Arm swelling


I went paddling recently for a couple days and came back with my left arm swollen up a few inches above the wrist. I found online a overuse ailment description that seems to fit this, but can't remember the name. I would like to know what may have caused this problem- a chronic condition with my ligaments or poor paddling technique/ out of shape for this particular trip.

When I first started paddling several years ago I experienced swelling on my forearm one time after a long day of paddling. For last weeks trip, the distance traveled was not beyond my conditioning, but I was fighting wind a lot of the time. The swelling went away after a couple days, but I still have a little discomfort in my forearm.

Previously when picking up heavy objects and carrying for some distance, the area above my wrist would feel stretched out and take day or two to go away, but this hasn't come back lately. Occasionally I do get some pain around wrist when paddling too, but it is more localized at the wrist (not above). On this trip, I picked up the heavy loaded boat several times to get it to shore. If I had the problem with ligaments when carrying heavy things before, would it make sense that on this trip, picking up the especially heavy kayak, in addition to intensive paddling would cause significant swelling a few inches above the wrist? Or is the swelling more likely to do with a separate injury related to poor paddle stroke? The reason I am asking is that if it is the former problem of picking up the heavy kayak, then I can probably resume my paddling as soon as the arm feels better and just avoid picking it up like that. if it is the latter, then I probably need to layoff paddling for some time and resume later with different paddling technique. what are your thoughts?

First, I would go to a PT
who is familiar with kayak paddling technique, and who can give you guidance on how to let your forearm recover, followed by reasonable preventive conditioning.



Second, I would carefully consider the paddling technique issue. I canoe and kayak, and yes, I sometimes do have strained muscles in my forearms. The other stress location is the shoulder rotator cuff. Problems in these areas may reflect either unreasonable peak loads (commoner in ww paddling) or to high a level of effort through a whole day of paddling (commoner on flatwater).



You’ll hear a lot about “don’t arm paddle” and “use torso rotation more”, but what the torso and shoulders do has to go through the arms and hands. I’m a big dumb guy who tends to paddle at too low a rate, but by learning to paddle with a shorter stroke and higher rate, I’ve managed to keep the entire linkage working without so many problems.



Standard lecture. The pain relieving and anti-inflammatory effects of ibuprofen, naproxen, and aspirin carry a penalty if used in excess. They delay healing. Healing of muscles and tendons is mediated by inflammation. Use NSAIDs only as you need them to meet your daily obligations. Otherwise, rely on your PT and MD for guidance.

Is it always on the left forearm?
All other suggestions are good - but if it is always on the same arm you might want to include a hard look at your paddling form along with whatever feathering (or not) you are using. The purpose of feathering the paddle should be partly to make for a more even strain side to side… but you may be using an angle that ends up being bad ergonomics for your body.

technique
Rowing taught me the importance of keeping a flat. neutral wrist position when the wrist is under load. this minimizes the work done by the muscles in the forearm. Flexing or extending the wrist repeatedly or under heavy loads can cause problems.



On shore, think about gripping and pulling options that let you pull in a straight line. For example, toggle handles are usually better than rigid handles because they can align to the load.



When paddling, there’s no need to grip the paddle tightly or bend the wrists.



The bottom hand pulls. Think of the fingers as hooks, pull from the elbow, keep your wrist lose and let the load pull it straight.



The top hand pushes. The most common mistake I see is people letting the elbow and forearm drop, which forces the wrist back under load. If you raise your elbow, you can align your forearm with the paddle shaft with a straight wrist. You should be able to relax your fingers and push forward with an almost open hand.

Carpal Tunnel

No. The “carpal tunnel” is in the wrist,
not in the forearm.

How hard
are you gripping the paddle? Any time the wrist is under stress and the hand is holding tightly to a paddle (or other object), the muscles contract and the tendons must work in a constricted environment. Static pressure also reduces blood flow to the area in question, increasing the potential for injury.



Bad technique, as others point out, can be a factor, but poor technique generally produces inefficiency more than injury.



If you are gripping the paddle tightly, relax the grip. You can even open the hand completely and cradle the shaft between thumb and forefinger or by curling the fingers around the blade.



Less important is that if you are using a feathered paddle, change the feather or go to an unfeathered configuration. I have only seen injuries with unfeathered paddles amongst those who squeeze the paddle too tightly.



Rick

could be both
Your age, the type of work or labor you do and have done, etc. See a doctor for an opinion on the condition and get a PT referral, preferably someone who deals in sports medicine. If they’re not familiar with the proper technique (may be tough to find), become familiar with the whats and whys of proper form, explain to the PT and they’ll understand the “why”.

not feathering
Thank you for the helpful comments. I don’t feather my paddle.



When I first started paddling seriously some four years ago, I thought the idea was to “push” and didn’t hear anything about “pulling”. I didn’t have any problem with my wrist (as opposed to forearm. forearm doesn’t normally hurt from paddling) until my surfski paddling brother in CA told me you also need to pull. Probably misinterpreting what he told me, I started pulling with a tight hand. Then I got the wrist problems. I stopped that not too long after and now its something that comes back once in a while. None of my problems (wrist, forearm, shoulder) are serious and I won’t let them get serious. Lots of time they disappear and then appear again. I guess that’s what happens when you get older (me 47yrs old).



I don’t want to invest time and money on a PT for my arms unless he/she is a paddler and knows how to treat paddling related ailments. I understand my insurance company doesn’t have anybody like that on staff. I did already see a PT for my shoulder and knees and he gave me useful strengthening/ stretching techniques. I get the impression it won’t be worth it to see them about my wrist/ forearm.

No tight hand grip - open your hand

– Last Updated: Apr-08-14 4:25 PM EST –

I suspect you were already gripping too tightly, and the advice you got just focused the issue at some new angles. It is very easy to grip the paddle too hard - staying loose enough is pretty counter-intuitive.

You should OPEN your hand as much as possible in all phases, in fact my hand is pretty much fully open in the push phase. You can count my fingers.

Pulling should not involve more work than is needed to keep the paddle from falling in the water. I rarely have all my fingers engaged in pulling, let alone beating up my wrist. I also paddle mostly unfeathered.

I am not saying this because I have a textbook forward stroke, far from it. But I do play violin and cannot afford to mess up either wrist, even with amateur status. So I have really worked to keep my hand loose and as open as possible, and it works just fine for getting me around.

The other issue is rotation. If you are leaning back rather than sitting up straight, and so likely not rotating your torso, it could easily be exacerbating the strain on one or another side for you. And/or it might work better for you to paddle feathered.

Try paddling slower and feeling the interplay of the push and pull, with an open hand in push and maybe two fingers on the pull. You will find that the paddle feels very secure when properly balanced between those opposing forces. You don't have to do much to hang onto it.

it feels like you
May be suffering from the Kung Fu grip. Relax your hands. Push and pull evenly. Also, gloves can exacerbate this problem for some people, don’t know if this apply to you.

I bet its from paddling, boat-carrying

– Last Updated: Apr-08-14 4:55 PM EST –

Oh, the title should say "NOT boat-carrying".

You mentioned the possibility that it might be from carrying the boat, but that seems very unlikely to me. First, the injury is not in the same place as the injury-prone location that gave you trouble in the past when carrying a heavy object. Second, the nature of the injury sounds more like what you'd get due to repetitive low-stress motion rather than something that occurred due to high stress in the short term (like carrying a boat). I'm no doctor, but I've sure injured myself enough to notice trends like this on myself.

I think the advice provided by most people so far is good. All I would add is that if the injury is on the upper surface of your forearm, that suggests you might be pulling the paddle shaft with your wrist cocked upward instead of having the wrist in a neutral position while pulling. The muscles on the lower side of the forearm are many times stronger and far less likely to be injured, but if that's the place that hurts, your wrist may be bent downward while pulling, but it's just as likely that you are gripping the shaft tightly, as suggested by others.

Think of your hand operating like a hook when you pull the shaft. You can pull the shaft without actually gripping it, just with fingers around the forward surface of the shaft and no real contact on the back surface. Besides eliminating any "death grip" that you might accidentally be using, this should help you to maintain a pulling action without any tendency to cock the wrist away from a neutral position, in case you stop thinking about what your wrists are doing.

Push don’t Pull

– Last Updated: Apr-10-14 5:22 AM EST –

Pulling is counter productive and there's no mechanical advantage for doing so. As you already found out the hard way, the bottom arm is the resistance and wants to go forward and not backwards. So let the top arm move it forward without a fight, or else you'll pay? After all, the bottom arm (without pulling) contributes the same, 100%, as the top arm, to propulsion.

Doesn’t fit what I do or what the racers
are doing. It isn’t push or pull, it’s a complex combination.



A while back, there was a reaction against “punching out” with the top arm. That was a mistake, too. But I’ve had more trouble at my shoulder (push or punch) than I have with my wrist, forearm, and elbow.

better yet, paddlers’ box
Hold the paddle in front of you, with your hands about as spaced apart as your shoulders. Elbows against your sides, forearms out perpendicular to body and parallel to the ground.



Commit that position to memory.



Then, turn by twisting your torso and upper body.



Then, dip one arm down.



Try to remember that this is all the arms do independently of the body for a forward stroke. Ideally the arms and paddle (paddlers’ box) stay in the same position and to the torso.



Of course, there has to be some latitude in movement for this to work physically, but if you try to remember the paddlers box and torso rotation you make things easier on your arms and shoulders.

And if you’re arm paddling, you’re more apt to grip the paddle shaft too tightly, leading to wrist or forearm pain or damage.

Don’t push, don’t pull, just turn
Rather than thinking about independently pushing and pulling your arms, adopt the simpler mental strategy of just burying the paddle cleanly and turning your body.



If you plant the paddle, push with your stroke-side leg, and rotate your body all the way down to your butt in the seat (like you are sitting on a turntable) you will FEEL a strong pull in your lower arm and a strong push in upper arm. Neither arm is independently pushing or pulling; it is the sensation that happens when your arms act simply as linkages that react to your big core muscles. Doing this still puts the paddle in tension and a strong paddler can bow the paddle shaft.



Most paddlers report a stronger “pull” sensation (approximately 60% of the force) than an “push” when using a “torso rotation” stroke.



Arm paddling is sometimes still taught. Some coaches still teach it for getting “out of the hole” at the start of a short sprint with the reasoning that the arms can move faster than the body for a short period of time. Once up to speed, torso rotation takes over.



Greg Stamer

The Three Principles of Paddling:
Rotation, rotation and rotation. I got it now! Thanks.

ps: but I still like punches and explosions

My body turns, but it doesn’t turn much
because I paddle cab forward, canoe and kayak. Waste your effort rotating the paddle way past your rear if you want.



Torso rotation is oversold. Expanding and contracting the torso volume involves quite a bit of inherent body friction. Better to shorten the rotation and get the rate up.



It seems to be easier for canoeists to get past the torso rotation thing than it is for kayakers. But using high angle helps.

ditto Guideboatguy…you’ll live Yadang!
Just overdoing it the first time…without building up to it with exercise and going easy the first bunch of times out…no matter what, kayak or canoe.

Here’s a way of looking at torso
rotation that can help paddlers see that some is good, but more is not better.



Rotate a friend’s torso from above, while s/he stays fairly relaxed, just keeping the torso erect and non-floppy.



You’ll notice that when the torso is rotated passively within a small range, there is little resistance. But as you rotate your friend’s torso toward the extreme the tissues will (passively) allow, you will encounter increasing resistance. Obviously.



Now imagine it’s your own torso and you’re considering a task where torso rotation can increase the range of task motion, and the forcefulness. But you just learned that more extreme torso rotation means increased passive resistance from the torso. You’re going to get lots of active contribution from torso musculature, but you don’t want to waste some of it, with the torso actively working against its own passive resistance.



It seems obvious to me that a lot of torso rotation can put you into the range of diminishing returns, because the torso is working more and more against itself. To avoid diminishing returns, keep torso rotation within a relatively smaller range where the active torso muscle action is paying off big, and the passive resistance is just a minor factor.



Elbow motion has a wide range with low passive resistance, but the active leverage situation is poor. So it doesn’t pay to use a lot of motion at the elbow.



The shoulder girdle is a more complicated situation. Frictional or passive resistance at the shoulder is relatively low, and the active leverage situation can be positive, what with the scapula and collarbone driven by muscles. I get into trouble, though, if I “punch out” at the shoulder, and the deltoids working at the end of the upper arm are working in unfavorable conditions.



Canoeists also use flexion/extension of the torso, as well as rotation, to derive power. Some go too far, just rocking the boat.



Torso rotation is a great source of power and endurance, as long as it does not become exaggerated and like Bible worship.