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

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 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

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 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

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 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