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Prevention of Paddling Pain and Injuries. Summary Of Injuries. Summary of Common Complaints. Common Injuries. Repetitive Stress Injuries. Postural Imbalances, repetitive movements, daily activities Result in Fatigue Microscopic damage to muscles Tightness of muscles Muscle pain.
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Repetitive Stress Injuries • Postural Imbalances, repetitive movements, daily activities • Result in • Fatigue • Microscopic damage to muscles • Tightness of muscles • Muscle pain
Repetitive Stress Injuries • General Muscle Tension • Caused by overuse • May or may not cause pain • Decreased range of motion, resists stretching • Can cause muscular imbalance • May lead to injury • Managed with exercise, stretching, and massage
Repetitive Stress Injuries • Myofascial Pain Syndrome • Caused by overuse of muscles • Trigger Points • Small, painful involuntary contractions within muscle cells • Locally painful • May refer pain and other sensations distant to the TP • Predictable location and pain referral patterns • May be active or latent
Repetitive Stress Injuries Trigger Points
Repetitive Stress Injuries • Myofascial Pain Syndrome • Treatment • Spray and stretch (vapocoolant spray) • Injections • Dry needling • Trigger point massage modalities
Repetitive Stress Injuries • Tendinopathies • Damage to tendons and tenosynovial sheaths • May also be caused by age, trauma, and other factors • Tendinitis • Acute damage, may include inflammation • Pain and stiffness with movement and stretching • Tendinosis • Long term degeneration of tissues, no inflammation • Pain and stiffness with movement and stretching
Repetitive Stress Injuries • Tendinopathies • Tenosynovitis • Irritation to sleeves tendons slide through • May have loss of smooth movement and grinding sensation • Treatment • Rest, ice, stretching, massage • Eccentric contraction exercises • Ultrasound • Splint or brace during activity for support
Repetitive Stress Injuries • Strains • Injuries to muscles or tendons • May also be traumatic, graded by severity • Injuries cause buildup of scar tissue • Decreased contractility • Weak, easily re-injured areas • Adhesions that decrease range of motion • Locally painful • Pain on stretching and resisted movement
Repetitive Stress Injuries Strain damage Scar tissue formation Weakness and re-injury
Repetitive Stress Injuries • Strains • Treatment • RICE (rest, ice, compression, elevation) • Proper rehabilitation with exercise • Stretching, massage
Traumatic Injuries • Sprains • Damage to ligaments • Inflammation • Redness, heat, swelling • Pain, loss of function of joint • May mask fractures
Traumatic Injuries • Sprains • Treatment • RICE (rest, ice, compression, elevation) • Movement to tolerance as soon as possible • Proper rehabilitation with exercise and stretching
Traumatic Injuries • Disc Injuries • May be traumatic or degenerative • Most common is lumbar herniation due to lifting and twisting • Canoeists tend to have more disc issues • May cause local pain due to muscle spasms • May press on nerve roots causing pain, numbness, tingling, and weakness in areas served by that nerve
Traumatic Injuries • Disc Injuries • Treatment • Depends on severity • Try to create space for disc to repair itself • Injections to decrease inflammation • Surgery
Traumatic Injuries • Shoulder dislocation • Forceful disarticulation of joint • May include soft tissue damage • Muscles will quickly spasm to splint • Reduce as soon as possible • Lots of pain and swelling • Loss of function • Once dislocated will more easily sublux or dislocate
Traumatic Injuries • Shoulder dislocation • Treatment • Reduction and immobilization • Physical therapy • Surgery
Chronic Injuries • Any unresolved injury • Causes • Returning to activity too soon • Not properly treating the injury • Results • Buildup of scar tissue reduces range of motion • Area is more easily re-injured
Chronic Injuries • Treatment • Physical therapy • Exercise • Massage to break down scar tissue, reduce muscle tension
Miscellaneous • Delayed Onset Muscle Soreness • Typical of new exercise or increase in activity • Not indicative of trauma • Usually resolves on its own in a few days • Activity may decrease pain
Miscellaneous • Nerve Compression • Sciatica, Thoracic Outlet Syndrome, Carpal Tunnel Syndrome, Disc Injuries • Caused by soft or bony tissue compressing nerves • Pain, numbness, tingling, weakness of muscles • Various causes and treatments • Trigger points can mimic symptoms
Thoracic Outlet Carpal Tunnel
Miscellaneous • Spasms/Cramps • Involuntary contraction of muscles • Often painful • May decrease range of motion • Several causes • Pain~Spasm~Pain cycle due to overuse/ischemia • Exercise induced • Not warmed up • Contracting from a shortened position • Dehydration • Nutrition, splinting, pregnancy
Miscellaneous • Spasms/Cramps • Treatment • Often depends on cause • Acute cramps: massage at attachments, heat/ice, stretching, contract antagonist • Spasms: massage, stretching
Causes of Injury • Muscle weakness and imbalance • Stiffness, shortened muscles • Trigger points/painful muscles • Previous injury/improperly resolved injuries • Fatigue
Between Trips • Conditioning • Many injuries are due to muscle weakness and imbalance • Regular strength and endurance training • Specific training for paddling • Rotator cuff/shoulder • Back/torso • Arms/forearms • Proper recovery time between workouts
Between Trips • Therapeutic or Sports Massage • Relieves muscle stiffness • Helps resolve muscle imbalances • Maintains/improves range of motion • Reduces pain and resolves trigger points • Helps resolve sub-acute and chronic injuries • Self-treatment between massages
Between Trips • Stretching • Yoga or other static stretching • Dynamic stretching • Maintain and increase range of motion • Core strengthening
Between Trips • Resolve Injuries Properly and Completely • Reduce scar tissue and weak areas • Reduce adhesions, increase range of motion • Physical therapy, strengthening • Prevent chronic injuries
On The Water • Boat loading/unloading, portaging • Never lift or lower with your back • Keep back as vertical as possible • Use leg muscles
On The Water • Before getting in your boat • Warm up with jogging, jumping jacks, something to warm the muscles • Dynamic, not static stretches, full range of motion • After getting in your boat • Back paddle 10 mins • Dynamic stretches in boat • Practice strokes
On The Water • Use Proper Biomechanics • Paddle ‘in the box’ • Have a practiced roll • Try to avoid high braces and other moves that can put shoulders at risk • Have Good Equipment and Outfitting • Good lumbar support • Comfortable paddle • Comfortable outfitting
On The Water • Avoid Fatigue • Eat properly before you paddle • Bring high energy snacks • Keep hydrated • Be careful about paddling several days in a row • Listen to Your Body • Know when to slow down or call it a day • Pay attention to pain and injury • Avoid being overly stressed or aggressive