Friend had rotator cuff surgery -- how to help her get back to kayaking?

A nearby friend who has been one of my most regular flat-water day trip kayaking companions for several years, had rotator cuff surgery 3 weeks ago. She’s very athletic and is determined to regain as much ability as she can to pursue all of her favorite activities (like hiking, XC skiing and paddling). I know there have been multiple discussions on here about rotator cuff issues but could not find any in the archives that were specific about how long it took before it was safe to paddle after the operation.

I’ve already suggested that once she is cleared by her doc to paddle again that she use one of my Greenland paddles. She had borrowed one briefly on one outing and declared that she did not like it (she tends to want to be aggressive in her paddling and I think she felt that it did not have enough “power”.) But she recently mentioned that her sister in California switched to a GP and really likes it so maybe she is more open to it. I also have pretty lightweight boats and already told her I would insist on doing all the loading and launching until we are sure she is well healed.

For those who have had the surgery: how long before you could safely paddle? And what adjustments did you find you needed to make?

Complicated issue…
Just have to go with the Docs and therapists…

My Doc can’t believe I have the range of motion I have after my injury.
I think paddling helps mine.

Good luck…

A couple of links:

“don’t reinjure
It was 4 months after rotator cuff surgery before my surgeon gave me the OK to paddle again, and after 9 months I am almost fully recovered. (Full strength but some limits on range still) If I were you, I would make the decision when to start paddling with lots of input from your physical therapist and surgeon - you certainly do not want to start this whole process over with a re-tear.”
https://forums.paddling.com/discussion/478209/paddling-after-rotator-cuff-injury
There are a few other comments in that link by those who have had the surgery.

Also:
https://forums.paddling.com/discussion/1213113/rotator-cuff-tear

Having had a fractured humerus, I think she’ll discover on her own that the Greenland paddle will be less painful until she’s fully recovered.

My wife had hers ( a major one) done in June and did a six mile race in less then a month
She figures four to six weeks.
Just carry the boat and load it for her
Remember the theraband is her friend even though it hurts

Keep hands and elbows below face level.

My friend had both shoulders done over the course of a few years. Lived w a non-paddler for the first and alone for the second, so many of the options involving others helping were not in play. She was in her late 50’s.

She did all the therapy religiously. It was still a number of months before she could paddle. Like your friend she preferred a powerful paddle while she was paddling Euro, the Ikelos which was really a bigger blade than her build.

The solution to both staving off the second rotator cuff surgery for a while and to paddling again after each was done was the GP. She had taken a class where she built her own and learned to use it correctly before the surgeries. While she didn’t consider the greenland boat a tourer, it apparently was very close fitting and in conditions more resembled a submarine, she found the same that those above have indicated. That paddling with a GP was a solid method to be able to get back on the water and mobile again.

Recovering from surgery, any surgery, is pretty individual. I am up to 5 inpatient ones so know that so far anyway, I am an unusually fast rebound. But it can vary a lot. I have known folks who had both knees done with quite different recoveries on each knee, same doctor and similar knee issues. Even I may be a glorified vegetable if I have to have something like rotator cuff in coming years.

The biggest diff in recovery from invasive surgery comes down to someone being willing to deal with a fair amount of pain in the early part of the recovery. Some hurt worse, but in the early weeks they all do.

How bad was the tear?

I had a small tear fixed by arthroscopic surgery. Got the surgery done in a November so as to coincide with our forced off-season (reservoirs closed to boating). I did the PT religiously, including with a special machine at first and was back on the water next season. Can’t remember how many weeks it took, but I think the first paddle of the year was in late February or early March.

There were no special provisions taken when starting, just the usual of going a shorter distance after a long layoff.

I have had this surgery to both shoulders. In both cases the tear was completely through the muscle, requiring screws and sutures to hold the repaired muscle together.

For both, it took about 4 months before I felt comfortable kayaking, primarily due to range of motion. I did the physical therapy with dedication and I did not feel almost back to normal regarding range of motion until 5 months, when I stooped formal physical therapy. I am what the physical therapists call “very guarded”, meaning my ligaments and muscles freeze up due to injury, so is a long slow process for me to recover range of motion.

There is a way to paddle that is both more effective while simultaneously protective of shoulders. Have a look at a proper racing style paddling technique with an extremely lowered angle and shorter paddle length. A small wing blade is a good starting point and a lighter boat helps with the load as well.
Oscar Chalupsky is an advocate of this style–have a look at his videos.

just out of curiosity, why is the Greenland paddle considered to be a solution for shoulder issues?

@Mountainpaddler While the total usable surface of a GP may be the same as a given Euro blade, it is distrbuted along a greater length. So the surface is skinnier and there is less of a kind of noticeable pull at the catch point in the stroke.

Plus most people who have not been well trained paddle at a more leisurely pace with a GP than the Euro they had. GP’s worked for the Inuits to chase seals etc, so speed is entirely doable with the right technique against a Euro blade. But most paddlers don’t get that good.

I’ve just started paddling with a Greenland and already I’m a convert. I can think of 2 additional reasons that sucha paddle can be easier on the shoulders. And this is just from reading, I’m not at all experienced enough to speak on the issue.

Greenland paddles are often made of wood, this is far more flexible than the high end carbon fiber, or even fiberglass paddles. This would also lessen the impact on the shoulder.

You also can’t have bad form with a Greenland paddle! Well, you can, but you’re not going anywhere. My form has improved a lot since paddling with a Greenland. I have much better torso rotation. Brian Schulz’s tip on “open the top hand on every stroke” really enforces this.

@Overstreet said:
Keep hands and elbows below face level.

Ditto this! I would also add keep the elbows close to your side most of the time. Use our core for strength not arms attached to shoulders. Sit straight with shoulders back to avoid lower back problems. An elbow behind our back when the paddle comes out of the water is a good indication of arm paddling. A stroke coming out near the hip may help keep from extending the elbow behind our back. The more you use your core , and the less you have to rely on your arms pulling and pushing for strength and power the less the shoulder has to deal with.

Thanks, good tips so far. Again, this is my friend who had the surgery and not me, so I won’t be privy to her discussion with her surgeon – she did have a pretty severe tear in her left (non-dominant) shoulder, in fact they told her she could not delay the procedure or she risked having the whole thing separate. She’s very determined and highly compliant with her PT – has always tried everything she can do to recover from surgeries (knee and wrist since I have known her, and now this.) She’s slim and athletic and stays active in part to limit progress of osteoporosis.

If I had a tandem I could take her out paddling with low risk of overstressing it once her doc gives the blessing. I usually put her in my Easky 15LV which propels with little effort and tracks nicely. I’d try her in my 18’ skin boat (which practically paddles itself) but she is grumpy about wanting a cushy seat and all I have in the SOF is a scrap of 1/2" ensolite directly on the frame.

Over the years I have broken my left proximal humerus, sheered off the olacranon process in the elbow on that side (took surgery and a 6" long pin to fix that one), fractured both bones in both wrists (my right distal radius still has 3 screws in it) and also broke my left clavicle. It’s become painful to ride a bicycle more than a few hours due to these injuries but I have never had any problems paddling long days, always with a GP. Never had any of my upper body joints complain from GP use.

I slid off a cabin metal roof that I was painting in the summer of 3 years ago. Didn’t realize until a day later that I could not lift my right arm above my shoulder. It got pretty severe until I went a few days later to see a spots physical therapist., since I was scheduled to race on the Yukon River Quest the following June. The doc, a surgeon, said I had a rough case of rotator cuff tear and offered to cut me open to fix it. Knowing others who had it done, I asked him how long I would have to hole my arm in a sling. He said 3 months! No way I could do the critical training needed with that. So gave me a targeted cortisone injection. It worked a miracle. I could move my arm in full motion without pain, lasting about 3 months as I continued my paddle training. Before I left for the Yukon I asked for another injection, which he gave me as he still offered to do the surgery. Same result, no pain and I successfully completed the Yukon race among others locally here in northern NY, including 3 Adirondack 90 mile races since then. If I think about it while under motion I can sometimes feel a twinge of pain under certain modes of motion, but not enough to restrict me in any significant way. I feel that careful paddling and training has strengthened my shoulder and I still feel great. No plans to do anything different from this point forward. I have a 90 mile cannonball (the entire 90 mile route in a single day) coming up next week.

That’s great to hear you had success going the no-surgery route. My friend did that for many years, training to strengthen the shoulder, staying active with skiing (downhill and XC), kayaking and cycling. But eventually the tear recurred and several doctors told her that she could no longer put off the surgical repair – the tendon was at risk of completely separating from the attachment points at the humerus. So please be careful!

I haven’t had the surgery but did have a cortisone fix following an injury. Also dealt with a broken collar bone. The rule of thumb is ‘do it if it doesn’t hurt’. The key to making sure it doesn’t hurt is keeping the elbow in close to the torso.

Also… my shoulder injury made me a better paddler. If I wanted to paddle without pain I DID, by god, use the torso and did NOT arm paddle.