Tendonitis - Treatment options?

The 404km Murray River Marathon here in Oz is a great event - 1100 competitors - this year (its 40th) even the temperature was OK (not the 47 degrees of the past 2 years!) But there was the headwind!!!
As a result I've ended up with tendonitis in both forearms and 3 weeks after the event they're still causing problems. I'm on 400mg Ibuprofen 2 x a day, have had ultrasound, wear support braces and its improving but...slowly.
Any tips on how to speed things up? (I haven't paddled in 3 weeks!!)

Hi Couta

I had the same problem for about 10 months and have finally got it sorted. My issue was the inside of my right elbow which I managed to keep at bay with diclofenac 75mg before each paddle - not a great future in that.

The doc got me lifting weights in a very controlled manner with a very slow release. It did cause some pain but this soon decreased. I ended up with a huge left bicep so had to work on my left arm so I would'nt paddle in circles. Bear in mind my fix was specific to me, I'm detailing the fix to give you some hope!

The greatest issue was finding a doctor that knew how to treat it and understood that I did'nt want to stop paddling. He understood that mind set completly so was able to build the treatment into my paddling.

Good luck

Hi Couta

Bad luck! You may want to chat to your doctor about steroid injections into the tendon sheath, otherwise you're doing all the right things. Also, don't try to make up for lost time when starting paddling again. Take it easy...

Have you tried using a massage therapist competent in myofascial release?

If you've got a pretty classic extensor tendinitis, keep those wrist braces on 24/7 or close to that. Those tendons need near complete rest to heal and they won't be able to do so if you're taking the wrist braces on and off throughout the day. The anti-inflams will help, too.

So, you're doing the right things. It just takes time. And, if you don't allow it to heal quickly and adequately in the beginning, you'll be trying to get it to heal all season or year long.

Interesting to read about how many paddlers have experienced this same, persistent problem. I had the problem in both inside elbows for almost a year, and it just wouldn't clear up - probably because it's impossible to immobilise elbows, so the condition becomes chronic. An op (similar to the one for tennis elbow, but on the inside elbow) also didn't help.

Be careful of cortisone as a solution - can have a bad reaction in other joints (knees, wrists) in some people. Never have more than two or three shots.

Since then I've heard several accounts of what helped paddlers through forearm/elbow tendonitis, including thin shaft paddles and Plaster of Paris for a few weeks!

Any sort of tendonitis is difficult to heal. We all assume you have stopped paddling, but my guess is you probably haven't (most of us wouldn't). Tendonitis injuries are usually overuse injuries and the secret to fixing them is rest. Anti inflams help a lot, stretching and myofascial massage can help. Massage can also stir it up if not done properly.

Rest can be achieved a lot of ways. Stop paddling, braces, plaster (medicos way of saying "stop paddling"), modify your training regime (paddle slowly, but don't exceed the pain barrier, don't paddle every day). Using a smaller blade helps my arms a lot. I use it whenever I feel my arms getting tender again. Shortening the shaft of your paddle (smartshaft) helps heaps by reducing the strain on your forearms. If you adjust your paddle to a shorter length, for example into a headwind, you will notice a fair reduction on the stress in your forearms.

good luck

I suffer too and have found these pressure pads very helpful. And they are quite cheap.
www.aircast.com/index.asp/fuseaction/pro...s.detail/cat/4/id/32

Hi Couta,

The tendonitis you have described is a common one to occur during the Murray Marathon, and other long distance paddling events, when there is prolonged exposure to high winds. It is called "Intersection Syndrome/tenosynovitis" and caused by tendons of the thumb rubbing over the tendons that extend the wrist, as both are taut from being under extra load keeping a grip on the paddle against the wind.

Unfortunately there is no quick fix (and hopefully by this time it is nearly better), and what the others have described already are all the appropriate treatments - rest (splinting), anti-inflammatories, and any other treatment therapies from your local physio will all help ice, ultrasound (a bit contraversial these days), laser etc. The splint needs to immobilise both your thumb and your wrist to stop the tendons moving over each other.

When you start back paddling you may need to have your wrist strapped to prevent excessive flexion/extension. Maybe someone can video your technique to see if this movement is an issue.

Get back into paddling slowly and when facing strong headwinds again be sure to keep your grip as relaxed as possible.

Good luck.

Buzz

This forum is a fantastic resource - I'm glad to report I'm back on the water and all is good! The advice provided was all valuable - most valuable was knowing that tendonitis is an issue others have experienced and successfully sorted out.
That gave me a confidence boost and helped overcome some of the uncertainties and frustration associated with sitting on the beach/river bank while other were out there having fun and working on their programs!
Thanks again.
Stay Safe
Couta.

Good stuff all , as an acupuncturist I of course would recomend acupuncture as another therapeutic tool to aid recovery ,on another tack is prevention. Some have suggested small diameter paddle shafts. I actually made mine slightly larger with some handlebar tape. My theory (and it has been working for me and a few other friends) is that by make the shaft thicker my grip or flexion is more in the middle of its range (depends of course on hand and finger size)and has a little more room to move dynamically before things tighten up and start pulling and rubbing and ultimately inflaming.The wrist , hand and digit movement is obviuosly quite complex and dynamic when paddling.Throw in some lump and wind and the microadjusting gets busy.It is an easy thing to try,you can secure the handlebar wrap with some vinly tape , just be sure to choose a less textured wrap and mind the winding on the shaft is uniform and in a comfortable hand position (most would say roughly shaft horizontal and centered on head grip so elbows form a 90 degree angle to slightly wider than shoulder width (this will probably spark some debate) again an easy experiment.the wraP also serve as good indexing .Hedres to happy wrists and hands, tendonitis sucks ! Sandy