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Wednesday, December 05, 2007

Advice for treating rotator cuff tendon injury from paddling

Hello Gary,
I have been involved in surf ski and marathon paddling for a couple of years, but lately have been experiencing shoulder problems that have kept me out of the boat. I have seen a couple of physios, bio - kinetists, and orthopedic surgeons to try and get to the bottom of the problems, and they all seem to agree that i have muscular imbalances in my shoulder, that are causing impingement of the rotator cuff tendon, but a cant seem to get a decent gym / stretching program out of the guys, as none of them are paddlers.

I have spent some time in the gym, trying to strengthen the rotator cuff muscles, core and shoulders, but lack a bit of direction with the program.

I have also seem a technique expert, who is helping me sort out any any / all of the stroke problems that may be causing the problems.
Do you have an all round gym program, as well as specific rotator cuff exercises, and a stretching program that will hopefully get me back in the boat?

Great site, and thanks for the time. Cheers David
Gary Moller comments:
The issue you raise is the most common ailment that I deal with on a daily basis. I would add that the resolution never requires medication or surgery and all those affected are able to resume full activity in no longer than a few weeks. Paddlers, cyclists, runners, swimmers and computer operators are generously represented. In most people there is some tenderness of the rotator cuff muscles.

What is most likely going on in your case, David, is most of the muscles of the back and shoulder have become knotted and inflamed as a consequence of years of heavy use from paddling. No manner or amount of strengthening, stretching or balancing - or even rest - will give anything more than short relief. You could rest six months, resume and be back where you were in a matter of weeks.

When muscles are exercised hard over a long period of time there is accumulated damage, including adhesions between muscles, tendons and fascia that would normally slide and glide smoothly past each other. Muscles can become painfully bunched, knotted, stuck and engorged with toxic fluid. Such areas may be visibly swollen and extremely painful to press on. If body PH is tested, the person affected is more than likely acidic and the muscles themselves even more so due to constant anaerobic prodiction of lactate and acidic metabolic wastes. This localised acidity is confirmed by the drop in body PH immediately following a massage of the affected areas.

If you have hard, knotted portions within a muscle, I recommend nothing other than gentle stretching. This is because excessive stretching may cause more problems because it is the softer, healthy muscle that stretches and not the hard gristle. Get rid of the knots and adhesions and then stretch and strengthen. I am sure that, if an experienced massage therapist was to examine your muscles, you will discover they are riddled with painful knots.

There is only one solution and one that is highly effective when done properly and persisted with and that is deep tissue massage of the affected areas. You need to find an experienced massage therapist. You need to spend time. A 20 minute physio appointment is no good - about an hour twice a week for about 4-6 weeks. This kind of massage is painful to begin with but becomes pleasant as the muscles recover to normal health. Positive results can be seen within two sessions in most cases.

Combined with this is a diet that promotes an alkaline constitution and which aids healing. Please read my articles about body acidity. Also ensure that you have generous vitamins especially vitamin C during the healing processes and to mop up the free radicals that flood the body from the toxins released during the massages.

Once you have commenced this regime, you need to listen to your body. It will tell you when to get out on the water again. Sure, you could join a gym; but if you are serious about paddling, then invest in a good kayak coach and do various drills on the water.

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