Good ideas, Matt
I have taken lots of vitamins and minerals including fish oil for decades. I did take glucosomine etc. when I had the rotator cuff pain. Maybe I’ll try it again.
My pain is more on the inside of the elbow, which the internet tells me is called golfer’s elbow. I think the injury/inflammation started because I went back to pumping iron last year in my old age. I think I even can identify which machine probably did it.
Hasn’t gotten worse and doesn’t hurt when paddling or typing, which is what I mainly do for fun.
lateral epicondylitits
– Last Updated: Apr-08-12 7:18 PM EST –
Tennis elbow is simply a lay term for lateral epicondylitis so you can google that and find a slew of advice on exercises specific to that diagnosis.
The diagnosis is pretty straightforward so there is no reason to believe that multiple physicians would have made the same incorrect diagnosis. Surgical treatment is recommended exceedingly infrequently so the notion that your condition is being diagnosed for some orthopod's economic gain is absolute poppycock.
It is a repetitive stress type injury that can actually lead to mucoid degeneration of the muscles that originate on the lateral epicondyle of the humerus (upper arm bone) and is usually precipitated by activities that stress the wrist extensor and supinator muscles and typically occurs on the side of the hand used to grip the paddle shaft in paddlers (which is usually the dominant arm).
When evaluating anecdotal accounts of success with various home remedies and medications remember that like most repetitive stress injuries, this one typically resolves over time with cessation of the precipitating activity and no other treatment.
If you have a "trigger point" that reproduces pain with palpation cortisone injections can sometimes be helpful in breaking the pain/inflammation cycle and counterforce bracing is often helpful, both of which have already been prescribed for you. The mainstay of treatment is cessation of activity, non-steroidal anti-inflammatory agents, and physical therapy. Most of the physical therapy you can do on your own, if necessary with information gleaned from the internet. Surgical release is typically reserved for individuals with severe pain and tendon entrapment caused by fibrosis and granulation tissue who have not responded to several months of conservative treatment.
I doubt the glucosamine/chondroitin would help for this type of condition since it does not involve a joint surface or capsule buy I guess it can't hurt to try. Dave is absolutely correct. Severe cases of lateral epicondylitis require at least a temporary cessation of the precipitating activity to allow the inflammatory process to resolve. Trying to "work through" this could land you in real trouble.
As I recall, you are a dedicated right handed paddler, are you not? Have you tried paddling on your left side with a single bladed paddle and if so, did you have pain? It is possible that paddling on your left side would not stress the wrist extensor and supinator muscles in the same manner as paddling on your right side.
This link shows a series of exercises for lateral epicondylitis: http://www.summitmedicalgroup.com/library/sports_health/tennis_elbow_exercises/
As mentioned, the stretching exercises can be started immediately and after your symptoms resolve, I would recommend you do these immediately before every paddle, and perhaps every hour or so during a prolonged paddle. The strengthening exercises should only be started after the severe pain subsides.
above post reads as professional advice,
– Last Updated: Apr-08-12 11:21 AM EST –
I suggest the original poster follow it...
Been there, done that, got the elbow brace.
Kaps
Susceptibility re grip hand, grip arm?
This is sort of a medical question re the susceptibility to tennis elbow (or golfer’s elbow) for single stick paddling.
Marc Ornstein said he assumed the injury was to the elbow of the “grip arm”. Pete Blanc assumed it was to elbow of the “grip hand”, which he then associated with the dominant hand.
Now, I’m confused as to which hand/arm are we talking about – the top grip hand or the shaft grip hand?
After clarification of that, my next question would be a medical one for single stick paddlers: Why would the top grip arm elbow or shaft grip arm elbow be more susceptible to tennis elbow damage than the other elbow? (Same question for golfer’s elbow.) What in the paddling motion would make one elbow more susceptible than the other?
Sorry
I meant the hand on the shaft. At least among the paddlers I have known with this condition that was the case.
I think the solo C-stroke is particularly bad for those with this condition as the start of the stroke tends to put the shaft hand in a position in which the wrist extensor and supinator muscles are stressed.
Shaft elbow was my assumption. Solutions
That would make sense to me because the “classic” J stroke correction puts a lot strain on the forearm muscles.
Probably the beginning of the C stroke does the same thing, but I’d like to focus on the end of the J and some partial solutions to the muscle strain there.
If you are gripping the shaft tightly as you finish the J, your shaft fist will turn down toward your wrist. This is the first uncomfortable stress on the forearm. Then, you push away from the boat with your wrist cocked downward to make the correction. This pushaway adds another stress to your forearm muscles and cocked wrist. It makes sense that this could torque the elbow into a repetitive stress injury.
This makes for a very uncomfortable stroke and is one reason, in my opinion, why lots of new paddlers never develop a good correction stroke.
I think there are four ways to relieve this double strain of the classic J. First, don’t use it at all. Turn the blade the other way and do a goon/rudder stroke correction. There are technique reasons why the goon is inferior to the J, but we’re talking here about reducing elbow stress for someone with a medical issue.
Second, don’t keep a death grip on the paddle shaft as your top hand rotates the shaft into the J position. Let the shaft rotate through a loose shaft hand so you don’t put your shaft hand into a downward wrist cock. You can then give the outward correction pushaway with the base of your thumb area.
Third, don’t do a lateral pushaway. Do an in-water forward loaded slice recovery, AKA Bill Mason’s Canadian stroke or Mike Galt’s Florida stroke.
Fourth, as Marc suggested, do a palm roll at the end of the stroke where you would ordinarily do the pushaway. I have found that (especially with a wide paddle) the blade roll itself, without any outward push or forward loaded slice, can correct the canoe. You can finish the palm roll with a full or partial in-water return.
As an alternative to all the above four suggestions for reducing the strain of the classical J, simply do as Pete suggests: paddle on the other side. I have always thought ambidextrous correction paddling should be a sine qua non for accomplished single blade canoe technique. Not only that, but alternating correction sides can probably help prevent repetitive stress injuries to your dominant elbow, as well as perhaps alleviating the injury afterwards.
Thanks!
You are a treasure if ideas. Here’s what I am doing. I’m more quickly switching to my dubble,I’m refining my left side stroke,I am using an inwater recovery even more,I will try the goon idea,I will try paddling more with my ottertail and vouager paddles,I will be less pridefull about slowing the group down and paddle gentler. On the medical side, last year my ortho told my about a promising new treatment not covered by ins. yet,maybe now it is.
Thanks, Turtle
tendinitis or tendinosis?
I have experienced what I believe to be “tendinosis” in my elbows, ankles, and wrists. It is NOT arthritis and it is not due to injury, overuse, or repetition. The pain I experience has not limited my paddling fortunately.
My doctor brushes it off as arthritis, which I know it is not. The pain is at the attachment and insertion points, not the joint. Glucosamine chondroitin, cortisone shots do nothing. About the only relief I get when the pain has been most severe was from OTC ointments–likely the massage action of rubbing it in helped the most.
So google “tendinosis” or look it up in Wikipedia. Above all, you will learn, as Wikipedia states:
“Tendinosis is often misdiagnosed as tendinitis due to the limited understanding of tendinopathies by the medical community.”
a plan
It sounds like you have a plan!
I have been posting as a guy that the calender says has left middle age while in my mind I’m still in my early 20’s. I will try to put on a more professional hat.
We should warm-up at the start of any physical activity. In PT sessions this is done with a whirlpool or hot packs. Aging/injured pro athletes often use exercise bikes to warm up their legs before entering competition. When I hike I try to gently walk on level ground to let the old joints warm up before adding speed or starting uphill.
For paddling, start very gentle and warm up by paddle slowly with reduced effort for the first 15 minutes. Fight the urge to crank hard to gain speed when leaving the shore or to chase younger paddlers; Give the body time to warm up to the demands of the activity. After a warm-up you can increase the work rate, but slow down and ease off if you feel any irritation developing. Consider “Vitamin I” before paddling if it doesn’t irritate your stomach and doesn’t interfere with other Rx that you may be taking. (Baby Aspirin taken for blood thinning is affected by Ibuprofen). Stretch after the paddle.
You probably already know this, but at the risk of insulting your paddling experience I will state it for any new paddlers reading this- Forgive me for stating what you probably already know and practice.
Insert the paddle into the water near the bow, apply force gently at first, and increase the force as the paddle moves towards your hip, which is the most efficient zone to apply power. A Vertical stroke is most efficient, low angle and wide are the least efficient. The application of force shouldn’t continue past the hip- this would promote wag in canoe tracking. The stroke can carry slightly further behind the hip in the recovery phase. You should work on obtaining much more of your paddle force from trunk rotation and much less from your arms. Easy to say and harder to put into practice. Paddle with a superior paddler and ask him/her to help you or take lessons with an experience and efficient paddler-not the newly certified instructor looking for someone to gain experience on. When fighting injury and aging, an older instructor may be more understanding of your issues than a very young athletic instructor who hasn’t yet been subjected to life’s lessons. A superior athlete in any activity makes it look effortless while excelling. Look for the paddler who is going very fast without even apparently working hard. (I can’t practice what I’m preaching as I’m now forced into use a less efficient low angle stroke with a double blade due to damaged/reconstructed shoulder-with that stroke adjustment, I continuing paddling frequently).
Use a paddle with a smaller blade area and some flex in the shaft.
At the end of every paddle ice the arm. You can bring gel packs and a ace bandage in a small zip-up cooler. Ice the arm soon as you finish- you are trying to reduce inflammation. Slapping on a gel pack with an ace bandage takes only a minute or two. Repeat the icing two to three times in the next hour or two for the best effect. Ice is a “wonder drug”-I would be a billionaire if I could patent and sell the therapeutic practice of icing.
Pain is a warning signal that you have/are injuring the area. Back off, ice, and be able to paddle again soon. I greatly stressed my rebuilt shoulder by stupidly swinging a heavy framing hammer over head while doubling up a door frame in a Katrina reconstruction project. The rapidly increasing aching quickly moved into sharp pain before it finally got through my thick head how badly I was irritating the shoulder. I put down the hammer for the day and iced the shoulder every half hour all afternoon and evening. “Vitamin I” was taken every four hours. With this extensive icing immediately after stressing the shoulder, I kept swelling down and was able to resume working the next day. I also refused all tasks that required me to use that arm above shoulder height for the rest of the week I was there.
Best wishes in developing and implementing your recovery plan and ultimately in healing. Pay better attention when your body talks to you than I do when I’m deluding myself into thinking I’m still in my early 20’s.
Do post in late spring/summer how you are doing,
Dave