Elbow Pain

-- Last Updated: Jan-14-07 7:42 AM EST --

A week ago near the end of a 10 mile paddle (sea kayak, unfeathered euro paddle) I had a twinge of pain in my left elbow. Yesterday I paddled just under 15 miles and my left elbow was aching quite a bit. -Not enough to slow me down but enough for concern. There is residual pain that is somewhat acute when I put a load on the arm -such as lifting myself up using that arm. The pain seems to be localized on the back of the elbow (funny bone region). After feeling symptoms, I was consciencly not arm paddling so I don't think that is the cause (could be I guess if I got sloppy when not paying attention). Both days were breezy and I was moving at a decent clip (3.5-4 knots) for most of the trip with a couple rest breaks to keep the group together.

Is this like tennis elbow? Should I do anything other than rest (I don't want to rest, I want to paddle!) to recover and do you have any suggestions to prevent this from recurring?

Thanks for any insight you can share.


what I’ve done
I’ve had that happen a few times, though never had residual pain. The pain puts me on notice that my stroke or posture has become sloppy. As soon as I correct my stroke and use proper rotation the pain goes away. I’d try finding the stroke that eliminates the pain first, and Ibuprofen and ice after the paddle if you still have residual pain.


Sounds like mine…

– Last Updated: Jan-14-07 8:48 AM EST –

...NSAIDs, one of those bands around the forearm
just below the elbow changes the geometry of
the tendon and nerve, and I do weights.

Weights: hold about 2 pounds and flex your
wrist in all four directions.

PS. The forearm band won't stay in place while
you are paddling.

take the pain VERY seriously
I know paddlers who have had surgery to repair the tendon once it gets too damaged. My husband is one of them. He iced, exercised, stretched and wore a brace but things had gotten too bad before he got serious (Do you sleep with your arm under your head every night? This puts the tendons under stress like you won’t believe for hours on end) There are stretch straps that will stay on while paddling. Strange as it sounds, make sure the shoulder is loose and try and strengthen it as well as the fingers and wrist. The elbow is the part that pays for the crimes of the whole shoulder-forearm-wrist system. Look for other things in your daily routine or job that might contribute since if you feel you are paddling correctly it might be simply contributing to the pain but not the whole cause. Ron drives UPS trucks for many years and knows that is one cause and his doctor told him arm sleepers are major factor to elbow issues.

Three hour tour–if it’s on the outer

– Last Updated: Jan-14-07 9:57 AM EST –

elbow, it's likely lateral epicondylitis, or tennis elbow.

You must rest it. No paddling until it is gone, and I mean gone.

Ice it for 30 minutes daily (bags of frozen peas or corn work well) for at least one week, two better. Ice ice ice.

NSAID, such as Ibuprofen 600 mg three times daily if no contraindication (I know we all know Ibuporfen, but read the label to see if you can take it) for 7-14 days. Not a pill here or there, but actually take it at this dose (unless you have a reason you cannot take it) for at minumum one week, two if it needs it.

And this might be most important, analyze you paddle stroke once you're over this. Something you are doing--and most times it is too strong a use of the arms in paddling with a flexion at the elbow on each stroke--that is aggravating. You are an intermediate paddler based on your profile, but you must check this out before you develop not only a chronic and habitual erroneous stroke, but a major condition of the elbow requiring surgery. Imagine a beach ball, as Nigel Foster says, on your chest and you have to keep the paddle out and away from the body while you paddle. Your arms must be generously apart on the paddle shaft, and you keep theimaginary ball between your chest and teh shaft, and this would tend not to allow you to pull in with your wrists.

Good luck to you.

Pay attention to your shoulder
When my shoulder was in need of rotator cuff repair, I had elbow pain on that side every time I paddled. Once the shoulder was fixed it went away. My other shoulder is now getting bad, and so is the elbow!


I am wondering outloud

– Last Updated: Jan-14-07 10:13 AM EST –

so don't get me wrong but I see in your profile you has a Capella that seems to be a much better paddling machine than the other boats in your fleet. I am wondering if the rec boat technique is carrying over. Same long paddle? 230-240 cm?Trying to go faster in the sea kayak? I am wondering if the long paddle is being lifted out of the water in an awkward manner? The blade exit specifically.
I have no idea about your technique other than you said you are making a conscious effort not to arm paddle. Makes me think maybe you might be using the same paddle for the different boats? Low angle strokes?
I have suffered from bicep tendonitis that has caused me pain in both my shoulder and elbow. It is caused from work related stresses from pulling pipe wrenches and not in the same location as yours but still. When I have had to paddle while in pain I try not use my elbow as much and simply lead with my shoulders more and rely on torso rotation heavily which is what I should be doing anyways. Thing is I would suggest using a much shorter paddle while using the sea kayak. Like a 220 or shorter. It may make those unwanted tendon stresses go away. maybe not. Higher stroke angle with shorted paddle may make cruising at 4 knots easier.
Have you talked to a doctor? If you do, be very specific about your paddling technique. Even though he may not have any idea about paddling, he might see a problem that you could fix.
Not trying to criticize at all. Just wondering out loud.
PS how heavy is your paddle? A 15 mile cruise means you have lifted a significant amount of weight over the course of your day trip.

As above
It well could be the start of tendonitis in the elbow, with possible stuff impacted higher up if you don’t give it some rest. Tendonitis can linger a really frustratingly long while if you let it get set in rather than nipping it in the bud.

I would suggest getting to a health food store and laying in some arnica, I find the teeny oral pills work better. Taken right after a sprain or muscle pull, it seems to really help to reduce inflammation for most people.

cool doctor reminds me…
Yes by all means you must lay off paddling until it goes away. Icing and NSAID will alleviate pain and make you think all is getting better but you are continuing to fray that old tendon over the elbow joint so by all means stop paddling now and rehab. Ron didn’t stop, just covered up the pain with Aleve, Motrin etc and icing-so beware of this. With all due respect to you docs out there;don’t expect your OS or sports doc to really know much about kayaking as they are so focused on other injuries. Ron’s doctor has done many elbow surgeries but really was lost about any mechanical advice. We think everyone’s advice on shorter paddles and rotating is golden. But if you find a Orthopedic Dr that paddles! Bonus!

Tennis elbow – exercises
Forward and reverse wrist curls with one-hand dumbbells – this fixed my tennis elbow. No guarantee that it will fix yours, of course, but there are many good reasons to try.

Start with a low weight, maybe as little as two pounds, certainly no more than five. Work up to a 50 or so reps (or if you do the slow let-down technique, maybe half that) then do it until failure. Do two sets per session, every two or three days. Over time, slowly add weight, but generally go for more reps rather than weight, to protect the small joints in the hand and wrist. (Over a few years I’m up to 20 lbs forward and 15 lbs reverse and maybe 15-25 reps to failure, with slow let-down.)

Stop if you feel pain for more than a couple of reps (I find that a bit of pain often goes away quickly, and that seems ok.) You may have to get it calmed down before you can even start this.

It took the better part of a year, but this cleared up my tennis elbow / tendinitis and it has never returned. The pain while paddling was mostly gone after 3-6 months, and was very mild and intermittent after that until it was altogether gone. Yeah, it’s a long slog, but worth it, IMHO. It’s also good for wrist pain (not necessarily carpal tunnel, however).


Thanks for the replies so far
I’m also a runner (get a bout of ITBS once in a while) and know to stop till things heal.

I figured it was probably tendonitis and the responses all seem to confirm that. The sleeping on your arm is an interesting factor I wouldn’t have thought of. I sleep in all positions depending on the time of night but often do have my arm under my head.

I’ve been paddling for a while and only now had some symptoms so I’m not sure that it is a chronic “error” on my part. That said, I will certainly pay extra attention to my form. Since both times was while paddling in breezy conditions I wonder if it is a change in form -or asymetry in my stroke as I compensate for the effects of the wind.

As to the rec boat tendencies, the Tracer is not a rec boat (16.5’ x 22.75") with moderate rocker. I was using a 220cm paddle so not too long (certainly not too short either).

I recently started playing around with a GP but was not using it on either of the two paddles that my arm bothered me.

The elbow has not caused me any pain today but I can tell it isn’t “healed” yet.



Oh, and…
…don’t rest your arm on your car’s center

console or the car door.

oh, and
don’t rest your elbows on the table ---- seriously - (mom was right on this one)

Nice fake term! The next thing you know, he’ll be suggesting Bird’s Eye frozen veggie combo mix! (the power of carrots & peas …)


When it hurts real bad…
…I lick it.

Does anyone have an opinion on topical application of Ibuprofen gel versus tablets? Are there advantages or disadvantages with either?