Shoulder injury is one of the most common injuries in canoeing and kayaking. Whilst shoulder dislocation is perhaps the most feared of canoe shoulder injuries, overuse injury including shoulder impingement or rotator cuff tendonopathy can equally limit paddling enjoyment.
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 bones, but instead most comes from the muscles and ligaments.
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. Equally if the muscles are overworking or working repeatedly in a position where they are at a mechanical disadvantage eventually a tendonopathy can be caused. The shoulder is vulnerable to impingement injuries and rotator cuff tendonopathy if a poor stoke technique is used when caoeing or kayaking.
Rotator cuff tendonopathy is often referred to as rotator cuff tenonitis. However the term tendonitis is now recognised as inaccurate as the suffix 'itis' means inflammation and it has now been shown that the inflammatory process doesn't have a role in most overuse tendon injuries.
Prevention of Paddle Sport Shoulder Injuries
- Trunk rotation. It is imperative that a good trunk rotation is gained especially on forward paddling and sweep stokes as without this to gain the same stroke movement the shoulder has to work through a greater arc. Joints are always more vulnerable to injury at the end of their range of movement.
- Maintain good posture. Sit in a slouched position and try to lift your arms up above your head. Now do the same with your back in an upright position, feel how much freer the arm movement is when the back is in a good position. If sitting slouched and lifting your arms you can feel the shoulder getting rammed into its socket. Now just imagine paddling for hours sitting in a poor position with the shoulder getting jammed on every stroke and it becomes easy to see how an impingement syndrome will quickly become established.
- The shoulder is at its most vulnerable if the arm is taken backwards above shoulder level. Avoid this position. The high brace is a high risk stroke for the shoulder if not performed correctly. Even if dislocation does not occur rotator cuff muscles can be strained in this position or a nerve damaged.
Treatment of Paddle Sport Impingement and Rotator Cuff Injuries
- Analyse stroke technique; video analysis will be helpful to see exactly what is happening at each phase of the stroke. Many phones and cameras have video technology that can be used for this purpose.
- Analyse any activities outside of canoeing that could be contributing to the shoulder problem
- Stability, proprioception and upper limb movement pattern exercise. Physiobench can provide a personal exercise programme for your canoeing shoulder injury
Disclaimer: The information on this page is written to help you understand shoulder injuries in paddle sport. 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.