Carpal Tunnel Comeback

Kiwibruce has reminded me to give a bit of feedback re carpal tunnel surgery. After nervously lying on the trolley in hospital two weeks ago in what felt like a green shower curtain and thinking, maybe I'd like to change my mind and go home, I can now say, it wasn't as bad as I expected.

The day after surgery the hand ached obviously, but the Prodeine Forte worked well. I didn't need such strong tablets after day one and just went back to the odd ibprufen after that. For two days there was discomfort if I moved it suddenly, but by the end of day two I was driving (a manual car)again with lots of firm bandaging protecting the palm of the hand. The Dr's instructions were to wear a sling for the first 5-7 days, which I mostly did except when driving of course. This prevents swelling.

By day five, I could wiggle my fingers vigorously and flex the hand and make a looseish fist. So far so good. There were a few brief unpleasant `electric' tingles as the nerve settled, but apparently that's normal post op stuff.

As for maintaining fitness, I could still do ab crunches each day, I was jogging by day six and in then in the gym a few times using treadmill and the machine where the elbows draw the levers & pulleys together(I haven't a clue what the name of it is). Push ups are off limit for a while yet.

And today I had my stitches removed and finally saw the 2.5 cm cut on the base of the palm. At present, a breathable tape is on the cut and the surgeon told me I can paddle by Monday if I feel like it. Do I ever!

However, I'm to paddle very slowly, in very calm water preferably and stay close to shore in case things go wrong. Sensible advice which I shall follow for a few days.

Grip strength after 2 weeks is not yet strong. I cannot for eg open a tight lid or hold a heavy saucepan handle for more than 30 seconds. No surprise there but I'm hopeful that this will improve over the next fortnight.

I hope this feedback helps anyone else with carpal tunnel who is considering surgery. I had little idea about what to expect post operation and maybe this info will reassure someone (similarly hesitant) that it isn't so bad.

Paddling is still an unknown and I shall post what it feels like when I venture out next week. I've also used the break to have a minor hole in one ski repaired. But if you surge past me on Pittwater or Manly as I crawl along, please don't suggest I get a faster ski! I'll just be happy to be back on the brine and NOT NUMB.

You need to remember that the surgery has altered your anatomy to provide a bit more room for the medial nerve. The thick ligament that had been between the nerve and the skin has been divided. This was necessary to remove the compression on the nerve in the carpal tunnel. The nerve now lies closer to the skin. I recommend that my patients wear a protective glove like a cycling glove with a gel pad for a while. I have found it easier for guys who work with their hands or drive trucks to get back sooner. There are some good paddling gloves here in the US like Warmers 1/2 finger gloves that are light and don't get too soggy. Generally however I find most people need about 6 weeks to get back to work if they use their hands. I am sure your doctor will refer you to an OT for strengthening and scar management if he thinks it is necessary.

Thanks DrTomPls, that's interesting advice about the gel glove. My hands are fairly used to rough work but I hadn't considered the problem of the nerve now being closer to the skin. In a day or two I'll try to paddle sans glove first, but I'll keep your very pragmatic gel glove solution in mind should I feel any pain or discomfit. I appreciate the feedback. As good as my surgeon is, he didn't provide much in the way of paddling advice post op.

I had my first paddle today since surgery 16 days ago. Just 30 minutes on flat water, and only at warm up pace. The good news is that there is no pain from the healing cut because the paddle makes no contact at all with this part of the hand.

The other good news is that my fingers didnt feel even the slightest numbness or tingling. Could the operation have been a success? I wont know for a while until I lengthen the duration of my training and up the pace.

I suppose it's to be expected but my wrist didnt feel as if it could pull very strongly through the water yet. Not pain, just a strain is lurking there. But as I was originally told 4-6 weeks recovery and I'm back on the water in less than 3 wks I'm not complaining.
I'll have a few more short gentle paddles then start to increase my efforts. I'm optimistic.

It's been three weeks since my open cut (not keyhole) surgery and I've been back on the water 5 times; today for an hour in strong wind and chop (a good test for my hand), and I've been able to paddle at a solid 80% effort after a 10 minute warm up. I keep waiting for my left hand to go numb again, but it doesn't. It's like magic!
These posts have been aimed at giving some practical info about recovery (specific to paddling) to anyone who has carpal tunnel syndrome and who is contemplating surgery, but I dont want to pretend my hand has fully recovered in 3 weeks. The heel of the palm is still tender with scar tissue so I can't do push ups or tricep dips yet because I can't support my body weight. (Does anyone know an appropriate exercise with dumbbells which works the same muscles?)
Also, the wrist is still rather weak and grip strength not fully returned. And barre chords on guitar are a bit painful also!
But I'm paddling well again and that's the main thing. Good luck to fellow carpal tunnel sufferers out there and don't put up with numbness while paddling (for over 10 yrs), like I did. Perhaps I'll do my dodgy right hand next year?

I wonder if the real cure was an operation was the only way to stop you paddling and doing 1 armed push ups for a few weeks???

Kiwibruce, you must think I'm built like a massive All Black to do one armed pushups. If only! Stopping paddling for 2 weeks in lovely Sydney weather was hard to take, but it's good now to be back on the water. PS. Good luck in the rugby world cup you kiwis, I love seeing your team in action (except when they're ahead of the Wallabies on the scoreboard).

I thought I had the same thing but went down the massage therapy route. I loved the massages and things definitely have improved, next I am dropping an paddle size and fixing some technique issues. So far so good.

Kiw Bruce - I hope your kiwis do really well and come third! Beaten by the Wallabies who just finished smacking those Bocke's.

I thought I had the same thing but went down the massage therapy route. I loved the massages and things definitely have improved, next I am dropping an paddle size and fixing some technique issues. So far so good.

Kiwi Bruce - I hope your kiwis do really well and come third! Beaten by the Wallabies who just finished smacking those Bocke's.

Westley, you're dead to me.

Not sure if your Kiwi or SA but if it is any help, I hope the winner of the Australia South Africa match win the cup - which should be the case as the Kiwi's will just choke anyway

Ahhhmmmm ...Back on topic...

I had been struggling with a bit of forearm pump/right wrist soreness in my right arm from gripping too tight.

Just put some spongy/grippy bicycle handlebar tape on the right side and wow what a difference. Having big hands it help me to relax my grip on the shaft and improves grip, no slipping of the paddle in my grip means less swimming

I have used good quality (important) duct tape as grip. Just apply with a slight overlap and secure the ends with el-tape. Its durable and holds up in both varm and cold waters. I adjust the "slippage" with a few light strokes of 60 grit sandpaper.

I used the bike tape and it is by far the best thing I ever done, but, it just doesn't last long enough.

It costs too much,takes too long to do and comes undone too soon.

Other than that it is great.

Id like a one piece slip on grip that feels the same that just shrinks on.

Rightarmbad wrote: I used the bike tape and it is by far the best thing I ever done, but, it just doesn't last long enough.

It costs too much,takes too long to do and comes undone too soon.

A roll cost me $8 and I only used half. About 8 paddles with it so far without it showing deterioration.

I found that it all looked good until it suddenly stretched and then stated to slip along and sometimes even drop a wrap out which is a pain in the arse to put back in.
Funnily enough, if I fixed it up all nice and pretty at the end of the paddle it would go tight at night and look great but soon loosen up on the next paddle.

Maybe there is a better brand that won't stretch after a while in water.

But for feel and control of the paddle, it was simply beautiful.
I've been wondering how cork would perform.
Just get a sheet and glue it on.

sorry, confused you with Wesley from New England!

Interesting topic.
I work as a sports med therapist week with paddlers in waka, kayak and multisports. These include NZ champions and age group world champions. Shoulder, forearm and wrist problems abound.

I have found that the key to injury-free paddling lies first in having a good technical coach and a training programme that has a healthy balance between stress and recovery.

Supporting these is getting the athlete's nutrition dead right and weekly deep tissue massage to prevent overuse wear becoming a hindering injury.

For example, deficiencies in zinc, manganese, iodine and selenium may set an athlete up for tendon and ligament disorders.

In Australia there is widespread exposure to heavy metals like lead and arsenic and these may show as ligament, tendon and joint problems. A lack of magnesium and pyridoxine will increase muscle tension and this will place stress on tendons.

A hair Tissue Mineral Analysis will determine any deficiencies/excesses and guide what to do about correcting matters; but be sure that you have it interpreted by a health professional who has training in using this tool and who knows how to interpret the test and apply it to the special needs of the athlete.

Deep tissue massage can break down and soften hardened, shortened ligaments and scarring. It will improve blood and fluid flow and reduce muscle tension. When done thoroughly and expertly the relief can be dramatic with significant progress usually seen by the third or fourth treatment session. Over here (Wellington NZ) I have paddlers who have been undergoing this kind of therapy just about every week for the last few years. These are the ones who train hard every week, pushing their limits while never losing a day because of overuse injury.

I have never had an athlete with musculoskeletal problems such as tennis elbow and carpal tunnel have to undergo cortisone shots or surgery when using the combination of nutrition, deep tissue massage, judicious rest and paddling technique appraisal. Seldom is an athlete required to have more than a few days off paddling when this combination of therapies is employed. Measures as simple as changing blades and altering shaft length can have dramatic benefits. All paddlers should seek video analysis of their style under the trained eye of a paddling coach.

Most physiotherapy, including ultrasound and acupuncture is ineffective, giving at most temporary relief. This is because the therapies employed may be little better than placebo in the best of circumstances, but mainly because the solution to paddling injuries like carpal tunnel are multifactoral (deep tissue massage, hair tissue analysis, coaching analysis and so on). There is no single solution that works on its own.

Surgery is a double-edged sword: While it may release pressure this surgery causes the formation of scar tissue and the enforced rest and immobility of the operated part causes muscle wasting and unwanted alteration of paddling form. These may cause further problems later on, as much as a year or so down the track. And it may be 6-12 weeks before the athlete is able to resume full-on training.

While I am not against surgical intervention, or cortisone shots, I am firmly of the opinion that these should be the last resorts, only to be employed once the conservative options have been totally exhausted. Currently, surgery and cortisone are too close to being the first intervention. This is getting the cart before the horse.

Often, when surgery is employed, I suspect that the enforced rest is what is giving most of the relief.

The All Blacks are looking good by the way.

When dealing with high level squads, you have one significant thing in your favour.
They got there because they are relatively well adapted to the sport in the first place.

They are capable of handling the larger demands of elite training otherwise they wouldn't be there in the first place.

In this case, preventive management is usually all that is required.
They also are in a life position to devote to injury prevention.


Now the real problems stem from office Joe and time pressed mum and dad.
No time to train, let alone sit down for a 2 hour stretching session or therapy.
A body that has adapted itself to their everyday life, not sitting in a skinny rocket and going like hell.
A body that was not necessarily a match for the sport that their mind chose to occupy itself with.

This is the real challenge.
Managing the non-elite.
Whose whole environment has not been setup to allow them to perform at their max without injury.
Who may not have control of their working environment that they spend most of their time at.

This is where most non elite problems stem from, their environment during their everyday, not the couple of hours on the water in a week.

And that is where most long term solutions are to be found.
Small alterations to their general life that set them up for injury, need to be made.

Small allowances in the way they paddle that may help cope with what the other stresses in their life set them up to suffer.

The solution is not always a professional, but an understanding of your own body and the environment that it lives in.

The more you know about your own body and how it interacts with the wider world, the better you will be at injury prevention.
Do heaps of research, get multiple opinions, eventually you will come to an understanding of how to keep yourself injury free.

Good luck.

I reckon Gazza has it spot on, I haven't had a problem with my arms since I moved from a fixed paddle I picked up 2nd hand to a adjustable Epic mid wing , I love the oval shaft as it seems to self locate in my hands.
Rugby- go the saffies,the aussies are too soft (they need even more kiwis in the team) Then the will meet the AB's and get smashed, I wonder if they are get a "special" breakfast 2 days before the game like the AB's got in 95!