Right arm bad

No, really, my right arm has gone bad. I am now wondering if the former poster, RAB (RightArmBad) actually had problems with his arm due to paddling. I got an MRI and x-ray and I have no structural damage, my rotator cuff is fine. After about an hour of paddling, my right shoulder blade gets sore. Doc says shoulder blade rubs the top of back of rib cage, causing irritation & inflammation. I am right handed and paddle right handed 60 degrees offset. Does anyone else have shoulder or elbow issues on their dominant side? Would it help if I either eliminated the offset or somehow switched to a left handed grip? I paddle min and mid sized Brasca 3, 4, & 8 205-215cm. I have been told I have decent form, have had lessons from Oscar, etc, though I am sure my stroke could use improvement. I win some smaller races, finish middle of pack of bigger regional races, typically 1-5 hr flat water ones. Are arm and shoulder problems, other than rotator cuff, a problem for other distance surf skiers? Any good tips? Thx

Worthwhile seeing an Osteopath, there is an in balance causing your issue I would suspect. I used to have a shoulder that would give me greif all the time and went to the Osteopath, he re aligned it after telling me the top rib was moving out of place. He told me that I would need to get it re aligned every 3 months or so as pressure built up or if it gave me problems. I wasn't to happy about that so I started to look at my posture and what I was doing to cause the pain during my workouts. I discovered some exercises would result in pain, some movement would releive it. Took a while but I found which movements to avoid and which would re align everything and the pain would go away. Even changed how I sleep, basically my shoulders were being pulled forward with my paddling, working, typing, pretty much everything, even my pillow was too low as I slept on that side. Once I was aware of what was causing the issue I took steps to reverse the issue with posture when sitting, driving, walking, sleeping etc. Now if I feel a small ache I know what to do to relieve the pressure and re align myself. At first the rib would move all the time as that was where it was used to being. With time the muscles etc are more developed in the correct alignment and the rib stays in place more often than not. Pain is no longer a problem although it still moves about a little as it occasionally pops back into place when I raise my arms above my head and stretch upwards.

So first off see an Osteopath. Take a mental note what movements he puts you through to relieve the pressure and try to replicate them at home and try to be aware of what you might be doing that puts you out of alignment. If he is good and not looking to make more money out of you he may tell you what to do to keep the problem at bay, otherwise you might have to work it out for yourself like I did. But get it treated first and you will feel a lot freer in your paddling motion when you first get back on the water.

For me it was my non dominant side.

"Doc says shoulder blade rubs the top of back of rib cage, causing irritation & inflammation."

The above sounds hokey - I can't see how that could be possible. Ribs out of alignment sounds a bit odd, too. I would be skeptical of that dx.

If you've had your shoulder MRI'd and it was read by a radiologist, then it's likely ok. What about your neck? A cervical disc herniation at C5-6 or 6-7 could lead to shoulder area ache and that might be the next place to look for pathology.

Had similar issues, once you've ruled out structural issues (eg neck, ribs, shoulder etc), what worked for me was an osteo/massage therapist to loosen tight muscle groups over a 4-6 week period. Homework was using a foam roller and tennis/cricket balls to massage specific areas. Stretch, especially pec minor muscles, open the chest. I'm now pain free in right shoulder, neck and elbow. Go for a monthly massage for a maintenance session and keep up the foam rolling at home twice a week. Also, in parallel needed some paddling technique adjustment. Being 45, need to look after the body a little more. Was able to paddle throughout treatment. Goodluck.

Good advise about regular massage and stretching at home. Be sceptical about osteopathic diagnoses based on touch and mental imaging. All that clicking their thumbs and pretending your body parts are now realigned is no substitute for ultrasound, X-ray, CT or MRI.

All great insight. Thanks! what about causes of the pain and paddling changes I may can make? Obviously, I am (unknowingly and unintentionally) putting more stress/torque/power into my right arm than my left since my left arm and shoulder are totally fine. Would changing the offset angle alleviate the load on the right arm? What about going with a left handed grip? Can a right hander even adapt to a left hand grip? What about shortening the left or right footplate with a small pad?? bottom line: is there a way to transition the power out of one side and onto the other via boat and paddle setup? thanks.

After about an hour of paddling, my right shoulder blade gets sore

Me too!

In my case Oscar C suggested that it was caused by my stroke - he said that I was lifting my elbow up too high.

My physio suggested that a set of rehab exercises with a theraband to activate and strengthen the muscles around the joint.

That was a couple of months ago and I've been trying to maintain the theraband exercises and have consciously tried to keep my elbow down in the stroke. That isn't always easy, particularly on big downwinds - and funnily enough, that seems to be when I mostly get the pain, which occurs as in your case, after about 50min to an hour.

I have helped out a paddle suffering simliar pain. Found that instead of setting his should down and through the stroke he rolled up and over the middle section. This realeses the bottom of you shoulder blade and can cause all types of injuries. Practice with elastic band through the mid section, maintaning the lower section of you shoulder blade activated. You may also notice a rock to the left as you go through the stroke. Tape a drink bottle to your deck to monitor your lateral movements. And big yes to massage once a month. Same person every time might notice a change in you technique before you do via tightness. Don't go crazy with angle as long as your entry is closed and your top hand wrist is comfortable. Give it try you can only learn more about your self.

Can guide a horse to water but can't make him drink.

michelleowennz.blogspot.co.nz/2012/06/po...ing-up.html?spref=fb

Do you work with a computer mouse a lot? I do and in my own opinion, it has a rather bad effect on my right side: wrist, forearm, and the lower neck/upper back on the right above and near the shoulder blade. Took months to begin to improve, once I changed my mouse, started using a more ergonomic chair, and decreased the number of hours I hold the mouse (especially without a break).

As for changing from right hand control to left, I guess - why not? I changed from right to none (or both?) when I switched from 60 degree offset to 0. For racing you will find that 0 offset probably not the best idea (noticeably more resistance upwind), but works well otherwise due to the full symmetry between left and right.

I had a similar mouse related problem at a time when I was not paddling. The pain was in my right shoulder and across my upper back. My Physio got me to stretch as follows:

Sit on chair with feet comfortably on floor and knees together.
Cross arms and place hands on outside of knees i.e. right hand on outside of left knee and left outside right. Then spread knees so that they pull your hands outwards. The effort must be in your leggs and not your arms. You will feel the stretch across the upper back.

I did this 4 to 5 times a day while I was working and the problem was completely gone after about a week. I now find this helps when my back/shoulder gets sore from paddling

Thanks Schravesande! I work a lot with a mouse. This stretch feels great!

I had the same issue and have corrected it, mostly.I got onto a app on my IPad called "Coach's Eye" it's a movement analysing programme, fanastic, I filmed myself on an erg and could see strait away my problem, what I thought I was doing was not the reality! My right arm was coming over very high compared to my left. Worked for me.

mickeyA wrote: I am now wondering if the former poster, RAB (RightArmBad) actually had problems with his arm due to paddling.

Ha, good to see the mere mention of RAB can draw a crowd....a lot of views for a week old thread

RAB and I have the same affliction, a seperated right shoulder or AC joint. Increases range of motion in the shoulder and requires paddlers to really work on good posture to look after your rotator cuffs.

AR, I'm curious how your doing after the ac surgery mishap. I had previously bragged about having an ac separation (wife says type 4) and had recovered pretty well without surgery. The same day I posted that, I went out and tore my rotator cuff on a 15 mile downwinder. Are you saying that the tear may be related to the ac separation, my posture and technique. How do I then prevent further injury(s) besides of course not paddling. Any suggestions will be appreciated.
Conditions were pretty challenging that day and should, in retrospect, have been on EVO instead of V10. Doubt injury would have happened paddling EVO.
Thanks, Kirk

Fath2o wrote: AR, I'm curious how your doing after the ac surgery mishap. I had previously bragged about having an ac separation (wife says type 4) and had recovered pretty well without surgery.

I am no orthopaedic surgeon but as a RN and taking an active interest in my health and reading all I could find about my injury I have a pretty sound knowledge base on this injury.

You mentioned type 4, once you get to type 3 you have no ligaments positioning your clavicle over the joint. the type 4, 5 and 6 are all just the positioning of the clavicle after the seperation.

I wont go into rehab as that is common sense and rotator cuff exercises are very easy to find on the net.

There is no clear "best practise" when it comes to shoulder (AC joint) separations. Although through my reading the attitude seems to be that for those who are less active positioning the shoulder in a neutral position (in a sling) to allow the shoulder to heal over 6 weeks or so, recover sufficiently to go back to most tasks without issues. The research I looked quite a lot were for military personnel and athletes where surgical interventions are more popular for those that put the shoulder under more pressure. Where it gets a bit seedy is that of course the manufacturers of the surgical fixation devices may be behind many of the studies and there may be some parties interested in pushing various interventions.

If I had my time over I would have gone for the Nottingham Surgilig at the beginning, but I didn't have the knowledge at the time (a few days post injury) and the surgeon assured me he had repaired an elite triathletes shoulder a few months before the Hawaiian Ironman and he was able to compete no problems.

www.shoulderdoc.co.uk/article.asp?article=973

As my shoulder isn't ideal (for those that weren't aware it seperated again after having a hook plate removed) but doesn't cause me undue pain and allows me to paddle at a pretty good pace I am not going to risk further surgery.

As those ligaments have now been ruptured the stabilizing effect of the clavicle is greatly reduced meaning your whole shoulder can move in greater range of movement(ROM). If you stretch both arms above your head you will notice that you can reach higher with your damaged shoulders arm and same at the front. This extra ROM means your shoulder muscles can be stretched further.

I have had ongoing issues with niggles in my rotator cuffs but have found that by concentrating on holding my shoulders back and down, especially when sprinting I have largely stopped these niggles getting worse and at present I dont have any.

Downwind is tricky as you have so many more things going on to think about you tend to forget and thats when I get caught out. Especially with brace strokes.

I have started taping the shoulder for events where I want to go flat out and this has worked well.

I taught my wife to do it using this video



Good luck finding out what works for you.

Great detailed post Brett.

I have had several shoulder ops, one big one in particular involving acromioplasty (shaving acromium shoulder edge ) with arthroscopy at same time after being knocked off my pushy, rupturing spraspinatus and infraspinatus ligaments. (Not sure what type.) As has been pointed out, rehab exercises, strengthening and continual focus on technique to hold that shoulder blade down and reduce impingement as well as not unevenly stressing all the bits of your rotator cuff, combine to lead to long term improvement. This has worked for me.

Was going to comment earlier on in the thread but there was enough good input not to bother, however your point Brett about the extra stressing of racing flat out and downwinding is worth commenting on.

I can manage distance swimming of a 20km race at a good pace and have paddled 70 plus whatever k's in a day Avon descenting all pretty much without shoulder trauma (now after a few years of work), however if I haven't been paddling/swimming for awhile and get out into a rough downwinder or silly surf swimming, I invariably pull up with shoulder injury. Same if I go silly doing sprint repeats with mates when I've been out of the boat for awhile.

Strength, acclimatisation to stress, evenly applied force and conscious shoulder discipline (technique) are all essential together. The first two of these one just has to be patient with and develop through work, the last two for me are easy to screw up - constantly holding form and maintaining correct technique until it becomes automated. Leave it too long and bad habits lead to injury. Again this the case for me at least.

AR, Watto thanks for your response and the video (especially liked the buffed shoulder model). Gives me a much better understanding of my situation.
AR glad to hear your doing well post op.
Just observed my arm reach. Right arm reach is almost 2 inches longer than left. Kinda freaks me out, but, explains a lot.
Didn't have surgery for tear and seems to be recovering pretty well post physical therapy. Paddling and surfing has been quite limited but not impossible.
Yeah, I think the 2 mile stretch of real confused water, (at the appropriately named "Diablo Pt."), with a lot of counter current and cross chop is mostly responsible for the tear. Required a lot of bracing and struggling to catch a run. Went from 9-10 mph to 0-2 mph.
I think a more stable boat may have helped prevent the injury. Live and learn I guess. As always hope this info is of some value to others.
Thanks again, Kirk

Just a quick note for strapping
please don't put a locking (anchor)completely around any limb and onto itself, just stop it short, it is important that the tape doesn't stop (in this case the bicep) from expanding in size as it is pumped up with blood.