Paddling with rotator cuff injury

Glad to see you’re back on the water. Wishing you a speedy recovery.

I've been paddling a bit more (although short daylight winter days and gales make that difficult).

Still niggling shoulder injury; just get that bit of pain that says not to push effort.

Last weekend I was going for a steady gentle paddle, about 1.5hours. Flat water (as much as the sea is ever flat) with light winds.

Noticed that I was letting my strokes get quite long, not going out. 'watched' myself and I was straightening top arm a bit early.

So, set to remedy this by keeping top arm in the 'bent' position it is in at the catch.

Three things happened:

Stroke shortened and swung wide.
Rotation increased.
The niggle in my injured shoulder disappeared!

I couldn't believe it. Went back to normal stroke; sensation of strain came back. Locked arm in bent position; pain went away.

It is like magic.

Did 8km last night in the dark at what, for me in my boat, is a good cruise speed; no problems. No pain, no strain.

That's great news.

Ivan has a video on how important it is to keep the elbow bent.

Mr charly that is great! I have had that same experience. Trying to paddle with a sore rotator cuff muscle forced me to paddle in a better way that didnt load up those little muscles. If I recall correctly it also involved more rotation for me.

LaPerouseBay wrote:

That's great news.
Ivan has a video on how important it is to keep the elbow bent.

I had that in mind when correcting my stroke. Ivan is well worth listening too; I'm not sure anyone has been as dominant as he was at the marathon distance AND managed a medal in olympic sprint.

Posted a comment about this on a facebook ski forum and a physio/ski paddler responded, saying that the bent elbow reduces the length of the lever, therefore reducing the load on be bicep tendon.

One of my original injuries was a torn bicep tendon, so that matches the improvement.

Yes, your long head biceps - the one that connects to the labrum. I tore one about 10 years ago. It's not unusual, mine was not painful, I din't even know it happened. The only symptom was the appearance. Everything else in the area sorta covered for it. I kept paddling right thru it.
Skinny guys like me that did throwing sports, basketball and hockey often have damaged shoulders. Mine were all minor, only one broken bone, no severe rotator damage. but plenty of minor dislocations and tweaks.
I never had pictures taken. Labrum and rotator cuff damage is common knowledge if you dig deep enough into the internet. I"m almost certain I have a smashed disc in my lumbar. My right thigh got sliced to the bone really bad in a skiing accident (missed the sciatic nerve by a whisker). My left collarbone is still in two pieces, right shoulder works pretty good, but it's gritty. Everything heals in time - to a certain extent. We all adjust and keep moving, with a little hitch in our giddyup.
Don't be too hard on yourself if your stroke isn't the perfect K-1 flat water stroke, particularly in the ocean. A blade in the water is not all about forward motion and lift.
Look at Walter Chalupsky's form on this downwinder. (He's the one in the V-9) He's a very experienced ocean ski paddler. He is doing a lot of control work at the end of his stroke - that's why he keeps the paddle in the water so far past his hips.
He's more focused on his weight balance - trimming the ski on the wave. That's ocean paddling. Starts at 10:50.

Recovering from a shoulder injury in the ocean is going to require a lot of discipline not to pull too hard into glides. Good luck.
I heard something pop in my right shoulder about 5 years ago. I was lifting something heavy at work. My massage girl said sometimes thats just an old protective scar releasing because the body thinks it's time - and the rest of the shoulder is ready to cover it. She was right. It hurt a bit, but not enough to stop working. I took about 6 months off the ski (it hurt to paddle) and came back stronger than before. Shoulders are funny that way. Very complex joint.
I don't see her anymore, I'm all fixed up. I went for years and grilled her incessantly about anatomy. I also dove deep into the internet. One thing I remember is that she said the teres minor is a sneaky one. That one would hurt like a bastard when she worked it. She said it needs to release or the entire shoulder will remain tight.
She is a wizard at releasing hidden spots average people never think about. I strongly suggest you get a good massage therapist to get in there and find out what may be out of balance. The key to healing is getting blood flow restored, bones aligned etc. It's really complex. But not for the pros. It's their job. They can feel where that scar tissue is, sometimes ripping it out - for our benefit. They know.
The body naturally wants to re align. It wants flexible joints and long, supple muscles. Our DNA will naturally rebuild damaged areas if we give them enough time. The trick is to stop submitting the area to the same battering that made it collapse in the first place.

Here's your biceps.


Basic anatomy of the rotator cuff.


Here's what happens when you cheat on your band exercises.


This one begins to show how important it is to have strong, supple rotator muscles. Tight stabilizer muscles will restrict motion and available power. All of our joints have very sophisicated sensors to prevent the big muscles from ripping our joints apart.

Mrcharly,
Here's another example of how ocean paddling can overload the front of a tender shoulder.
As before, it's about the blade remaining in the water past the hips - for control.
The paddler is pushing down, to push his weight back up to center.
Starts at about 1:25.



That is the exact opposite of propelling the boat forward with "good technique"

It's not ideal form, but very common. That's what happens if you are a tad bit behind the sweet spot on the wave.

Keeping the elbow tight protects the joint. But that's the opposite of a nice wide release, lifting the paddle out with the back of the arm...

That's ocean paddling - full of surprises and compromising reactions.

Yes - I note that with the top hand dropping, there is a tendency to 'chicken wings' the drive arm (life elbow high), which hugely loads the drive shoulder, is very inefficient, and scoops water with the paddle.

Keeping a very very short stroke and not dropping arms helps with stability and preserving joints.

mrcharly wrote:

Keeping a very very short stroke and not dropping arms helps with stability and preserving joints.

Yes, i agree, a shorter stroke helps.

Sometimes a shorter stroke is not possible.

What I'm talking about is a paddler driving the blade deep, say on the left side, then realizing that their center of mass is also leaning left. "lifting the blade out early, to help stability" will result in a capsize.

Sometimes, it's better to leave the blade deep and resist forward motion. A paddler can literally push backwards on the lower hand. It imparts a righting moment on the center of mass, preventing a capsize.

You can see the current ICF surski world champion here, leaving the blade in "too long."
If the ocean is zooming up behind too quickly - his strokes are powerful and he leaves the blade submerged.
He's feeling where that wave is - focusing his eyes forward. He's not thinking about "air time."
If he's going too fast, he takes very light strokes, planting very late. Again, feeling where the wave face is.



Controling one's balance and location on the wave face is paramount in the ocean. Perfect technique comes second.

I used to be a very tremulous K1 paddler. Only just coped with mid-stability K1s in races. Then, for a laugh (I'd already been in the water once), I got in one of the very unstable club boats. And didn't fall in .

Subsequently bought (by mistake) a stab 1 K1.

What I learnt from paddling those boats is that you can 'lean' on a paddle in stroke as long as it is generating power *but only while the paddle blade is face-down or vertical*.

So if the end of your stroke is going out, power is still being generated, and it will provide stability.

Of course, in moving water (flow or waves), the direction of water relative to the paddle can change very dynamically, so the 'purity' of the K1 stroke doesn't always exist.

mrcharly wrote:

What I learnt from paddling those boats is that you can 'lean' on a paddle in stroke as long as it is generating power *but only while the paddle blade is face-down or vertical*.
So if the end of your stroke is going out, power is still being generated, and it will provide stability.

The paddle blade does not have to be face down or vertical to provide forward power or provide stability.
Blasphemy in the K-1 world, but not in ski. Video evidence is easy to find.

Here's Clint, a gold medalist in sprink kayak, world champion downwinder.

That stroke he does on the right at 0:44 is a perfect example. He enters the water nearly past vertical.



If the top hand isn't going across the horizon, it's not wrong.
Nor is it "wrong" to exit the water "late."

Is ideal form better? Yes.
Is it common in the ocean? Not for me. I prefer to adjust my stroke and effort to the conditions, not to what looks good in a gym, or on flat water.

If I was recovering from a rotator cuff injury and wanted to paddle in the ocean, I'd go back to basics.
I'd do these Oscar drills. They break down the stroke, with the elbow tight, shoulder protected.

I've had full thickness repairs in both shoulders. One of them kept its long head bicep (LHB) tendon, the other didn't.

It's been explained to me that this particular tendon is evolutionarily losing any utility -- it's a relic from when we were more arboreal, living and swinging in trees.

It is responsible for less than 10% of bicep power, if even that, and it doesn't do very much, except maybe have some utility in extreme ball-throwing circumstances or similar.

What it can do really well still is HURT! Should it rupture, it often just stops hurting.

The rotator cuff muscles are entirely different. They are really important.

When I fully tore my first rotator cuff in my non dominant arm, I did so bracing on the wrong side of a wave. Ouch. There is no way I could have lived with that arm and no repair -- it ached all night and often through the day, I couldn't really think straight.

Unfortunately, repairs carry significant uncertainty, no two people will have the same experience. They are all different shapes and sizes, sometimes the tendon can delaminate too, like a braided rope coming apart. Size, number of tendons and tissue quality all play a big part in outcome, as does how long the damage has been there, particularly if the brain has habitually been guarding the area for some time.

That's annoying, because many shoulder injuries will resolve without intervention - and trust me, that's a much better outcome than any surgery. Except, when confronted with specialist opinions that state 'sooner is better' and 'it might just get worse', it's kind of hard to wait it out. Not to mention being off the water.

I returned to paddling on that first shoulder repair carefully, following medical advice, at around 6 months. Unfortunately for me, some complications came along a little while later, for which I never got a diagnosis, but that shoulder then hurt me non-stop for years afterwards. Not nice.

But I did keep paddling, accepting that it was hurting, but perhaps not damaging me. I just wasn't very much fun to be around in those years.

A number of years later, my other shoulder started hurting and I went in for a biceps tenodeisis operation -- where they remove that long-head-biceps tendon and staple it to the upper arm. A decent procedure, with maybe a 2-3 month recovery time, quite common in climbers, who tend to make a full recovery. They discovered a full tear in the rotator cuff there too, meaning it was 6 more months and another full shoulder repair. This one healed normally with no complications at all.

The amazing part -- once the second shoulder started hurting, the first kind of stopped bothering me. It didn't exactly stop hurting, but just stopped bothering me.

Now days I am paddling 5-7 days per week in all conditions. I'm happy to be out there

I've religiously done every possible shoulder rehab regime there is. In my opinion, whichever one I choose, the most important thing is that I believe it is doing me good. The shoulder area is really neural, lots of nerves, close to the brain, kind of really important for life, and in my opinion as long as I think it's going to cause trouble, well, for me, it does... so my rehab is about demonstrating to my protective brain that all is good, safe, strong enough. It's a hard message to get through when that part of the body is going to be seriously tested by ocean paddling.

Every time I have subsequently set myself back it's been in the gym, not on the water. I'd rather keep paddling than lift anything remotely heavy. The gym work I do is all about gluing my bits from foot through to hand together, which is what I understand a paddle stroke is kind of all about. I have no need to do anything overhead in the gym, with bands I can always get the same results and stay 'under-head'.

When paddling, keeping my elbows below my shoulders is important, and as Ivan says, having a 'break' in my bottom arm. Also, these days I feel the stroke load on my torso (kind of from hamstring to chest) more-so than the arms, if that makes any sense. For years and years I used my arms to paddle, which I think made injury much more likely.

Basically, shoulder injuries really suck for paddlers. But we can get back out there and be strong again

Feeny - thanks for sharing. Really interesting observations! Thanks for writing it out so clearly too!

mrcharly wrote:

I couldn't believe it. Went back to normal stroke; sensation of strain came back. Locked arm in bent position; pain went away.
It is like magic.

Here's a nice visual on a bent elbow. This guy has a lot of good info on his channel, on the water and in the gym.