Prevention of Paddling Pain and Injuries

Summary Of Injuries

Summary of Common Complaints

Common Injuries

Repetitive Stress Injuries Postural Imbalances, repetitive movements, daily activities Result in Fatigue Microscopic damage to muscles Tightness of muscles Muscle pain

Repetitive Stress Injuries General Muscle Tension Caused by overuse May or may not cause pain Decreased range of motion, resists stretching Can cause muscular imbalance May lead to injury Managed with exercise, stretching, and massage

Repetitive Stress Injuries Myofascial Pain Syndrome Caused by overuse of muscles Trigger Points Small, painful involuntary contractions within muscle cells Locally painful May refer pain and other sensations distant to the TP Predictable location and pain referral patterns May be active or latent

Repetitive Stress Injuries Trigger Points

Repetitive Stress Injuries Myofascial Pain Syndrome Treatment Spray and stretch (vapocoolant spray) Injections Dry needling Trigger point massage modalities

Repetitive Stress Injuries Tendinopathies Damage to tendons and tenosynovial sheaths May also be caused by age, trauma, and other factors Tendinitis Acute damage, may include inflammation Pain and stiffness with movement and stretching Tendinosis Long term degeneration of tissues, no inflammation

Repetitive Stress Injuries Tendinopathies Tenosynovitis Irritation to sleeves tendons slide through May have loss of smooth movement and grinding sensation Treatment Rest, ice, stretching, massage Eccentric contraction exercises Ultrasound Splint or brace during activity for support

Repetitive Stress Injuries Strains Injuries to muscles or tendons May also be traumatic, graded by severity Injuries cause buildup of scar tissue Decreased contractility Weak, easily re-injured areas Adhesions that decrease range of motion Locally painful Pain on stretching and resisted movement

Repetitive Stress Injuries Strain damage Scar tissue formation Weakness and re-injury

Repetitive Stress Injuries Strains Treatment RICE (rest, ice, compression, elevation) Proper rehabilitation with exercise Stretching, massage

Traumatic Injuries Sprains Damage to ligaments Inflammation Redness, heat, swelling Pain, loss of function of joint May mask fractures

Traumatic Injuries Sprains Treatment RICE (rest, ice, compression, elevation) Movement to tolerance as soon as possible Proper rehabilitation with exercise and stretching

Traumatic Injuries Disc Injuries May be traumatic or degenerative Most common is lumbar herniation due to lifting and twisting Canoeists tend to have more disc issues May cause local pain due to muscle spasms May press on nerve roots causing pain, numbness, tingling, and weakness in areas served by that nerve

Traumatic Injuries Disc Injuries Treatment Depends on severity Try to create space for disc to repair itself Injections to decrease inflammation Surgery

Traumatic Injuries Shoulder dislocation Forceful disarticulation of joint May include soft tissue damage Muscles will quickly spasm to splint Reduce as soon as possible Lots of pain and swelling Loss of function Once dislocated will more easily sublux or dislocate

Traumatic Injuries Shoulder dislocation Treatment Reduction and immobilization Physical therapy Surgery

Chronic Injuries Any unresolved injury Causes Results Returning to activity too soon Not properly treating the injury Results Buildup of scar tissue reduces range of motion Area is more easily re-injured

Chronic Injuries Treatment Physical therapy Exercise Massage to break down scar tissue, reduce muscle tension

Miscellaneous Delayed Onset Muscle Soreness Typical of new exercise or increase in activity Not indicative of trauma Usually resolves on its own in a few days Activity may decrease pain

Miscellaneous Nerve Compression Sciatica, Thoracic Outlet Syndrome, Carpal Tunnel Syndrome, Disc Injuries Caused by soft or bony tissue compressing nerves Pain, numbness, tingling, weakness of muscles Various causes and treatments Trigger points can mimic symptoms

Thoracic Outlet Carpal Tunnel

Miscellaneous Spasms/Cramps Involuntary contraction of muscles Often painful May decrease range of motion Several causes Pain~Spasm~Pain cycle due to overuse/ischemia Exercise induced Not warmed up Contracting from a shortened position Dehydration Nutrition, splinting, pregnancy

Miscellaneous Spasms/Cramps Treatment Often depends on cause Acute cramps: massage at attachments, heat/ice, stretching, contract antagonist Spasms: massage, stretching

Injury Prevention

Causes of Injury Muscle weakness and imbalance Stiffness, shortened muscles Trigger points/painful muscles Previous injury/improperly resolved injuries Fatigue

Between Trips Conditioning Many injuries are due to muscle weakness and imbalance Regular strength and endurance training Specific training for paddling Rotator cuff/shoulder Back/torso Arms/forearms Proper recovery time between workouts

Between Trips Therapeutic or Sports Massage Relieves muscle stiffness Helps resolve muscle imbalances Maintains/improves range of motion Reduces pain and resolves trigger points Helps resolve sub-acute and chronic injuries Self-treatment between massages

Between Trips Stretching Yoga or other static stretching Dynamic stretching Maintain and increase range of motion Core strengthening

Between Trips Resolve Injuries Properly and Completely Reduce scar tissue and weak areas Reduce adhesions, increase range of motion Physical therapy, strengthening Prevent chronic injuries

On The Water Boat loading/unloading, portaging Never lift or lower with your back Keep back as vertical as possible Use leg muscles

On The Water Before getting in your boat After getting in your boat Warm up with jogging, jumping jacks, something to warm the muscles Dynamic, not static stretches, full range of motion After getting in your boat Back paddle 10 mins Dynamic stretches in boat Practice strokes

On The Water Use Proper Biomechanics Paddle ‘in the box’ Have a practiced roll Try to avoid high braces and other moves that can put shoulders at risk Have Good Equipment and Outfitting Good lumbar support Comfortable paddle Comfortable outfitting

On The Water Avoid Fatigue Listen to Your Body Eat properly before you paddle Bring high energy snacks Keep hydrated Be careful about paddling several days in a row Listen to Your Body Know when to slow down or call it a day Pay attention to pain and injury Avoid being overly stressed or aggressive