Training protocol after surgery

In the past 22 months I have had rotator cuff surgeries on both left and right shoulders. The right had massive tears to 4 tendons, the left was less difficult with 3 tendons. Five days ago I had arthroscopy to the left shoulder to correct a different problem. My surgeon is one of the nation’s best- so I anticipate an excellent recovery. I did paddle following my initial two surgeries. We now know that I will have to modify how I return to paddling this time- if I elect to return. Both my surgeon and therapist want to make that possible. What we lack is a treatment protocol that is geared specifically toward paddling. I’d appreciate hearing therapeutically sound advice on this subject. Thank you!

Recovery from shoulder surgery/paddling
I am not a surgeon or PT and I didn’t sleep at Holiday Inn last night. However, I was a competitive athlete in HS and College dealing with my sport injuries, have coached athletes for many years dealing with their injuries, and did have three hours of surgery to repair my shoulder in 2004 after a fall on ice. My goal in my PT program (18 weeks, 2 x wk, home exercises the other 5 days) was a complete recovery and full return to paddling. I accomplished that goal and have been paddling for 6 years since surgery. I’m closing in on 65 and still going on 4-6 hour paddles usually without and discomfort after. The rare cases when I have slight ache after a long hard paddle I use ice and take vitamin I when I stop paddling and maybe again that night. Always have been pain free the next day.

When you mention a therapist I assume you mean a PT. If not, my first suggestion is to find a PT who works with athletes who want to maximize their recover to resume the sport they love. Avoid a PT who works mostly with old folks just to relieve most of their symptoms (pain) and regain some strength and some range of motion. Set your goals higher. To paddle again, you want to work for as close a return to the days when you were young, strong and injury free. You know you won’t reach that point, as even the best surgeon isn’t god and repaired joints are never as good as when they were healthy. Just make it your goal to come as close as possible to that elusive state.

Second, in conjunction with the counsel of your MD and PT, push the therapy (within their guidelines) to maximize the recovery. I can’t legitimately give you exact advice as I don’t know the extent of damage or repairs done. My strategy was to push every exercise to the point where I felt the SLIGHTEST twinge of discomfort and continue working at that weight or strength of stretch band. I continued working at that point but never went beyond it to the point of actual pain. If there was any ache the next day I dialed back a bit in weight or strength of bands or reps.

A bit of advice for the future:

You probably already know from past shoulder surgery that any hard work above shoulder level is risky and usually brings discomfort if done slightly and serious ache if continued-avoid it. I learned this the hard way swinging a hammer overhead in a Mississippi reconstruction project.

Likewise you probably have learned that you need to continue shoulder exercises a few times a week to maintain strength in the shoulder muscles. Be sure to do so.

Use a very narrow euro paddle or better yet a Greenland paddle to reduce stress on the shoulder. Go to a low angle stroke if you haven’t done so. Those options are less efficient, but they are much easier on repaired shoulders.

Enjoy paddling when you return to it and don’t race to keep up with the young strong dudes.

Best wishes for a superb recovery and many year of paddling after.


Also Didn’t Sleep at a Holiday Inn But
Keep yer elbows down and close to your body. Lots of torso in your stroke. Greenland Paddle. Gradually increase your paddling time. Ibuprofen good.

(My shoulder injury was fixed with cortisone so it won’t hurt my feelings if you ignore my advice)

I had a lot of problems with my shoulder
after having arthroscopic surgery. The doctor and PT seemed to miss a big part of the recovery. After 8 years of limited use and discomfort I visited a sports message therapist, on a recommendation from a friend, and had instant relief. My range of motion was instantly back and I was able to use my shoulder normally again. I still can’t believe that the doctor and PT’s didn’t have a clue to this major part of surgery recovery. I started using a greenland paddle during this time and found it to allow me to paddle for longer periods of time with less discomfort. My point is, see a message therapist after you are cut and if your doctor or PT does’t suggest this, I would question their competency.

Shoulder re-hab
Dave- Wonderful response from you, and wise advice! I do have a PT and personal trainer who are both well trained to work with athletes. I’ve been working with my PT for nearly two years, have an excellent home exercise program. The damage to my right shoulder 2 years ago was massive and the shoulder will always be weak, but PT has yielded full range of motion. Careful training will continue to make it stronger. The left shoulder is a work in progress, and has had extensive repair as well. Both my surgeon (shoulder specialist) and PT want to see me on the water again. I’m only 6 days post op on this go round, so we are in wait and see mode. I do know that I will have to make changes. No more car-topping. That’s what trailers are for now. A modified stroke, and probably less ambitious water are in order. Good suggestion on the paddle- though I already use all carbon. Boat is a kevlar Tempest 170- so my equipment is light. I’m just going to remain optimistic and take it s-l-o-w! Thanks for your input and encouragement. Sandollar

massage as adjunct therapy
I’m a true believer in massage therapy, and it is an active part of my recovery. Fortunately thru PT I was able to achieve full range of motion. I have a gifted team- Dr., PT, personal trainer, massage therapist. I also work very hard within my limits of discomfort. I hope to return to paddling, but if I choose not to, it won’t be for lack of expert help and determination.

shoulder surgery recovery

I was hoping that the “one of nation’s best” surgeons was a “shoulder specialist” but didn’t mention that as your surgery had already been done. I live near Yale Med school and there are many orthopedic surgeons with good reputations here. However, I spent two weeks searching out who was the best “shoulders only” surgeon in this area. Finally found the only one as all the rest were “joint of the hour” surgeons.

When I fell, the biceps tendon was split and 2/3 of it was ripped off the bone. Clips had to be installed to reattach the tendon parts onto. The joint capsule was ruptured and had to be repaired. A bone spur was removed and the frayed tendon was cleaned up. The bone at the top of the joint was shaved to create more space in the joint. I had to delay PT for a month to allow the joint capsule repair to heal. Was in a sling for that month and had to sleep only on my other side for four months. (Made a “wall” of pillows to prevent my rolling over onto my repaired shoulder.) Slept for two hours or so then woke up, went to the bathroom and then resumed sleeping on the “good” side only. Was an ordeal, but I would do it the same way again if I had to do it over as the results were excellent.

Sounds like you have an excellent supportive team who are willing to work with you. I watched the PTs at the clinic when I went through the “pre opt. PT compulsive figures” before surgery could be approved. After surgery, I insisted on working with the one PT who was carefully tailoring the exercise program to the exact needs of that patient. With her guidance, I was even able to go back to the pool practicing kayak rolling near the end of the PT program-strict concentration on keeping my arm tight to my body and rolling mostly by trunk rotation (layback roll).

Now knowing the extent of your shoulder injuries, I strongly recommend your using a solid red cedar Greenland paddle with some flex in the paddle. The narrow blade and the slight flex in the paddle both reduce stress on your joints, a most important consideration with your injuries. Have an experienced paddlemaker make you one to fit your body size and your kayak width. If you haven’t used one, have someone knowledgeable show you how hold and use it. Be like a turtle, slow and easy; enjoy the sights. While the term “Lilly Dipper” is used derisively by gonzo paddlers to describe gentle paddling, work to become a lilly dipper. Your shoulders will thank you.

Best wishes for a lengthy kayak paddling future,


Good advice!!
Hi Dave-

Rest assured I do have world class SHOULDER surgeon- I made sure of that. Have just returned to PT and in three sessions am already making nice progress. I’ve found a maker of custom Greenland paddles who is also a 4-Star BCU coach. He lives only an hour from me. He’ll work with me when/if I decide to return to paddling. All of this is going to have to be thoughtfully choreographed. I am in no hurry- I was three days ago, but I realize this is going to be a protracted healing and strength-building journey. I simply am not going to put these shoulders at risk by trying to hurry the process.

I am pleased to read how well you are doing following your harrowing accident. It gives me, and others, hope for returning to the sport we love. Thank you for all your encouragement and suggestions.


I have had Rotator cuff surgey 3 times on the left, two on the right, & a partial joint replacement on the right this past March 6th. I started very slow and easy after the joint replacement this spring. I have paddled with Greeland paddles for the last two years, and would highly reccomend their use. There is so much less strain on the shoulder joints. I am now back to paddling 10 to 12 miles every other day, camping and paddling the Apostle Island in Lake Superior, and feeling no shoulder pain for the first time in years! I am a believer in finding the best surgeon out there! I had my last two surgeries done at Mayo Clinic, by a guy that does over 400 shoulder surgeries a year, and it made a world of difference.

Take it slow, listen to your doctor, but he may not understand kayaking. I think kayaking was the best therapy for me. It’s almost arobic, paddling flat water that is. Some people think of kayaking as some activity crazy people do down whitewater rivers. Not knocking the river kayakers, but touring flat water can be great therapy. Take it slow and be smart, First time out this spring I had my wife tow me in the last mile because I started feeling some pressure in my shoulder. Read your body, it will tell you what to do. Don’t be stupid!

Shoulder Surgery

Wow, you’ve been through it all it seems. Your comments are very encouraging indeed. I’m now 17 days post op, and doing well. I’ve been practicing paddle strokes, and the shoulder feels very good. My biggest problem is my restlessness, frustration, anger at not being on the water for two years now- except for a brief foray this past April. I have to guard against my impatience, and it’s hard. I suspect paddling is several months off yet, so I’m going to have to take a deep breath. Yes, I am going to get Greenland paddles, and I will be working with a BCU coach once I get cleared to paddle again. Thanks! And congratulations on your successful return to the sport. Sandollar

I Feel Compelled to Repeat…
I know you can do a LOT of things with healing shoulders (and clavicles) as long as you keep your elbows in close to your body. Take some ibuprofen and get out there and have some fun.