One of the most common injuries in all forms of paddlesport is shoulder injuries. This is either in the form of a traumatic injury, often an anterior shoulder dislocation, or a repetitive injury the most commonly seen being impingement syndrome.
The shoulder is a ball and socket joint supported by muscles and ligaments, it has the greatest range of movement of any joint in the body. This means that little of the stability of the joint can be provided from the boney configuration, but instead most comes from the muscles and ligaments. When these muscles are put in a position in which they are at a mechanical disadvantage the joint can be traumatically injured, especially if, when the joint is in this disadvantaged position, a considerable force, such as that from moving water, is applied.
Every time the shoulder is moved there is a complicated interaction between the rotator cuff muscles to make the shoulder roll and slide, if this doesn't happen the head of the humerus ( the top of the arm bone) catches in its cup on every movement and eventually this starts to cause pain, this is called impingement syndrome. The shoulder is vulnerable to impingement injuries with paddling if a poor stoke technique is used.
Traumatic Shoulder Injury- Shoulder Dislocation
The injury that all paddlers fear most, shoulders can dislocate either forwards or backwards, but because of the shoulder anatomy it is much more common for a shoulder to come out forwards. this is called anterior dislocation. The problem is that for a shoulder to come out of joint it has to at least stretch if not tear the front rotator cuff muscles and can also rip the labrum which is a cartilage rim extending the socket that the top of the arm bone sits in. Many shoulder surgeons now operate on first time dislocations, to repair any labral damage and tighten ligaments, particularly in younger people or those with demanding sports or jobs. Even after surgery, but especially if surgery is not done, it is imperative to strengthen shoulder muscles otherwise the likely hood of redislocating the shoulder again in the future is high.
With traumatic shoulder dislocation in paddling it is certainly a case of prevention is better than cure. Strong shoulder muscles will help prevent dislocation, but even a shoulder with the strongest muscles can dislocate if enough force is added whilst the joint in a vulnerable position.
The most vulnerable position in which a dislocation is most likely to happen is when the arm is above shoulder level and then taken backwards. If you try this now with your other hand on the front of your shoulder you can feel the top of the arm getting pushed forwards. Just imagine adding a lot of force to your hand now, such as a body of fast moving water pushing on the paddle and you can see how a dislocation could occur.
Good technique therefore is the key to preventing dislocation. Torso rotation decreases shoulder usage and avoids extreme shoulder movement. Keep the arm below shoulder level, especially on stokes that are most recognised as putting the arm in a vulnerable position such as the high brace and rolling.
Although even the strongest shoulder can be dislocated if enough force is applied to it in a vulnerable position, a strong shoulder will resist lower forces. The important muscles to strengthen are those at the front of the shoulder, backward paddling is a valuable strengthening exercise.
A personal exercise programme can be provided for prevention of, or treatment after, anterior dislocation.
Disclaimer: The information on this page is written to help you understand your traumatic shoulder injuries in paddlesport. There are many possible causes for shoulder problems and should you have any concerns you should always seek advice from a qualified health professional such as a Chartered Physiotherapist or your GP.