Shoulder injury (rotator cuff). Help needed

[JulioSUPBrazil]

Hello guys I'm new on this very nice forum and have a little history to tell:

I've started SUS about three years ago. At the very start I paddled every day for a couple of weeks (I was on vacation), which caused me a rotator cuff injury (tendinitis).

Afer an ultrasound exam my doctor said: "It's not a big deal, ice it, do some physiotherapy sessions and dont't stop paddling, just slow down."

After couple months, Physiotherapists said: "Your problem is chronic, you don't need to come back, live with it."

Didn't got any better, new doctor said: "Not big deal, don't surf for three months, ice and hot and more physiotherapy". After 5 months... I paddle out then the pain come again.

I'm on this cycle for 3 years. Changed paddle length, blade size, flex, no help. Today I'm using 2" over head, 7" wide blade full fiberglass paddle, little progress but still alot of pain.

Let me explain how this pain works: After 10~20 min of paddling it starts to hurt. If I sit and rest for around 20 minutes the pain stops, but come back after a couple waves. In prone, no pain at all.

My technique seems to be OK. As goofy my last and strongest 2-3 strokes are allways on the left rail (my problem is on the right shoulder).

Well, any help will be very appreciated 

[Bean]

Do you have access to a different doctor and physical therapist?   

I went through several years of shoulder issues and in my case, very specific stretching and strengthening exercises did the trick. But this was only after finding the right orthopedic surgeon who was able to pin-point my specific issue.

[balance_fit]

Hi Julio

Welcome ! Sad to hear from your shoulder issue. I also had a very debilitating injury in my right (stronger) shoulder that produced a lot of swelling and irradiated pain to several nearby structures. It took my out of distance paddling, and i vowed to find a solution with help: a great MD, and an unfair advantage...i'm a physiotherapist.
Long story short, issue comes because i have a curvature in my spine -scoliosis- and it causes one scapula to be rotated contrary to the other one at rest. Right shoulder stays behind left one, and when paddling on the left, right arm had to cross over mid body just a bit too much, multiplied by many strokes, pain. Sounds familiar?
Please, as previously recommended, get a second opinion. Have your shoulder be evaluated in the context of the whole anatomical region, including scapula, spine and even hip. On evaluation day, mimic the movement of paddling and ask for a postural evaluation to be made, static and dynamic.
A shoulder specialist is indicated, but also, a chiropractor, athletic trainer, physio or coaches with experience in overhead sports will help.
Keep us posted !
Be well

[JulioSUPBrazil]

Thanks guys. I have to admit that I've stopped to search cause after see 3 doctors. Will try to find a shoulder specialist.

[crtraveler]

I've found that when I just go right to surfing after a period of non-paddling, I get some shoulder and elbow pain.  If I'm conditioned by some flatwater training first, then the pain doesn't show up.  For me, it seems that the pain comes from over-exerting myself surfing when my body isn't used to paddling in general.  Maybe (if you aren't already) you should incorporate periods of low stress flatwater training to build strength.  Then maybe surfing wouldn't result in pain...?  Also, if you haven't tried a full carbon paddle, it may help a little due to being a bit lighter than fiberglass...of course you want something that still has good flex...

[Sup-position]

I had a "Chronic" shoulder pain problem before I started Sup. Daily prone surfing.
The Chiropractor told me after several sessions that he could keep treating me
but he didn't think he was the solution. He mentioned Active Release Technique as
a viable solution. I searched for a practitioner and found a number of Chiropractors
and a couple Therapists.. made some calls and selected the Therapist..
After almost a Year of pain, my shoulder was fixed in a couple sessions...
We have referred many of our friends to this guy and they all rave about him.
Jim Narang in Irvine, California, USA.
http://www.yelp.com/biz/jim-narang-a-r-t-irvine

Hope you find some help.

Ralph
Sup-position
Huntington Beach, California, USA
(714) 899-3020

www.Sup-position.com
 

[Wetstuff]

I was unable to 'paddle out' prone thru shore break. I simply could not windmill my arms. Ahhh, I figured I would simply bust my way thru the pain.. Eh-eh.   

I had both shoulders injected last March.  I have been pretty fine since.  $1800. for a 30min procedure. 

Jim

[SlatchJim]

We went several years through a host of diagnosis with my daughter's torn tendon.  The finaly guy caught the problem using a dye injected MRI.  No dye, no detection.  Cost her a season of college volleyball on scholarship because the doc before the final one didn't diagnose it correctly.  I recommend the dye, and a doc that doesn't stop until you're better.

Don't settle.

[supthecreek]

I have damage to both my rotator cuffs.

Happened 10 years ago... got slowly better over the years.
Still hurts when I sleep or try to lift anything.
Still can't lift a gallon of milk with my arm out.

Anything near shoulder height and I lose all my strength.

I am sure there are many ways to damage the same area...

For me...paddling is ok. I always lift the paddle up with my lower hand.
My top hand gets a free lift.
On the down stroke it is ok.

In a race last week, I pushed much harder than usual... and I had pain for most of the course.
I thought I may pay a price for it, but as soon as I stopped if felt better... next day... no issues.

Don't know what this does for your case, but maybe by adjusting the way you paddle to use your strengths will net some results.

Also... people on the Zone swear by the Kenalu paddle for shoulder relief. They are different than other paddles. Search the Zone for shoulder issues or Kenalu.

Good luck with it... I'm sure in time... it will improve.

Post some Brazilian SUP shots & vids

[JulioSUPBrazil]

I realized some time ago that lifting could be the reason, so i try to do the same: lift the paddle with the lower hand, still working on it, can't remember every stroke, especially when catching a wave. but thanks for the reply i will keep this in mind 

I have damage to both my rotator cuffs.

Happened 10 years ago... got slowly better over the years.
Still hurts when I sleep or try to lift anything.
Still can't lift a gallon of milk with my arm out.

Anything near shoulder height and I lose all my strength.

I am sure there are many ways to damage the same area...

For me...paddling is ok. I always lift the paddle up with my lower hand.
My top hand gets a free lift.
On the down stroke it is ok.

In a race last week, I pushed much harder than usual... and I had pain for most of the course.
I thought I may pay a price for it, but as soon as I stopped if felt better... next day... no issues.

Don't know what this does for your case, but maybe by adjusting the way you paddle to use your strengths will net some results.

Also... people on the Zone swear by the Kenalu paddle for shoulder relief. They are different than other paddles. Search the Zone for shoulder issues or Kenalu.

Good luck with it... I'm sure in time... it will improve.

Post some Brazilian SUP shots & vids

[PonoBill]

I have really bad shoulders, it's one of the reasons I teamed up with Lane Mead to start Ke Nalu paddles. I'm no longer involved with the company, but the paddles are still saving my shoulders. You'll probably have a hard time getting a Ke Nalu in Brazil--the shipping for a single paddle is just horrible--but I might be able to steer you in the right direction.

You need your paddle shaft to do two things--flex between your upper and lower hands, and take up a little shock. The flex between upper and lower hand distributes the load to a degree--puts more load on your lower hand. A tapered shaft will do this for you. Then you need a little overall flex to mitigate shock. If you can get your hands on a Ke Nalu get either an xTuf or an xTuf(S) shaft. They're really magic for bad shoulders. I used one of my 100Flex shafts for surfing a few days ago, just to see if my shoulders could handle it. Answer: No. Ouch.

Next, you need a very stable blade. If you are closing your hands to "steer" the blade you're hurting your shoulders. Your hands need to be soft and open, to do that your blade needs to track well and not wobble. That means you need a fair amount of dihedral in the blade and not too much offset.

You also want your blade to be light, and going too narrow might be the wrong direction. A big, light blade won't hurt your shoulders as much as a heavy small one will. You'll be pulling the small blade too hard and too fast. When my shoulders are feeling touchy I switch to a Molokai (9", 105 sq inches) and an xTuf shaft and don't pull so hard.

I'm not sure where you can get a paddle like that other than a Ke Nalu, but that's what you want to be looking at. If you have Jimmy Lewis paddles in Brazil you might try one of those. The shafts have too much flex for a lot of people, but they won't hurt your shoulders. They have the old quickblade Kanaha design for the blades, which I consider a superior design to some of the current Quickblade paddles

[adamrod]

see a physical therapist. I've had issues with rotator cuff injuries. See a physical therapist, they will give you exercises with an elastic band. If you do those exercises every day, after two weeks should have significant improvement.

The exercises really work. I had a torn rotator cuff for half a year, finally went to the Dr. to see about surgery, he suggested I see a PT before going under the knife. In the two weeks of therapy, I was basically healed before I even made it back to get an MRI.

the main reason people don't see progress after they go to a physical therapist is that they don't do their exercises. do your exercises. you will get better.

[PonoBill]

I'll bet there is no physical therapist that will make that claim. It's true that most people don't do the exercises long enough or faithfully enough, but every injury is different, every shoulder is different. Your mileage will vary.

[balance_fit]

Please allow me to chime in for a moment. As a physical therapist myself I have to deal, daily, with non compliance to treatment recommendations, which directly affect results. That been said, I must add that exercises, rest, medication, massage, stretching, analgesic modalities and other physical therapy interventions can't be effective if not adhered to.

Every injury has a cause and it's effect. In many cases, if the cause of the injury is identified and corrected, the injury itself becomes much easier to rehab in it's proper context.
Aside from trauma, such as a fracture, contussion, dislocation, etc, one cannot expect a successful return to activity if causal factors are not identified and solved. Even if adhering to a treatment within the realm of physical therapy.

In other cases, the structural integrity of a joint could be damaged to the extent that physical therapy might not guarantee successful rehab. In such cases, once the patient has been treated for pain, weakness, range of motion limitations, etc, and stabilized, to a point, other alternatives must be considered, such as surgery.

Our paddling friend here has an issue, no doubt. His pain while lifting could be traced to several causes. There could be rotator cuff injury, cartilage damage, a bone spur, neurological entrampment, etc, and any of these could be caused by several things. Compensating, in this case, by removing the lifting action from ther upper arm completely and leaving it to the lower arm could, in time, create it's own set of problems.

Our experiences with injuries, as paddlers, are of great value to our friend. He might identify causes and possible solutions from our well intended recommendations. Even so, he shouldn't rest assured that following our rx will heal him and solve his issue. He must seek a qualified clinician who identifies the problem and traces it to it's cause.  Our experiences will definitely help, but might not solve.

May all be well

[NXLVL]

i had a right rotator cuff injury that was painful in all activities. due to my income, i was not able to pay for operation or physical therapy. so with this i ventured to "youtube" for some advice or excercises that would help. i have since self-rehabilitated my injury with the help of a pilates elastic band and strengthened tendons around the damaged ones. basically with four motions and some discipline, you can have the same results depending on how extensive your injury (no spurs).

https://www.youtube.com/watch?NR=1&v=WJ47bA0uBb4&feature=fvwp