Injury question

Hi guys,

From time to time, especially in summer and when I kayak long distances 20 miles and more - I get a dull, burning pain in the shoulders. It starts a few hours after paddling and can last a few days - persistent, dull burning sensation. It does not affect shoulder movement, neither it gets worse with movement. But it is extremely unpleasant, feels like someone has put some sand inside your joint and it scratched everything inside and I even had problems sleeping with it. The Quacks just shake their heads and suggest I take ibuprofen for the pain - despite the fact that painkillers do not seem to be a lot of help, except for really strong prescription stuff.

Usually I use Aleut stick and paddle at a rather relaxed pace, maybe 5-6 mph? And I’m fairly fit for my weight (145 lbs) - I’ve paddled with Greenland-stick-using instructor a few times - he could not see any issues with my stroke.

Anyone have had/heard about anything similar?

could just be
Arthritis, or some nerve damage. Without structural problems, going the doctor/surgery route probably won’t help a ton. I’m imagining that is why a doctor is hesitant to do anything. It’s hard to justify action if the trigger for pain is a blantent overuse.

For really long paddles I often just take 3 ibuprofen about a half hour before getting started. That helps my neck and shoulders. It could be placebo, but ill take it.

You could also do some light weight training to build strength. Good luck and try lots of different things, cause not paddling is worse.

Ryan L.

“5 or 6 MPH” is not a relaxed pace
especially for 20 miles.

Try paddling at 3.5 to 4 MPH and it wouldn’t surprise me if the pain didn’t go away.

Jack L


– Last Updated: Jan-27-13 11:09 AM EST –

OK, I've been overly optimistic with my speeds :D it's in land miles, not nautical (I'm from "km country", not "miles country") and I would say I only do 5 in favorable conditions - which is usual conditions for longish paddles for me, plus I have a fast boat. If there it's windy or anything I usually drop to around 3.

Age ?
It sounds like it is arthritis/tendonitis. You can do some strength training with weights, work on your technique and premedicating with ibuprofen, which is actually a very effective anti-inflammatory. if you have pain afterward and you don’t have stomach problems, you can take naprosyn or alleve (trade name) for a few days for the pain and inflammation.

One obvious advice is to see a sport medicine orthopedist who specializes in shoulder issues. If that person suggests a steroid injection, you need to look for another specialist. A good physical therapist, again one who deals with athletes, might be one way to go.

The not so obvious advice - is to work on your forward stroke, I bet donuts to your local currency that you are arm paddling.

Jeez, I don’t know about the negative appraisal of an injection. I have a pretty serious calcium deposit in my shoulder. I could not lift my hand 2 inches forward from a starting position with my arm hanging at my side. Excruciating pain. Doctor said surgery, or try cortisone. Literally within 10 minutes I was pain free, unlimited motion. That was in June last year. Just an occasional twinge now, for instance throwing my boat (67#) up on the car after a 15-20 mile paddle. Is that better than surgery? If I need a shot of cortisone every 8-9 months, I’m ok with that and so is the doctor. I’ll probably get another in April. Life is good, no long rehab and recovery from surgery, no missed skiing or paddling, I love cortisone, the guy that invented it should have gotten the Nobel prize for medicine as far as I’m concerned!

I Second That
Sounds like an ‘arm paddling’ thing. Are you getting torso into your stroke?

Male, 31.

Well, I thought it was “arm paddling” but according to instructor with whom I went out just so he could see me paddling for a longer time end of last year - it’s not. As far as I can feel I’m putting plenty of torso rotation in. And ibuprofen does not really help after - never tried pre-medicate though. Tramadol does help taken after, but I don’t like being on it.

why would

– Last Updated: Jan-27-13 6:40 PM EST –

You instantly object to an anti inflamatory shot? Other than the fact that the pain subsides in its own. Just interested.

Ryan L.

Burning sensation
suggests tendon issues. Bone injuries are sharp or dull consistent ache. Ligament issues (sprains) are also very sharp and intense with plenty of swelling. The actual cause is hard to understand, though I will guess that holding the paddle lower and with a softer grip may help.

The shoulders are a remarkably weak joint and holding the paddle high puts a lot of static stress on the shoulders. Rigidity in the wrists limits the range of flex at the shoulders as well, so loosening the grip may also be a factor.

Good luck with resolving this. I don’t believe paddling should cause this particular pain (I’ve never experienced it, but we do vary between individuals), so there is possibly something in your technique that could be influencing this.


Overusing ibuprofen?
Your docs may not be reading solid research going back two decaades.

Ibuprofen, naproxen, aspirin, and other NSAIDs work by suppressing inflammation. But inflammation is an essential part of the healing process

In one study, subjects with rotator cuff injury were matched into two groups. One was fiven an adavanced NSAID. (Non steroidal inflammatory drug) The other was given a placebo which affected neither pain nor inflammation.

Scans and physical exams showed that the NSAID group had delayed healing relative to the control group, even though the NSAID group had reported decreased pain.

Use ibuprofen not for lingering pain, but only for pain that makes you unable to carry out necessary functions Do not treat ibuprofen as “vitamin I”.

I used to do the same things as you have done, until I read the research. Many docs have not read the research, and shoud be questioned on their recommendation.

One more thing. If you have to take an NSAI, naproxen (Aleve etc.) is a safer bet than ibuprofen.

The 1950 Nobel Prize was …

– Last Updated: Jan-27-13 11:56 PM EST –

... awarded to Dr. Kendal for ... discovering the cortisone

That said, there is no free lunch and research shows the side effects tend to increase with repeated and increased use. The shot does not cure, it suppresses the immune system. Unless you do something between shots to improve your condition, whatever you had that caused the pain in the first place will likely come back stronger...

Hardly, I would say - it just does not do anything whatsoever for this particular pain. I have a PhD in biochem anyway, so I do know a few things about what I can stuff my gullet with, chemistry-wise - the healing vs pain thing I’ve seen on myself when I had a dislocated ankle. But anatomy of joints is not my strong side and I agree, doctors around here don’t seem to know much - the greatest benefit of socialized medicine - it’s free, but also pretty useless!

But thanks guys. Once the sea thaws I’ll start over and pay extra attention to the stroke. Unless my arms fall off first :(.

The weirdest thing that the pain neither does not affect movement, not is affected by it. I’m used to thinking that an injury pain is supposed to get better if the joint is at rest. In this case my perception is that it is strongest when just sitting or lying still on my back.

Take a clip and post it where folks can see it.

Even though a coach says you are good, I have met enough arm paddling coaches to see how the advice might not carry a whole lot of meaning. Heck, I’ve seen instructional videos where folks are exclusively arm paddling, one for PH springs to mind. Unfortunately, the usual advice - do what feels good - is the worst advice ever, since I’ve never met anyone who would find torso paddling very natural, or a concept that one is likely to develop without outside input.

BTW, the red herring for arm paddling - you are using GP, in my experience it is equipment cure-all for a variety of stroke deficiencies. And, GP paddlers, don’t get your skirts in a knot, some of you are really good, but some suck neoprene booties.

I have found, for myself, that using a
high paddle stroke for an extended time will cause my shoulders to hurt. By lowering the arms helps to alleviate those sypmtoms. Also, it helps not to have a death grip on ones paddle. Been there, done that. Having a relaxed grip, where my ‘pinky’ digit is not tightly involved on the paddle is the way I go, otherwise there will be pain in the lower arm muscles.

As others have said, the torso rotation is also important. Oh, how many of us have learned these things the hard way?

Many thanks again to those on this board with their suggestions that have helped me and others improve our enjoyment of paddling.

May your situation be resolved so you can enjoy your time on the water.

My Knee

– Last Updated: Jan-28-13 4:42 PM EST –

I had tendonitis in a knee. The doctor said take 600 mg of ibuprofen before a bike ride and do a long, easy warm up before pushing hard. It helped a lot. Do 600 mg again after 6 hours. Ice afterwards if you hurt. Give it a try and see if it helps.

Cortisone and shoulders
Opinions differ greatly. My understanding is that Cortisone is a potent anti-inflammatory. It does not mask pain. In some cases it will eliminate the inflammation long enough that the irritation (bursitis, impingement, etc) will actually heal. For some people the effects will only be temporary.

I had moderate pain from a bone spur/impingment (caused by an old AC joint inury). One injection of cortisone, followed by massage and weight training has kept me relatively pain free for two years.

That said, most doctors agree that multiple injections of cortisone (more than 3) can weaken the tissues, so should be avoided.

Don’t guess! Go to a sports specialist and get an X-ray and an MRI. You might have a mechanical issue, such as a bone spur, tear, etc. Until you get the facts you are just guessing.

Greg Stamer

ROR, if your sleep is interrupted
significantly by pain, or anything else, your pain may be a kind of localized fibromyalgia. A Canadian researcher, Moldofsky, established several decades ago that if stage 3/4 sleep (rather than REM sleep) was repeatedly interrupted in volunteers, they would feel tired and achy the next day, as if they had slept on hard ground. REM sleep interruption left volunteers tired, but not achy. The sleep structure of actual fibromyalgia patients suggested that they were not getting stage 3/4 “restorative” sleep to a normal degree.

This is only an oblique contribution to your situation. I think the tissues in or near where you hurt are sending in pain impulses even though there is no normal source of pain. When you move, input from proprioceptors gates off the pain impulses and you don’t feel the pain.

Things that might help. Normal movement, to get the pain receptors to shut up. Certain GABA manipulating substances like Neurontin that work on peripheral pain. Certain new sleep meds known to help neuralgia. (I’m not enthusiastic about the latter.) Forty years ago, the pain clinic in our rehab medicine center would have done autonomic nerve chain blocks to help you. But that fashion seems to have died down.

You could also try a TENS unit if someone would prescribe one, or acupuncture (??) or ice packs or yoga or rolfing… But in the meantime, find out if just being more active might actually help, or at least not make it worse.

“do what I say, not what I do”
“I thought it was “arm paddling” but according to instructor . . . it’s not.”

Maybe the instructor is arm-paddling too. :slight_smile:

Sometimes shoulder-paddling is harder to detect. Video can be a good help here.