Paddling with rotator cuff injury

I tore my rotator cuff back in 2019. I decided at the time to avoid surgery unless it was absolutely necessary. I’ve been paddling successfully ever since without too much pain. Lately, my shoulder has been acting up more than usual. I know there are stretches and tricks to keep myself functional.

Any paddlers have/had a shoulder injury and what did you do?

Also would like to know.
PT says mine is not a rotator cuff injury (well, part of a tree fell on it, so no surprise).
CT scan showed a lot of inflammation and blood around tendon of the long bicep, but I don't have pain when curling . . . PT just confused.
This looks to be a useful site, I'll try some of it myself: www.shoulder-pain-explained.com/muscles-of-the-shoulder.html

Posting this link for my benefit www.yorkvillesportsmed.com/blog/dealing-...exercises-for-relief

My experience is rotator cuff injury can only be fixed with time off especially if you are over 50. I hurt it once with bad technique, then it got better and kept paddling for a year with a little pain on and off. Hurt it again on a beach break. It became painful to even lift my arm to hang up a shirt. Only thing that helped was stop paddling for a year. It will take another year of slowly ramping up in paddling. I use Oscar Chalupsky's technique of elbow always down now. Move the body rather than the arms.

That is a horrific story... A year off paddling! Aaaargh!
I did my rotator cuff at around 45 and it took about 3 months and 100% rest to heal. I ended up going to the local Sports Science Institute where they referred me for a cortisone shot in the joint. All very well, but there was no advice/after care at all. I couldn't believe it - their attitude was, "you've had the shot, go forth..."
So I took another month of slow, gentle paddling on a lake - and worked on technique - before venturing back onto the sea. I was left dubious about the efficacy of the cortisone shot, but the upside was that I was back on the water.
The injury was caused by my holding my paddle above my head while going out through big surf. I still have the image seared into my brain of being literally smashed backwards over the tail of the ski... My introduction to Durban surf many years ago, the day before the Scottburgh to Brighton race. I did the race, but a week later, my rotator cuff was in agony.
So - "good luck, and take it slowly" to anyone with this horrible injury!

I'm 65, paddle 4 - 5 times a week, hour+ most sessions. Got a wonky right shoulder from weight lifting in my 20s and 30s. What helps me the most, and keeps me on the water, is keeping my shoulders down and my elbows lower than my shoulders through the stroke. Hope it works for you.

I have had five shoulder surgeries over a 9-year time frame, three on one side, two on the other. Been through a lot of rehab. Clavicle fracture and repair, rotator cuff, SLAP tear, debridement, biceps tenodesis........

I find theraband/theratubing work, Bodyblade work outs and just general mobility work is the key. You want to keep as much Range of motion as possible, so you don't have adaptive movement patterns that predispose you to additional or future issues.

I find that a shoulder complex of band pulls, internal and external rotation of the shoulder, and working the surrounding muscles of the shoulders really helps. Ivan Lawler had some good band workout videos he made during COVID lockdowns in England that he posted on his YouTube page. Message me if you want more specific info. I am a sports chiropractor and work with athletes.

Hi five DrA5 - oops low five that! Same for me, three reconstructions left shoulder, two on the right from 17yo to now 72 mishaps skateboarding, rugby, motorbikes, cycling and general abuse swimming (long distance) and paddling. Throw in twelve months ago a bout of arm wresting with a 25yo after a few beers (did not end well). Same as you DrA5 have managed with a similar range of rehab activities and constant focus on swimming and paddling technique.

My last miscalculation however has resulted in ultrasounds, X-rays and after The Doctor and Worlds this year in Perth (if everything holds together in the meantime) an MRI (about $400!) and potential surgery again. Regardless of this injury which definitely causes discomfort with some shoulder movements here's the irony. If I don't paddle it gets worse!

My hand around the blade always across my face in front of me around chin level and always parallel with horizon (use a GoPro mounted front of your boat and replay slo-mo). Exceptions to this is forward stroke recovery high brace style when getting slapped occasionally in clapotis (refracted side-chop), but that is pain free with arm up high, right angle at elbow out front, if that makes any sense.

My focus is always twisting from the waist arm straight (maybe a tiny bend for leverage sometimes but aim is always to keep straight) and as per Lawler and other videos, paddling away from the boat and getting that blade out of the water at hips.

A final point re Rob's post; had two cortisone injections last 12 months, first very carefully and thoughtfully managed (two SKG female professionals) which worked for about a 70% recovery then a second scheduled pretty cursory injection (male SKG professional) which didn't help one iota. Without crapping on too much spent a few weeks in hospital at year's end 2022 diagnosed with seronegative rheumatoid arthritis (!) and as part of the program for about 6 weeks onto prednisone big time, slowly getting weaned off. During this time my shoulder pains and discomfort basically disappeared!! My point, other than an injury through a tear which needs time to heal, subsequent inflammation will exacerbate joint movement so minimising inflammation through nsaids, effective movement/proper technique and strengthening surrounding muscles and attachments will really help.

I have only had two shoulder surgeries. First one was significant resulting in only a 70% recovery in terms of movement and strength.

I have just come off a one year layoff due to a second shoulder surgery. Unfortunately similar prognosis in terms of mobility and strength. I can be as fit as I want to be, but there are limits in terms of what I can expect of my shoulder so speed wise, I am very limited in what I can achieve.

However, I can paddle albeit slowly and I am grateful for that. In terms of my experience. You have to make sure that you work on your mobility AND NOT just for your shoulder. The body is a kinetic system, if you focus only on your shoulders and are not working all the other joints and muscles, there will be an issue down the line. Everything needs to be mobile and have strength at the extremities of movement. What that strength looks like, is going to be very personal based on your age, possible mobility and range of motion etc.

I also make sure that I warm up before every paddle. I take a theraband with me and do pull aparts and face pulls for 5 - 10 minutes before getting in the water. A warm, pliable shoulder is far less prone to injury. Because my strength is limited, I cannot really hurt myself pulling hard through the water like in a DW, but if you do not have those limitations, be sure and build up to full focussed power over time. Adrenalin can make you pull harder than you thought possible and in that you could hurt the shoulder again.

Overall, it is something that needs to be managed, mostly off the water with proper mobility and strengthening work and then a bit of stroke focus on the water. My stroke looks nothing like an ideal stroke, but it is the stroke that allows pain free paddling.

There is life after shoulder surgery and even though I have limited strength and mobility, I can still get on the water. I will never win any races, but I will be out there for many, many years to come if I manage my physiology correctly. That should be the goal, longevity over the short term euphoria of beating a mate in a DW or winning a race in your age group.

Wise words Manta!

I've stopped paddling.
Doing more cycling.
Some gardening.

Shoulder as bad as ever. Over 6months since initial injury.
Despairing of this ever healing.

Hey McCharly

One of the mistakes I made, was waiting too long to see a specialist. I waited a full 6 months before seeing the specialist and in that time, I had only made the injury worse.

I eventually had the surgery and it was a big operation. My recovery was a lot slower than even the surgeon intimated it should be. I found a great sports masseuse and religiously stuck to the exercises the physio had given me. It took some time, but one day I woke up and realised that for the first time is almost a year, I had no pain.

I am not 100% yet, far from it, but my shoulder is functional and I am able to paddle, albeit slowly and with care.

A shoulder is a bugger, rather have it professionally seen to and then take your time with the rehab and recovery. I speak from experience, I had a big surgery on my right shoulder almost 20 years ago and it took a long time to fully recover but it did. Patience is a key with this joint, but if you put in the work, you will be back to normal. It was that learning that helped me with this recent surgery on my left shoulder.

You can do it.

Thanks.
I'm somewhat despairing. I've had bad injuries before (broke my wrist/hand so badly they said I'd not recover full use of 3 of my fingers, that recovered).
This just doesn't seem to get better. I've had an ultrasound scan. Seen a physio.
There is a private sports physio who is highly recommended, but has a 3 month waiting list. Might put myself on the list.

Well, utterly frustrated by not paddling, I went out yesterday.

It wasn't suitable weather, but the only time I could get out in daylight.

Blowing 30knots, gusting harder. An easterly, and the lochs face east so that funnels the swell. 'my' loch has a smattering of islands (ranging from 30m across to multiple acres and 30m high). The islands do block the swell, but make for confused water.

It was hard going, my left arm was weak and I lacked general fitness. I plugged into the wind, taking a rest in the lee of islands.

The ride back downwind was a bit wild. Swell swinging in from one direction, reflected chop from the islands.

I couldn't power through, so had to work using body weight more. Haven't done this before and it made a huge difference.

Expected my arm to be dreadful this morning, but it seems to have eased the problems a bit. So I'll try paddling more regularly.

No paddling for months now. Arm extremely weak in 'top hand' position.

Biggest issue is getting boat in/out of storage. Can't lift left arm above shoulder height, so can't get boat out.

I've bought a rowing machine to try to maintain some fitness.

Working on some exercises (write alphabet with tennis ball on wall, some theraband stuff). No direction from PT though, still waiting for appointment (which might be another month . . .).

Seriously thinking of making a single blade paddle - I think I could paddle with one ok, since I have reasonable strength with arm in forward up position. Doesn't solve the problem of getting the boat out though, and in this weather, it has to be put away.

Sorry to hear that mr charley. I know you love doing this sport as much as any of us. Wishing you a speedy recovery!

An update - and information for any other paddlers.

I ceased paddling entirely. Arm so weak, I had no reliable strength in stroke on the right side.

Arm continued to deteriorate. Difficulty sleeping at night, by 4am every night I had to take ibuprofen.

A friend suggested I request a copy of my medical records (so I could take the scan and x-ray results to a private physio).

I did so, and discovered a note on the ultrasound, saying that as well as evidence of torn biceps tendon, the scan showed likely adhesive capsulitis (frozen shoulder to you and me).

So, armed (ha!) with this, I googled the condition, and discovered that ceasing movement and use was the worst thing I could have done. Frozen shoulder is a buildup of scar tissue through the muscles of the rotator cuff, and, when just rested, the scar tissue continues to mesh with the muscle bundles.

So I've started a series of (slow controlled movement) exercises designed to 'bust apart' the scar tissue. Break the adhesions to the muscle tissue.

It is working. 5 days of doing that and I managed a slow, gentle 8km paddle.

It is beyond me why the first physio didn't recommend similar exercises. I didn't invent them, I got them from the web for treating frozen shoulder. It seems that she only read as far as the description of the bicep tendon damage.

So sorry to hear that Mr Charley. I’m fortunate that I can still paddle with my rotator cuff injury. Still haven’t had the surgery. I’m terrified it will make it worse, and the idea of being off the water for 6 months is unbearable.

Good luck with your recovery. Hope you can find your way back to the sea soon.

Thanks for sharing Mrcharly.

There's some really good info there.

What I take out of this is that it's really important that we all act as our own advocate. We don't need to be medical experts; we just need to stay engaged. Read reports, ask questions and try to understand the basics of our condition. That way we have a better chance of optimising the mechanisms by which the treatments aim to remedy the situation. Importantly; don't hesitate to seek a second opinion if you are not getting exactly what you need from your specialist. Sometimes just having someone else explain it all to you in different words can make a big difference.

Atlas, I agree.

There is an appalling tendency for non-sports physios to disregard any injury that isn't completely disabling (although mine was heading that way, I was needing help to get a T shirt off).

Getting hold of the full reports can be problematic in the UK health system. You have an absolute right to them, but have to jump through hoops. Sadly, a decade of under-funding has left our health care in an abysmal state (not commenting further on that, since politics doesn't belong here).

If I'd been living back in Cambridge, I would have made use of the company private health cover and no doubt been sorted out within a month or two.

Instead, I'm part paying the penalty of living in a remote location with limited healthcare resources.

I'm making huge strides in recovering from frozen shoulder.
Seen physio, who approved of my self-researched exercises and added a few more. Also gave guidance on how far to push it.

I'm mostly working with therabands. Key to using these is not in the exertion (stretch) phase, but a very slow relaxation. 'Frozen shoulder' seems to be adhesions between muscle and scar tissue. Lengthening muscles involves individual bundles relaxing, increasing the load on adjacent, contracted, bundles. I hypothesize that this interaction is breaking the scar tissue up.

This is one instance where a desk job is an advantage. I have bands rigged so I can do a few reps every time it occurs to me.

The shoulder is still weak, less than 50% normal strength. But range of movement and strength are returning.

Managed 3 paddles in the past 7 days. All only short, under 10km, in absolutely calm weather. Still have no strength for accelerating, but it is getting there.