treating tendonitis
i was just reading the post about tendonitis and underlying constitutional conditions (auto-immune, multiple joint pain, steroid use etc).
the best form of treatment would be Oriental medicine ie - acupuncture and/or herbs.
these practitioners take into account the big picture,
not just the body part that hurts.
i believe in it, i’m an acupuncturist!
(wanted to name my practice Kayakupuncture!)
good luck,
jean
Multi day trips?
Not being a doctor, i would cut back on the intensity of your paddling. You are exasperating a condition and the only way to help it heal is let it heal by not abusing it. I would try a different paddle and at least smaller blades and non feathered or a GP. You don’t have to stop paddling but something has to change to allow it to heal. No sense seeing a doctor if you are not going to change what you are doing. The condition can heal if you let it heal. In the meantime, over-the counter anti inflammatories can give great relief which I’m sure you are doing. Good luck, you’re not alone.
agree and don’t agree re: Euro
No Little Prince–how about Emperor’s new clothes. Matt is a very good paddler, who already has excellent stroke mechanics is my guess. Seems for Matt that the primary problem is that he unfortunately prone to inflammatory tenosynovitis. Tweaking a Euro (if there’s anything to tweak) will still give him a paddling stroke that looks like raking leaves, which is the classic definition of overuse for intersection syndrome. It may help, but it won’t be a big change and he has a big problem. Switching to a low elbow, canted GP stroke will fundamentally alter the stroke dynamic for wrists, elbows and shoulders and may provide significant relief–or not, a testable hypothesis. Clear that what he’s doing isn’t working, which is a real bummer, so IMO no point in continuing. Also agree with Jay Babina: need to slow down, then rebuild–great opportunity to pick up GP with a serious intent to get as good at GP as he is with a Euro. There’s no limitation with a GP re boat control strokes or much of anything except towing against the wind and tide in Penwyn Myr (sp?).
UC?
Been there, done (close to) that and have been mostly asymptomatic with Crohns for 25 or so years now. Of course the ostomy and skipping some of the plumbing didn’t hurt…
Above suggestion for accupuncture is good, you should also consider adding in some Yoga and/or massage focused on myofacial relief.
repetitive stress
Matt -
First and foremost get someone to analyze your stroke with video. I think you are down south now, perhaps Ben Lawry could do so. It seems that your stroke mechanics need to be observed, in observing yourself though video, you may be able to change.
When video’ing, take a marker and draw a thick line through the middle of your wrist down the backside of your hand to the middle finger. That will give you a marker for when you are observing and will allow you to see when your wrist is bending the wrong way.
Greyak has offered you the best advice - keep the wrist neutral. They are meant to be moved up/down not left/right. I think that you need to SEE when you are doing it in order to correct it.
Don’t let anyone lead you to believe that you can’t correct/change your stroke. If you keep doing what it is that you are doing, you won’t be able to paddle. Of course you can learn to roll with an unfeathered paddle, if you learned to roll feathered, you can learn to roll unfeathered.
One idea would be to use a GP for a month or so, to try and change your body mechanics using the euro.
Good luck to you!
Suz
another point
to mention - my pt gave me med length velcro wrist splints to use. She said most problems ie wrist/elbow stem from the bending of the wrist and move along tendons to the elbow (not sure on this one but that is what she said and I am not in the medical field) So i tried using the splints but they are too restrictive for much of anything as i feel i am in casts on both arms! but what i do which may or may not be good, i bought some of that ace bandage without pins that sticks with velcro and wrap my wrists to try to help them stay somewhat straight while paddling along with the plastic forearm braces from a previous pt (bet I look pathetic though but whatever…i am paddling!!) The bandages get wet but thats just part of paddling. not sure if this helps any but worth a thought.
Marilyn
Medication?
Matt,
I can’t offer any advice on how to tweak your stroke to help your issues as I don’t have enough experience. My question though is has your doctor prescribed any medication to assist you? I know medication is not always the best or right answer, but it can help provide some interim relief until you’re able to fix your issue. When I had sever tendinitis in my hand my doctor put me on Celebrex. I know some people can’t take this drug due to site effects or other interactions. I found it immensely helpful in reducing inflammation and pain. May not be the answer for you, or maybe you’ve already tried it.
Best of luck and I hope you start feeling better soon. My dad suffered bad carpal tunnel in both wrists for years before having surgery on both, so I am familiar with your pain.
Solving the problem
– Last Updated: Aug-25-08 11:56 AM EST –
If you know that you grip the paddle to tight when paddling hard then why not practice this. I had the same problem and noticed it more when towing someone. Opening my push hand and beinging conscious of the pull hand solved the problem.
Will this help your tendonitis? I don't know.
Paddlin' on
Richard
shaft size
…or, try a smaller shaft size. It actually made a big difference for me.
Or maybe an Aleut…
… with even more interesting grip area shaping and overall ergonomics. 
GP might be the ticket, might not. Sometimes with this sort of thing you have to completely stop paddling for a few months (gasp!), then rehab (work + patience), then resume LIMITED paddling and reevaluate how you’re doing things. Otherwise it only progresses.
I’m certainly not disagreeing that a decent GP stroke will make major changes in what gets stressed and how - often for the better -I just don’t think it’s realistic the way people keep prescribing them for everything for everyone (and I make and sell traditional paddles! I’m also a product designer who has studied ergonomics and relevant anatomy of this).
A wrist brace is just going to be a cheaper, easier, and more reliably effective first step toward getting a handle on this than a GP. If his tendons are already damaged - making them change grip to a more open handed grip (on GP blade roots) could help - or the new hand positioning could do even more damage - particularly if he doesn’t already have good neutral wrist habits (and a lot of people we’d consider good paddlers don’t - but get away with it via greater tendon strength, resilience, wrist structure differences, etc).
Mixed bag led to this
Likely the whole package - not one cause. Sorry, but age could be in there too, 35 is an age many note some changes starting - poartucularly wtih recovery and healing times…
For sorting out the wrist angle stuff - brace should quickly show you what’s up in your paddling.
When I had a bout - using a computer mouse agravated it and contrubited to a slower recovery - so look at all your activities and wear the brace for all.
Tendons heal VERY slowly. Takes a good 6-8x longer than mucsle to repair, ofetn longer - and that’s if you leave them be do do so. A LOT longer if you don’t.
Also - take a bit of extra care with nutrition. I also might suggest a Cal/Mag/Zinc supplement for a while. Fish oils will also help the inflamation/pain. Unlike most things - you should actually feel some difference with these in a few days. Sometimes less with the minerals (slight deficiencies can contribute to this stuff - and generally overlooked).
Even up/down bad when pulling/pushing
Any deviation, not just to the sides.
True
but he basically has two choices, stop for a while and then try GP or try GP and, if not helpful, stop paddling for a while. My guess is that he’s got pretty good stroke mechanics with a euro paddle and that he needs to change paddling styles to have much chance of getting better–otherwise why the questions? this is a separate question from whether or not a period off the water will make a difference–probably would be a good idea, but that’s a tough sell for a committed paddler. my thought would be to slow down and focus on gp technique: forward stroke and boat control. if that helps, great; if not, it’s a hiatus from paddling. also, i know that you know that traditional paddles vary a lot depending on use (touring/surf etc) and that it takes a while to dial in what you like. i doubt matt’s spent much time with paddlers who are devoted to greenland paddling or tried a lot of different paddles. could be fun for him while works out the details of rehab.
Wrist and forearm strengthening
– Last Updated: Aug-25-08 8:14 PM EST –
I've had numerous wrist and elbow tendinitis sorts of problems, and one thing has cured them all. No guarantees for you, your body and paddling technique, of course, and it's definitely not a "quick fix", but here it is...
*** Build up your forearm and wrists with wrist curls and reverse curls, using progressive moderate weight and high repetitions. ***
Of course, you've gotta get it healed enough to start that regimen, but try skipping winter paddling to give yourself a healing rest. Just paddling will not do it, because it will just continue the cycle.
You may experience pain when first doing the curls. If it persists during a session, back off and wait, or go to even lower weights. If it hurts a bit then goes away with more reps, you are probably OK.
If you try this, it's probably wise to consult a good trainer with some orthopedic chops. I'd recommend a physical therapist for many things, but for some reason the ones I've tried do not get this one -- they seem to prefer "treatment", for which, of course, they can charge and take credit (pardon my cynicism.)
Like I say -- this has cured my problems in wrists, forearms and elbows -- an impressive range. I did it for the winter months the first time and the pain did not reappear the next season. Then after a couple of years, I let it go, and the problems returned. So I had to to do it again for months. Now I do the regimen at least once a week faithfully and have absolutely zero tendinitis problems. Prior to trying this, I was worried about having to give up paddling!
Of course, try the other things too -- good technique frequently helps; different paddles work differently on different people, etc.
more on feather
Greyak,
Maybe I don’t really know what you meant when you said "Lastly, use ELBOW lift to control feather - do NOT cock wrists! If you do, wrists will be bent up or down (Palmar flexion and Dorsiflexion = BAD!).
I think of all this from a biomechanical perspective. In order to control feather using elbow lift and no wrist flexion/extension, your elbows will not be coming up to the same level on both sides. If they are, you are controlling that feather with something else. Keep in mind that the level to which we lift our elbows has nothing to do with elbow motion, it comes from varying degrees of shoulder flexion, abduction, or a combination of these. It’s just biomechanically impossible (and I hate to use the word “impossible”) to do the same exact motion with both arms while paddling with a feathered paddle and plant the blade the same on both sides. Something has to compensate for the different blade angles.
Maybe we can use this as an excuse to get together and do some paddling in the Keys. 
That is, of course, if these storms leave us alone.
Pete
Switch in 15-deg increments?
I was using zero feather, switched to 15 deg. feather for one season, then switched back to zero feather this year. Had no problems with rolling after the switches.
Maybe if you switch from 30 to 15 to zero, it will be easier.
“devoted”
– Last Updated: Aug-26-08 2:12 AM EST –
Scary word.
Participation in various regional paddling cults has never been shown to help with tendonitis. Braces, recovery time, rehab work, and activity modifcation has.
grumpy are we?
– Last Updated: Aug-26-08 7:40 AM EST –
devoted means to skills development--grin
More like cynical
The GP talk’s been drifting back toward the “magic” and both new and old dogmas seem to be taking hold again.
When you mention paddlers who are devoted to Greenland paddling it also makes it sound like there’s some sort of homogeneity out there among GPs and their users, yet I’ve found little.
Lots of variations on 3 knot forward stroke advice though L
hold on a minute
You’re telling us that bowler can’t attempt to relax his grip? Come on. He’s not an old dog; if Tiger Woods can modify his swing then Bowler can handle this.
Try relaxing your grip.
Then try not moving your wrists.
Then try a straight shaft.
Then try a smaller diameter shaft.
All of the above, one at a time.
sorry to be blunt, but to say someone can’t adjust is ridiculous, and I really have an aversion to looking to different gear to solve incorrect mechanics.