Tendonitis And Paddling

-- Last Updated: Aug-10-05 4:14 PM EST --

Howdy,

I just recently got both tennis elbow and golfer's elbow in both my arms, what a pain in the a$$! I couldn't open a bottle top for a month. It's defiantely better now, but still healing.

From what 2 doctors have told me, it is easy to reaggetaite these tendons once you have injured them. One of my greatest fears is paddling. I really hope paddling does not reinjure my tendons or aggrevate them.

Has anyone had this before? and if so, do they get aggetated from paddling all day?

Any input would be greatly appreciated. Thanks in advance!

Regards,
Yo Han

An Ounce Of Prevention…
I have some experience with tendonitis in the knees and bicycling. A doctor gave me the following advice and it worked:


  1. You need a long slow warm up. The older you are, the more important this is.


  2. Take 600 mg (3 tablets) of ibuprofen shortly before biking / paddling. Take the same amount again 6 hours later.


  3. Apply ice if you hurt.



    I have found that the more I warm up SLOWLY, the less I rely on ibuprofen.

Build up your wrist and forearm muscles

– Last Updated: Aug-10-05 9:29 PM EST –

At least that has worked for me. I've done a very steady, increasing regimen of forward and backward wrist curls and just holding small barbells from a my downward dangling hands and moving them back and forth. It's taken a while -- months -- but my tendonitis is now totally gone. Before, it was getting very regular and close to disabling for paddling. Bonus: my wife likes my newly buff forearms ;-))

If you do this, consult a trainer, and don't overdo it. There are small ligaments and bones in the wrists that you can injure if you push too hard too fast.

You may have to let the pain subside somewhat before starting this. I found, however, that despite some initial pain in my first sessions, that exercising those muscles did not actaully aggravate the tendonitis short term, and of course, cured it long term. It may be good to do this over the winter when you are not paddling.

Meanwhile, have you tried an arm band? Used properly, that can releive the pain by reducing the strain on the tendons.

Disclaimers -- IANAD and YMMV

--David.

Form, Form, Form . .
Correct me if I’m wrong but tennis elbow is an injury to the tendons attached to the back of the forearm and Golfer’s elbow is an injury to the tendons attached to the front of the forearm? These are muscles that are not used during normal paddling. Overuse of these muscles in paddling is commonly cause by people who paddle with their hands, pushing the paddle this way and that by flexing their wrists (hand up and hand down). It’s possible (in fact considered good form) to paddle without using these muscles and tendons that are giving you problems.



Most people take years and years to learn how to paddle with good form because they don’t have tendon concerns. Since they aren’t concerned about injury they don’t concern themselves with using proper form. That you do have tendon issues leaves you with a choice. You can either choose to paddle as most people do and re-injure yourself or stop paddling or you can take this opportunity to learn correct form which uses a completely different set of tendons and, with proper form, rarely leads to injury of any kind.



Paddling is the least aerobic sport in the world. Done right the only work that’s being done is being done by your abs and just a little bit of quads. Have someone show you the ACA’s “Paddler’s Box”. Learn to use this form in all of your strokes and tendon issues will quickly become a thing of the past, you stamina and speed will also go through the roof but that 's just gravy.



Cheers,



Jed

Tendonitis
To reduce strain on those arm tendons, don’t use your toggles to carry your boat when doing a double carry. Wrap your arm around it.



Demand to have 4 or 6 people carry a loaded kayak, using slings, rather than use those toggles.



Keep your hands and forearms warm with gloves and sleeves.



I bought a tow rope, then it seemed I was always having to tow someone in less than an emergency situation. Now I don’t. (I still carry the tow rope, but I’m less sympathetic! )

Thanks…

– Last Updated: Aug-11-05 1:27 AM EST –

all for all your suggestions and advice! Some very good info.

David, my ortho gave me those exact exercises to do on top of palm up curls and palm down curls, ending with 2 forearm stretches. Just started doing them this week..since it is tolerable now.

I should of mentioned how I did it. It was 2 weeks off stripe bass fishing. 6 hours a day straight, of throwing 1oz plugs nonstop on a thick heavy rod. 8 days and I started having the issues.

Keep it coming! Thanks again!

Forearm stretches
Can you describe the forearm stretches. I’d love to have more good stuff like that in my workout routine.



–David.

Form

– Last Updated: Aug-11-05 6:48 AM EST –

Jed's comment about form is well taken. This is the year that I have (finally) gotten my my act at least somewhat together regarding forward stroke mechanics. So that's another possible explanation for the dramatic disappearance of my tendonitis.

But I ain't stopping the exercises. I really feel like that they are a major factor in the improvement. My forward stroke has not improved ~that~ much. Besides, every body is unique. I know that unless I work on it fairly intensively, my upper body tends not to be particularly strong. So that, combined with a fairly aggressive approach to paddling, might leave me vulnerable to this injury.

One other observation -- correct me if I am wrong -- is that I don't think you need to use a muscle all that much to get its tendons inflamed. That is, you don't need to use its muscle power much, as long as you are constantly flexing it with a little tension, enough to rub the tendon repeatedly across a bone. In any case, I definitely had classic tennis elbow, with pain just under the knob of the elbow, on that ridge... or so said a physical therapist.

I really work pretty hard to not use my hands much the way Jed describes, but may, of course, not altogether succeed. In fact, an old shoulder injury prevents me from raising my right elbow as much as recommended to get the shoulder, elbow and hand aligned for the forward push, so there is definitely some pressure on the wrist muscles. But (a) I had tendonitis on ~both~ sides; (b) 97% of people paddle that way -- elbow too low, forearm too vertical -- even some luminaries I have observed. But not many get tendonitis, at least that I have heard.

IAC as I said, YMMV.

not to be discouraging, but
I’ve had tennis elbow, golfer’s elbow, and tendonitis in my hip and currently knee. I’ve worked out in the gym for ten years, so consider myself in relatively good shape. I can think of no activity on which to blame my tendonitis, nor have I found anything which helps it, including cortisone shots, wraps, straps, stretching or warm ups. I recently spent $1200 on an MRI of my knee and learned nothing. So the bad news for me is that the only thing that helps is time–the good news is that time does seem to help. I hope it helps for you too.


tlspitz…sorry to hear that and thanks. I hope yours healup well with time.





David, the to stretches are this:



For both you have your arm straight out with your elbows lockedout.


  1. with your palms down you grab your fingers and pull them towards your body…pulling your palm towards your body. 3 sets of holding it for 15-20sec


  2. With palms up, pull your finger tips down and back. 3 sets of holding it for 15-20sec





    Another exercise he has me doing that I forgot. Is holding a dumbbell by one end with arm fully extended strightout… twisting my wrist/hand from side to side with the dumbbell…so the other end of the bell outlines a rainbow shape when going side to side. I can really fell this one work my forarm muscles.



    Hope these make sense…if they don’t let me know. Good luck to all with theirs!



    Yo Han

Sorry about your intractable tendonitis
… but among your failed measures I did not see building up the wrist and forearm muscles. Have you tried that – forward and reverse wrist curls; “hanging” curls, etc? It’s not a cure as much as a preventative. And of course, it takes a while, weeks and months, to get the muscles built up enough to make a difference, so it’s not a quick fix.



I haven’t though much about the theory, but I assume it’s something like building up those muscles enables them to absorb and/or prevent much of the stress that otherwise goes straight into the tendons on repetitive motion, making them rub repeatedly on bone and get irritated. Because this is RSI and not pulled muscles or other things suddenly traumatized by a single event, even subtle changes can make a big difference.



But as always, IANAD + YMMV



–David.

These sound terrific…
… Thanks! I’ll add them to my routine.



–David.

I don’t take care of this myself
. . . but I have some good friends who do. In the past year, I have had tendinitis on both sides of my dominant elbow first on the inner or medial side and now on the outer or lateral side.



The advice I got was patience. Elbow tendinitis is a chronic problem and easily aggravated. Cool it down with ibuprofen, ice (and,for me, applications of “Icy Hot” cream), and rest. Rehabilitation is best done through a reasonable stretching and strengthening program such as what has already been posted.



I have also become a big fan of the elbow straps. Having tried a few, I have found what I consider the best: it is an ACE product that is made of a elastic neoprene like material which makes it ideal for paddling since it holds its stretch when wet and won’t slosh out of place. I got mine at a K mart for around $12 and it was labelled “ACE Elbow Strap.” The wider fabric type straps that feed through a plastic buckle I found to be relatively useless.



The strap is mainly a prevention tool for me. When I know I am going to be doing something that will potentially aggravate the problem, I wear it. It works by spreading the anchor of the muscle/tendon group over a larger area and changing the angle of the force.



Hope you feel better. Be patient. Both bouts required several months to clear up and now I am more diligent with prevention (and I am working more on my technique!)

I have to be very careful not to crank
mine up, but paddling has never made it worse.I have paddled when I could barely tolerate touching my elbows. When it flares up, the tennis elbow bands keep it from getting worse, along with Aleve.

Activities that exert stress on my fingers, like using a screwdriver, are what makes mine flare up.As has been pointed out, paddling correctly shhouldn’t hurt you.

Ah, the pain the pain!
I had tendinitis diagnosed in both elbows for 13 yrs. Was told by more than 1 doctor to try not to use them. Didn’t seem likely to me with the hands being downstream from the elbows and all. After suffering with back pain I finally let a couple of friends talk me into seeing a chiropractor. The first thing that cleared up was the elbow pain, turned out to be a pinched nerve in my neck. 20 yrs. later I’m still pain free. If both elbows started hurting at the same time don’t rule out another opinion.

arm band
my wife put a narrow arm band just below the elbow and this made a world of difference for her.