Prevention of Paddling Pain and Injuries

1. Prevention of Paddling Pain and Injuries

2. Summary Of Injuries

3. Summary of Common Complaints

4. Common Injuries

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

7. 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

8. 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

9. Repetitive Stress Injuries Trigger Points

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

11. 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 • Pain and stiffness with movement and stretching

12. 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

13. 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

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

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

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

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

19. 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

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

22. 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

24. Traumatic Injuries • Shoulder dislocation • Treatment • Reduction and immobilization • Physical therapy • Surgery

25. Chronic Injuries • Any unresolved injury • Causes • 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

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

27. 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

28. 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

29. Thoracic Outlet Carpal Tunnel

30. 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

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

32. Injury Prevention

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

34. 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

35. 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

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

37. 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

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

39. On The Water • Before 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

40. 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

41. On The Water • Avoid Fatigue • 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