com/

    It’s fairly simple stuff that can be done at home. I don’t know how serious your injury is, but it has helped with mine.

    Good luck and hang in there.

    Ari

  14. Austin on January 19, 2011 at 19:50

    Bummer. Hope your shoulder gets better soon Richard!

  15. Todd Hargrove on January 19, 2011 at 20:40

    Richard,

    Sorry to hear about the shoulder pain. Kurt is right that pain lives is in the brain not the body. Here is a recent blog post I did that summarizes some basic pain science, which basically explains the many reasons that pain does not equal tissue damage and vice versa. http://toddhargrove.wordpress.com/2010/06/24/seven-things-you-should-know-about-pain-science/

  16. Troy on January 19, 2011 at 22:52

    son of a bitch!!! i have been wondering why my breath and mouth taste has been weird lately… i have been using this pesto sauce at my work quite often lately that has pine nuts in it!!! I usually make my own with Macadamia nuts… I am done with that pesto at work!!!

    troy

  17. Methusela on January 19, 2011 at 23:04

    Richard – look into Serrapeptase. It’s an anti-infllammatory that’s sold as a food supplement but which is said to have powerful effects without the unwanted side-effects associated with pharmaceutical NSAIDs (like ibuprofen). If serrapeptase then you can can continue to hate the drug companies and still get relief 🙂 it has worked for me. In Germany doctors prescribe it.

  18. Troy on January 19, 2011 at 23:21

    Oh yah… theres this systemic enzyme blend made by dr wong, through his website at http://www.totalityofbeing.com. I use it and recommend it to anyone who wants to keep inflammation low… I have tried both wobenzyme and vitalzyme… and his works the best, without having to take so many.

    troy

  19. Samson on January 20, 2011 at 02:15

    I never had pine mouth. But i have a glass of pine nuts here my mother gave to me a while ago that i never finished because of an awefull metallic taste. (tryed maybe 2-5)
    When i told my mother it turned out that she gave them away because my father would like them either.

    I don’t know wether the taste would be covered when used for cooking because i decided not to use them.

    I think its an inexpensive brand from an asian specialitys store.

    Any toughts on that?

  20. Samson on January 20, 2011 at 02:41

    I forgot to mention. I am from germany. Might be of interest in this context.

  21. C. August on January 20, 2011 at 03:00

    Same here with the pine mouth thing. I got bulk pine nuts for this awesome gorgonzola-stuffed steak wrapped in prosciutto recipe, and while it was awesome, the next day I got an awful metallic taste that lasted for at least a week.

    As with you and others here, I diagnosed it as bad pine nuts (this was nearly a year ago and I haven’t tried pine nuts since). I think someone else mentioned this, but I read that to avoid that bad Chinese ones, buy Italian ones.

    I think I’ll try this recipe again — it really was awesome — but only if I can find Italian-only nuts from a specialty store. And even then I’ll be wary.

  22. Jan on January 20, 2011 at 04:41

    I have indeed heard of Pine Mouth, mostly because I’ve experienced it – and not with cheap, bulk pine nuts, either. It has gotten so bad every time I cook with them, that I won’t use them any longer and ask that they be omitted from dishes at restaurants.

  23. JD on January 20, 2011 at 05:06

    Hi Richard,

    There is a direct link between rotator cuff injuries and the bench press, so avoid doing bench until you are fully recovered.
    I would even suggest you stop doing bench press at all, and replace it with weigthed push up and military press to avoid getting injured in the future.
    Jason have a good article about this here: http://jasonferruggia.com/just-another-victim/

    • Jeff on January 20, 2011 at 07:25

      Uh-uh, this is terrible advice. I agree with regard to stopping bench press, but military press is the #1 cause of rotator cuff injury. Working overhead weights is a big no-no if you have impingement.



    • JD on January 20, 2011 at 12:31

      Of course if you are already injured is best to do nothing ultin you are fully recovered.

      But I can only speak for myself since I have being doing standing military press and weigthed push up for 5+ years and handstand pushup for 1+ year and no problems with my shoulders or rotator cuff, not even single pain and I am aware it is because I avoid bench press like the plague.
      Why?, because the bench press limit your shoulder movement and that is a big NO nO when you are pressing under a bar with 450+ lb weight.
      I prefer doing push up with a 100 lb weighted vest plus my BW of 158 for a total of 258. And you know what is funny? my chest look more impressive that those guys at the gym pushing 400+ lb and with less effort hahaha!
      Of course isn’t like i am the Military Press lover since most I do is 135 lb. but i think that is enough I like Bodyweigth exercise the most. Maybe another reason I hasn’t get injured.
      I am 5’8” tall if you also wonder and I don’t look like a bodybuilder I look more like a fitness model.



    • Ned Kock on January 21, 2011 at 06:45

      Good points. In fact, one of the natural BBs with the most impressive chest development I’ve ever seen is Scooby, and he says he never, ever, does bench presses. Here are his rec.’s for chest exercises, with videos:

      Having said that, Scooby has had serious shoulder problems, by his own admission. I ams suspicious of one exercise that he likes a lot, dumbbell flies, which I find rather unnatural when done along the full range of motion of the joint.



    • JD on January 21, 2011 at 09:30

      Hi Ned

      Thanks for the link, Scooby have some goods advice regarding exercises



  24. Ned Kock on January 20, 2011 at 07:08

    Hi Richard. I have a bit of a theory as to why rotator cuff injuries develop, and it has to do with the lack of natural low weight movements that our ancestors probably performed on a regular basis. Scooby, who has had serious should injuries, and he recommends “innies and outies”:

    http://www.youtube.com/watch?v=HpdlF_Vh7zg

    I tend to think that light throwing exercises for a few minutes a week can be very helpful, like throwing-catching a tennis ball against a wall. This also helps develop hand-eye coordination. Our ancestors probably relied heavily on throwing for hunting and fending off predators; think dog attack today.

    Sapiens the thrower!

    • Jeff on January 20, 2011 at 10:20

      I’ve had rotator cuff surgery (nearly three years post-op) and I still do innies and outies, although I use a resistance band. These are essential movements to prevent RC problems.

      My uncle, an orthopod, says part of the problem is that the useful life of the RC is only about 40-50 years. Nearly every old person has tears in their RCs, although it’s not debilitating for most of them.



    • Ned Kock on January 21, 2011 at 12:48

      Hi Jeff. I know of at least 2 cases of folks who had RC injuries in their 40s. Not only did they recover completely, but now they have to be careful not to injure the other shoulder. The reason is that the previously injured shoulder is now a lot stronger than the uninjured one. Compensatory adaptation often leads to overcompensation:

      bit.ly/c5wYiq

      RC recovery seems to be slow though, and my guess is that many people compound the injury because they don’t give it enough time to recover before going back to heavy weights, high loads, full-range movements etc.

      Or maybe I am just in denial trying to shoo away the depressing thought that RCs last only 40-50 years.



  25. Greg on January 20, 2011 at 07:09

    Watch this video here on proper bench pressing.
    http://www.youtube.com/watch?v=vUcjOIZc80c

    I had the same shoulder problems causing me to stop for a couple of weeks. The improper technique is called the chicken wing. Bring your elbows closer to your body and get your back involved in the lift.

  26. adam roumell on January 20, 2011 at 07:09

    I got nothing on the pine nuts… but the shoulder thing I can relate to. It’s sounds almost identical to what I’ve experienced myself. It’s the flat bench press’s fault. It’s because of the heavy benching, and it’s not just your rotator cuff, it’s the outer biceps head tendon that’s inflamed, or biceps tendinitus. The eccentric motion of the flat bench causes ridiculous amounts of force on the tendon insertion that attatches to the upper most corner of the scapula (under the rear delt) trying to control the downward motion. I could bench over 300 lbs when I was 18 pain free. I can’t bench 135 lbs anymore without stabbing pains. From my experience, stop all chest exercises, at least for the time being. Work your back more, bench pressing overworks the pectorals and exagerates tendon issues. If they’ve begun to overtighten at all you have to compensate by strengthening your back, and in the future, work your back twice as much as your chest. It’s a muscle size/work ratio thing. Your back is a very large muscle group that needs two to three times more work than your chest. When you bench, only two muscles are getting all the work. The only chest work I can perform these days are a 20 degree incline dumbell press (the only angle I can press from pain free), and dumbell flyes. I can handle 110 lbs dumbells without pain, but to this very day I can’t use a barbell anymore. At one point I even lost sensation in half my left arm because of this and didn’t get it back until I only performed back exercises (specifically movements that work the rhomboids) for about a month.

    Good luck.

  27. Jonathan Barnes on January 20, 2011 at 07:17

    Richard…Jansen and Jansen, I know them well. They get amazing results with thr ART treatment. I’ve been there and done that…my treatment was with Matt. I also know their Dad, Rudy. I working with him at Lockheed…did business trips with him and the like…he Product Assurance and me, Reliability. You’re in good hands with the Jansen brothers.

    Jon : > )

  28. Ned Kock on January 20, 2011 at 07:21

    Oh, I also wanted to say something about painkillers. I think they are a bad idea if you are using them to help you continue exercising, because they suppress signals that your body is sending to protect you. Painkillers may be helpful to relieve pain outside the context of exercise.

    In my mind, if one is having joint pain, exercise should continue but only with: (a) emphasis on movements that cause no joint paint, using normal resistance; and (b) low resistance for the movements that may cause pain, stopping when the pain starts (which is why the pain should not suppressed by painkillers).

  29. Marci on January 20, 2011 at 07:27

    For rotator cuff problems, I recommend you look into Classical Stretch. It’s a stretching program designed by a former ballerina, Miranda Esmonde-White. I am in no way affiliated with Ms. Esmonde-White except that I love her program and use it at least once a week to keep myself limber for all other activities.

  30. fredt on January 20, 2011 at 07:30

    Sound like my “mouse shoulder” … really tension in the shoulder after stressed mousing around the net or drafting for hours while very tense, stressed, worked up, excited, or distracted. The pain hit me after several years ago, at about age 60, just one day.

    I spent a lot of time and money looking for a cause and relief but nothing helped much. Then I reverted to an old — Living with Chronic Pain — booklet, and tried relaxation.

    I got relief by learning to relax the shoulder while mousing. I never even realized how tense my shoulder was using the mouse. I now use the -tense it, hold-relax it,hold – feel the difference- method of muscle relaxation, and make an effort to relax my shoulder when mousing for long periods.

  31. Chris Sturdy on January 20, 2011 at 07:36

    I recently started taking Turmeric extract (Curcumin) for a sore knee and it seems to help. We have had a lot of snow to shovel recently and this seems to help more than a mineral-based approach that I had tried since June (SierraSil). Like a previous poster noted for another alternative to Ibuprofen, Curcumin is supposed to have anti-inflamatory (and antioxidant) properties equivalent to NSAIDs without the gut irritation side effects.

    I just purchased a HUGH bag of pine nuts and, thankfully, have not developed pine nuts (my bacon and eggs tasted just fine this morning!). I’ll let you know if this changes.

    Best of luck with the rehab. Frustrating, I’m sure.

    • jared on January 20, 2011 at 08:26

      The turmeric approach actually is based on some sound science, although I understood the benefit was more for arthritis (joint inflammation) as opposed to soft tissue inflammation, but it wouldn’t surprise me if it was beneficial for both issues. Good to know!

      And the “gut irritation” side effects you mention includes GI bleeding, which kills THOUSANDS per year. (not to pimp my own blog, but there is some NSAID goodness near the end of the post for anyone interested and it’s easier to link to my blog than the individual sources…yeah, I’m lazy)



  32. jared on January 20, 2011 at 08:20

    Best of luck, Richard! As a DC, I see lots of patients with problems such as yours. For the real stubborn shoulder issues that are more related to “soft tissue” pathology, I refer them out to an amazing MT who does soft tissue work and it is fantastic. A lot of times, we co-manage, but it looks like the place you’re going to has everything in house, which is cool. Stay the course. You’ll get better. We need ya out there, man!!!

  33. Christ on January 20, 2011 at 08:57

    Nearly everyone who starts weight training after sitting on their ass for 10 years ends up injured because it adds tension to muscular imbalances. Unless you correct the imbalance I suggest you quit weight training or get used to it and be happy treating the symptoms.

    Bench press is stupid…haters gonna hate

    • Greg on January 20, 2011 at 09:02

      Right,

      All compound exercises are stupid. Curls, shoulder shrugs, and leg extensions are where it’s at…



    • Matt on January 20, 2011 at 12:45

      That’s not at all what he said.

      You can still do big, compound movements while involving corrective exercise therapies.



    • rob on January 20, 2011 at 13:52

      I don’t do the bench press at all myself, injured the same shoulder twice doing it and idiocy is doing the same thing over and over and expecting different results.



  34. poindextrose on January 20, 2011 at 09:21

    I once had a impinged rotator cuff and was told I would have to have surgery. Fortunately, I came across Stuart McRobert’s Beyond Brawn where I found out about an exercise called lying L-flyes. You lie on your side with your elbow fixed to your side and lift a small weight from your stomach to vertically above your elbow. I use 10 pounds for 15 reps on each arm. This exercise fixed my should in 2 months after having dealt with pain for over a year. McRobert suggests everyone do this exercise as preventative measure if you are benching at least your body weight. It saved my should and I’ve had no more problems over the last 8 years.

  35. Shawn on January 20, 2011 at 11:12

    I had a shoulder issue very similar to what you are describing. ART is what did the trick for me. I do agree that perhaps up to 24 hours after the first treatment you kind of go.. huh? Is this it? But once the soreness of the muscle manipulation/scar tissue breakdown fades you’ll find a huge increase in mobility and decrease in pain. (or at least I did)

    Good luck with the rehab and hope you find your answer.

  36. Paul C. on January 20, 2011 at 11:54

    I don’t think I’ve ever had a pine nut in my life, but I did have the metallic taste thing happen after eating a family size bag of Funyuns. It sounds exactly like what you are describing. What substance do Chinese pine nuts and Funyuns have in common.

  37. Aaron Ashmann on January 20, 2011 at 12:44

    Richard, maybe you have some localized inflammation in the shoulder that is causing issues? How many times a week are you working out? You may have to change up the types of exercises that you are performing. I’ve improved my shoulder the most with pushups and pullups (not chinups) — I suffered a really bad separation 2 years ago, now I have almost no issues. I’d would say you should limit lifting to 2-3 times a week at most (And give yourself a couple of weeks off). And remember, intensity maters more than absolute weight <—- you probably know this. As long as your muscles are feeling the burn at the end, you will experience benefits.

  38. Doug McGuff, MD on January 20, 2011 at 16:59

    Richard,

    Sorry to hear about your shoulder. I agree with Dr. Harris about the possibility of TMS, if not as a sole cause, at least as a contributor. From the exercise side of things I might suggest you go back to your Vimeo on your October 10th Leangains post. Keep a close eye on the area that is currently hurting you and see what you think. Pay particular attention to the way you set (slam) the weight down. This effect is amplified by the fact that the bar is slamming down onto the metal support as opposed to the plates hitting the rubber bumpers. This produces quite a shock wave through the subachromial space. If you are doing your other movements with this kind of form then you have an opportunity for avoiding future pain. Keep your workouts high intensity but low on force. Also, tendonitis, disc herniations, back pain etc, (in my experience) are kind of a “canary in the mineshaft” of overtraining. Sometimes you are just being sent a signal to recover more.

  39. Mary on January 21, 2011 at 10:32

    Regarding your shoulder, you might want to look into cranial-sacral therapy. It is a form of unwinding the body and clearing energy blockages. Some PT’s can do this, as well as some seasoned Massage therapists. I have shoulder issues myself and have found this therapy very helpful. The shoulder pain you describe may be related to a rib or facet that is shifted and pushing or pulling the muscle. The muscles could also be trying to overcompensate for an imbalance or weakness in another area. The shoulder pain could be caused by by something else out of alignment, typically from your feet up, tight hamstrings, tilted pelvis, etc. Hope this helps.

  40. Richard Nikoley on January 21, 2011 at 11:34

    Hi all:

    Thanks much for all the advice and things to check into. Wish I could thank you all individually but I’m trying to keep typing and mousing to a minimum right now.

    Just had my second ART treatment this morning along with some deep massage and lots of poking and prodding. Noticeable improvement. Right now it’s kinda like chasing the pain and it’s begun to shift around a bit. But definite improvement.

    I will look into each of your many suggestions. Gives me a lot to go on. Thanks again.

  41. Tim Starr on January 21, 2011 at 11:41

    Just remembered another cheap suggestion: Buy yourself a “theracane.” Great for self-massage on otherwise hard-to-reach areas. Love mine.

  42. […] Subscribe ← Lost Mojo: an Impinged Rotator Cuff and now, “Pine Mouth” – What Else? […]

  43. NoGluten on January 21, 2011 at 15:36

    I’ve bought from here:

    Goods From the Woods
    14125 Hwy C
    Licking, MO 65542
    http://www.pinenut.com

    I was happy with the service and the products. I tried pine nuts in the shell and didn’t really care for them. Fair amount of info on their site too.

  44. Modderbaard on January 21, 2011 at 15:36

    I experienced the pine mouth several times two years ago. It only happened with small pine nuts that originated in China. Since then I only use the longer (bigger) ones from Italy. No problem ever since…

    At that time I did a lot of reading on this issue. As I remember it is is caused by certain triglycerides from the nuts that attach to the receptors for bitter taste on your tongue. This attachment is permanent. And wears off when the cell dies and is replaced by another. This happens in 3-7 days.
    Every time you eat the receptor triggers en shouts ‘bitter!’ to your brain due to this attached triglyceride. No matter if the food is bitter or not.
    I lost the source. So, cannot paste the link here. Crap.

    • Richard Nikoley on January 24, 2011 at 09:27

      modderbaard

      That explanation makes the most sense I’ve heard yet, given the way thongs play out. Taste buds are always dying off and being replaced, so one would expect the effect to diminish, which is exactly what it does for me. Now a week in, I’m at the tail end of the thing, gradually diminishing day by day.



    • Gerard on January 30, 2011 at 00:26

      FYI, here is somebody who keeps track of the research results for Pine Mouth. There is also something there about the alleged trigs effect.



  45. Dr.BG on January 22, 2011 at 09:20

    Richard,

    I hope you get better VERY SOON! You survived and thrived at MovNat w/LeCorre and you’ll get over this rehab soon, no doubt in my mind! Had a R-shoulder impingement 5 yrs ago moving houses by somehow overextending carrying heavy boxes. For one yr I was compliant and did all the exercises recommended (L-flies, superman stretch) and had no issues whatsoever.OF course when things felt ‘alright’ I stopped the preventive measures and that was a huge mistake. Now I have to do A LOT to maintain shoulder health: rows, bent rows, weighted squats, swim, L-flies, etc. And I have to vigilant ALL THE TIME to keep elbows tightly in toward the core and shoulders/scapula squeezed. BTW How long have you been on motrin/ibuprofen? > 1-2 wks use can actually hinder the healing phase. It potently and excessively blocks all prostaglandins including the anti-inflammatory and healing ones (PG1, PG3). Ice ice ice baby? Does that control some of the inflammation? What side do you sleep on? My PT advised for severe discomfort, sleep on the un-injured side and tuck a rolled towel or firm pillow under the injured-side elbow which prevents shoulder from rolling forward, unstabilized. My PT also suggested avoiding all triggers where the shoulder maybe de-stabilized — benchpress, curls, etc (and I question functionality). For me, unless I have strong shoulders/core I also avoid pushups (knee are ok), planck, and flies. Speedy recovery to you my dear! G

  46. DajM on January 27, 2011 at 11:32

    Dude, I had pine mouth, too. I never said anything to anyone because I thought something was seriously wrong with me and was scared to verbalize my symptoms. Then, one day at work, someone started talking about it and described the symptoms. he did the research and knew it was pine mouth. I will never eat another pine nut for the rest of my life. In fact, the restaurant I work at stopped serving them. Fuck pine nuts!

  47. vanman on January 28, 2011 at 08:12

    Interestingly, I had a rather unpleasant experience after using one of the locally produced pesto brands but thought nothing of it. It looks like those guys were using too many pine nuts in it…

  48. momk on February 4, 2011 at 09:59

    My son just experienced horrible “pine mouth” after munching on some pine nuts I had gotten for a fish dish 3 days ago. Everything tasted bitter–especially anything that was supposed to be sweet. Found an article that suggested a misfiring of the nerves cells so that the sweet taste buds no longer fire and the bitter taste comes through. The author suggested sugar or sweetener on the tongue or food to help…and it did the trick (so far). Not sure how that would work with the bitter taste-receptor theory (which would mean it might come back until the affected taste buds slough off), but here is the link:
    http://bodyodd.msnbc.msn.com/_news/2010/06/03/4452626-pine-mouth-syndrome-leaves-a-bitter-taste
    btw, looked on the package of pine nuts, and they were from China. 🙁

    • Richard Nikoley on February 4, 2011 at 10:14

      yea, well, especially, emphasize to your son that it does resolve in 7-10 days, and by about day 5 in my case it noticeably gets less and less. Gone through it three time now, the 1st 2 not understanding what it was.



  49. […] first let the cat outta the bag back here. And then my friend and MD radiologist with specialization in neuroradiology (spine & shit), […]

  50. […] Lost Mojo: an Impinged Rotator Cuff and now, “Pine Mouth” – What Else? […]

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