In other words, the sadomasochist generally desires that the pain be inflicted or received in love, not in abuse, for the pleasure of either one or both participants. This mutual pleasure may even be essential for the satisfaction of those involved. Here, Ellis touches upon the often paradoxical nature of widely reported consensual S&M practices. It is described as not simply pain to initiate pleasure, but violence—"or the simulation of involuntary violent acts"—said to express love. This irony is highly evident in the observation by many, that not only are popularly practiced sadomasochistic activities usually performed at the express request of the masochist, but that it is often the designated masochist who may direct such activities, through subtle emotional cues perceived or mutually understood and consensually recognized by the designated sadistIn his essay Coldness and Cruelty, (originally Présentation de Sacher-Masoch, 1967) Gilles Deleuze rejects the term "sadomasochism" as artificial, especially in the context of the quintessentially modern masochistic work, Sacher-Masochs Venus In Furs. Deleuzes counterargument is that the tendency toward masochism is based on intensified desire brought on or enhanced by the acting out of frustration at the delay of gratification. Taken to its extreme, an intolerably indefinite delay is rewarded by punitive perpetual delay, manifested as unwavering coldness. The masochist derives pleasure from, as Deleuze puts it, the "Contract": the process by which he can control another individual and turn the individual into someone cold and callous. The sadist, in contrast, derives pleasure from the "Law": the unavoidable power that places one person below another.
Bicipital tenosynovitis  is tendinitis or inflammation of the tendon and sheath lining of the biceps muscle. It is often the result of many years of small tears or other degenerative changes in the tendon first manifesting in middle age, but can be due to a sudden injury. Calcification of the tendon, and osteophytes ("bone spurs") in the intertubercular groove  can be apparent on x-rays. The condition (which can also occur in dogs)  is commonly treated with physical therapy and cortisone


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