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Prevention of Paddling Pain and Injuries

Summary Of Injuries

Summary of Common Complaints

Common InjuriesRepetitive Stress InjuriesPostural Imbalances, repetitive movements, daily activitiesResult inFatigueMicroscopic damage to musclesTightness of musclesMuscle pain

Repetitive Stress InjuriesGeneral Muscle TensionCaused by overuseMay or may not cause painDecreased range of motion, resists stretchingCan cause muscular imbalanceMay lead to injuryManaged with exercise, stretching, and massage

Repetitive Stress InjuriesMyofascial Pain SyndromeCaused by overuse of musclesTrigger PointsSmall, painful involuntary contractions within muscle cellsLocally painfulMay refer pain and other sensations distant to the TPPredictable location and pain referral patternsMay be active or latent

Repetitive Stress Injuries

Trigger PointsRepetitive Stress InjuriesMyofascial Pain SyndromeTreatmentSpray and stretch (vapocoolant spray)InjectionsDry needlingTrigger point massage modalitiesRepetitive Stress InjuriesTendinopathiesDamage to tendons and tenosynovial sheathsMay also be caused by age, trauma, and other factorsTendinitisAcute damage, may include inflammationPain and stiffness with movement and stretchingTendinosisLong term degeneration of tissues, no inflammationPain and stiffness with movement and stretching

Repetitive Stress InjuriesTendinopathiesTenosynovitisIrritation to sleeves tendons slide throughMay have loss of smooth movement and grinding sensationTreatmentRest, ice, stretching, massageEccentric contraction exercisesUltrasoundSplint or brace during activity for support

Repetitive Stress InjuriesStrainsInjuries to muscles or tendonsMay also be traumatic, graded by severityInjuries cause buildup of scar tissueDecreased contractilityWeak, easily re-injured areasAdhesions that decrease range of motionLocally painfulPain on stretching and resisted movementRepetitive Stress Injuries

Strain damageScar tissue formationWeakness and re-injuryRepetitive Stress InjuriesStrainsTreatmentRICE (rest, ice, compression, elevation)Proper rehabilitation with exerciseStretching, massageTraumatic InjuriesSprainsDamage to ligamentsInflammationRedness, heat, swellingPain, loss of function of jointMay mask fractures

Traumatic InjuriesSprainsTreatmentRICE (rest, ice, compression, elevation)Movement to tolerance as soon as possibleProper rehabilitation with exercise and stretchingTraumatic InjuriesDisc InjuriesMay be traumatic or degenerativeMost common is lumbar herniation due to lifting and twistingCanoeists tend to have more disc issuesMay cause local pain due to muscle spasmsMay press on nerve roots causing pain, numbness, tingling, and weakness in areas served by that nerve

Traumatic InjuriesDisc InjuriesTreatmentDepends on severityTry to create space for disc to repair itselfInjections to decrease inflammationSurgeryTraumatic InjuriesShoulder dislocationForceful disarticulation of jointMay include soft tissue damageMuscles will quickly spasm to splintReduce as soon as possibleLots of pain and swellingLoss of functionOnce dislocated will more easily sublux or dislocate

Traumatic InjuriesShoulder dislocationTreatmentReduction and immobilizationPhysical therapySurgery Chronic InjuriesAny unresolved injuryCausesReturning to activity too soonNot properly treating the injuryResultsBuildup of scar tissue reduces range of motionArea is more easily re-injuredChronic InjuriesTreatmentPhysical therapyExerciseMassage to break down scar tissue, reduce muscle tensionMiscellaneousDelayed Onset Muscle SorenessTypical of new exercise or increase in activityNot indicative of traumaUsually resolves on its own in a few daysActivity may decrease pain

MiscellaneousNerve CompressionSciatica, Thoracic Outlet Syndrome, Carpal Tunnel Syndrome, Disc InjuriesCaused by soft or bony tissue compressing nervesPain, numbness, tingling, weakness of musclesVarious causes and treatmentsTrigger points can mimic symptoms

Thoracic Outlet

Carpal TunnelMiscellaneousSpasms/CrampsInvoluntary contraction of musclesOften painfulMay decrease range of motionSeveral causesPain~Spasm~Pain cycle due to overuse/ischemiaExercise inducedNot warmed upContracting from a shortened positionDehydrationNutrition, splinting, pregnancyMiscellaneousSpasms/CrampsTreatmentOften depends on causeAcute cramps: massage at attachments, heat/ice, stretching, contract antagonistSpasms: massage, stretchingInjury PreventionCauses of InjuryMuscle weakness and imbalanceStiffness, shortened musclesTrigger points/painful musclesPrevious injury/improperly resolved injuriesFatigue

Between TripsConditioningMany injuries are due to muscle weakness and imbalanceRegular strength and endurance trainingSpecific training for paddlingRotator cuff/shoulderBack/torsoArms/forearmsProper recovery time between workouts

Between TripsTherapeutic or Sports MassageRelieves muscle stiffnessHelps resolve muscle imbalancesMaintains/improves range of motionReduces pain and resolves trigger pointsHelps resolve sub-acute and chronic injuriesSelf-treatment between massages

Between TripsStretchingYoga or other static stretchingDynamic stretchingMaintain and increase range of motionCore strengthening

Between TripsResolve Injuries Properly and CompletelyReduce scar tissue and weak areasReduce adhesions, increase range of motionPhysical therapy, strengtheningPrevent chronic injuriesOn The WaterBoat loading/unloading, portagingNever lift or lower with your backKeep back as vertical as possibleUse leg muscles

On The WaterBefore getting in your boatWarm up with jogging, jumping jacks, something to warm the musclesDynamic, not static stretches, full range of motionAfter getting in your boatBack paddle 10 minsDynamic stretches in boatPractice strokes

On The WaterUse Proper BiomechanicsPaddle in the boxHave a practiced rollTry to avoid high braces and other moves that can put shoulders at riskHave Good Equipment and OutfittingGood lumbar supportComfortable paddleComfortable outfittingOn The WaterAvoid FatigueEat properly before you paddleBring high energy snacksKeep hydratedBe careful about paddling several days in a row Listen to Your BodyKnow when to slow down or call it a dayPay attention to pain and injuryAvoid being overly stressed or aggressive