The shoulder contains three bones and three separate joints. Many muscles act at the shoulder as movers and/or stabilizers. The muscles have several functions depending on the shoulder’s angle during movement. Of special importance is the rotator cuff, which is made up of four muscles and their tendons originating from the scapula. These tendons help hold the “ball in the socket”, are important stabilizers, and help rotate the shoulder (glenohumeral joint).
Injuries to the shoulder occur for many reasons including acute injuries from sudden trauma such as dislocation, separation or fracture. However, the most common injuries tend to be chronic that can develop from the following:'
1. Prolonged raised position of the shoulders. Holding any muscle in one position too long can cause strain.
2. Repetitive movements and overuse.
3. Doing too much too fast.
Any of these may cause inflammation to the shoulder which occurs when a muscle or tendon is stressed beyond its limit and causes microscopic tears. Inflammation is actually a normal part of the healing process. However, if the muscle or tendon is not given enough time to heal before it’s subjected to the same activity, inflammation can become chronic and cause progressive damage to the tissues.
Activities where you repeatedly raise the arms above the shoulders, such as surfing, swimming, and of course paddling, causes the head of the humerus, or ‘ball’, to slightly rotate up in the shoulder ‘socket’ and narrows the small space between the head of the humerus and the bony projection from the top of the shoulder blade (scapula) called the acromion process. This causes friction between the rotator cuff tendon and the acromion process which can develop into irritation and inflammation, better known as rotator cuff tendonitis or tendonosis.
Also, this movement can pinch the sub-acromial bursa, a sac containing a small amount of lubricating fluid, that lies under the roof of the shoulder and develop into shoulder bursitis. ‘Impingement Syndrome’ occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds the tendons.
Another cause of angst for your shoulders is a tear of the rotator cuff. More common in people over the age of forty, aging can cause degeneration in the tendons leaving them more susceptible to tearing. Advanced degeneration may lead to a tear during normal everyday activity. Acute tearing, although less common, can happen from lifting a heavy object above shoulder level overloading a tendon causing a tear or a sudden arm movement such as throwing.
If during or after stand up paddling you experience pain in the top outer part of the shoulder, or pain when lifting the arm above your shoulders (that may radiate to the elbow), along with pain while lying on the affected area, you need to address these problems or they will worsen. The next two articles will discuss the importance of strengthening and stretching your shoulders, along with specific exercises and stretches you can do to protect them. Also, you will get a personal trainer’s perspective on how to paddle efficiently with proper technique and posture as well as how to choose proper equipment.
Research studies have shown that people with the lowest flexibility have the greatest chance for injury. Unfortunately, increased shoulder flexibility will not come with doing a few stretches right before an activity, but rather from weeks of engaging in a regular stretching program. Being on a continuous stretching program (not just for shoulders, but the entire body) will help prevent injury and promote efficiency during stand up paddling, improve elasticity of muscles, increase range of motion in joints, and minimize muscle soreness.
The following four stretches are to be done after a five to ten minute warm up or after a session of stand up paddling. These are not meant to be done with ‘cold’ muscles prior to paddling. It’s common for many surfers to walk down to the beach before entering the water, put down their boards, and begin manipulating their bodies into ‘Gumby-like’ poses without first warming up. This can be dangerous and is not recommended. If anything, going for a ten minute jog on the beach before paddling out may be more beneficial than stretching.
Remember; be sure to warm up for at least five to ten minutes before attempting these stretches. These are static stretches which means slowly moving the body part into position and holding for a set time. Hold each stretch for about ten to twenty seconds, rest for ten seconds then repeat. Intensity of each stretch should be on a ‘pain’ scale of 1-10. Begin with light stretching (1-3) and increase over time to moderate (4-6) and heavy stretching (7-10). Stretch two to three times per week or more. These stretches are meant for healthy individuals with no history of shoulder instability as they can potentially cause a recurrence of instability. Please consult with a physician if in doubt.
One-Arm Shoulder Flexor Stretch
Technique- Stand upright with a slight arch in back, bring right arm behind back and bend elbow to 90 degrees. Grab the right elbow with left hand. Pull the right arm across the back and up towards the left shoulder. Repeat on other side.
Modification- If elbow cannot be reached, grab the wrist instead. Remember to keep elbow bent at 90 degrees.
Muscles Stretched- Deltoid, pectorals muscles, neck, rotator cuff
Pretzel Stretch
Technique- Take this one slowly. Stand upright raise one arm over and behind head. Bend elbow. Bring other arm behind back and bend at 90 degrees. Clasp both hands together and hold. Repeat on other side. If lacking ‘spaghetti arms’, please use the modified version of the stretch below.
Modification- (photo: modification) Using a towel or stand up paddle held behind back by top hand, move bottom hand up as high as possible.
Muscles Stretched- rotator cuff, teres major, deltoid, latissimus dorsi, pectorals, triceps
Posterior Shoulder Stretch
Technique- Stand upright and bring right arm across front of the body. With left hand grab just above right elbow, and with the left hand pull right elbow down and around the left side of body. Repeat on other side.
Muscles Stretched- Shoulder, rotator cuff, upper back muscles, triceps
Codman’s Pendulum
Technique- Hold on to the edge of a sturdy object, bend forward, and keep knees slightly bent. Relax shoulder and let arm hang limp. Swing body back and forth and use the momentum to cause motion at the shoulder. Swing body so that arm moves in clockwise and counterclockwise directions. Do NOT move your arm. Let your BODY initiate the movement.
Muscles Stretched- Rotator cuff, trapezius, deltoid, teres major, latissimus dorsi, rhomboids
Next time….beneficial shoulder strengthening exercises to keep those shoulders buff, strong, and healthy!!
Now that you have a better understanding about how your shoulders are put together and have hopefully been doing the shoulder stretches from the previous article, it’s time to look into paddling technique and equipment choices that can decrease the potential for shoulder injury, while improving performance. Also included in this article are a handful of strengthening exercises for the vulnerable rotator cuff and shoulder muscles geared toward optimizing balance, stability, mobility, and joint function.
Equipment
From experience and also from speaking with fellow sup’ers, paddle choice has a large impact on how your shoulders are going to feel. If you have suffered any shoulder pain from paddling or have had a previous shoulder injury that is causing you grief, consider changing your paddle. Look for a paddle that is a little bit shorter, has a more flexible shaft, and a smaller blade size. Why will all this help?
A shorter paddle, one that ensures the top hand does not go higher than eye level when paddling, may prevent the dreaded shoulder impingement syndrome and muscle strain from repetitive raised shoulder position mentioned in the previous article. Do not go too short because you will end up bending too much at the waist, possibly causing back strain and also losing your balance more easily. Try a paddle that is about six to seven inches above your head.
A paddle with a more flexible shaft minimizes impact at the catch, meaning it flexes a bit at the beginning of each stroke. This relates to the lower hand which, while reaching forward to take the stroke, opens your shoulder joint to a vulnerable position. The flexibility in the shaft absorbs some of the initial impact so that it doesn’t transfer into ligaments and tendons of the shoulders. Kevin Seid of Everpaddle.com in Haleiwa, Hawaii has developed a Flexi Bamboo stand up paddle with a flexible shaft geared for individuals that have shoulder injuries. The bamboo/carbon hybrid has a smooth, natural feel without the ‘jerk’ at the beginning of the stroke.
Next, a smaller blade with either less surface area , for example the Kialoa Methane, or one that features a longer more slender outline rather than the typical ‘teardrop’ shape can be a great option for someone with chronic shoulder problems. A paddle with a blade that is too large may cause muscles to fatigue quickly which will compromise your form, thus causing you to compensate with the incorrect muscles. This may open the door to more shoulder woes. With a smaller blade or longer and more slender-tipped blade you can vary the power of your stroke more, eliminating some of the ‘bite’ that may be experienced with a larger teardrop shaped paddle, reducing bottom hand shoulder fatigue. The Carve by Werner Paddles is a great example of the long and slender blade shape.
Technique
Make sure to examine technique closely. If possible, have someone take video of your stroke to see how you can modify it. By using your ENTIRE BODY when paddling, a significant amount of pressure will be taken off of your shoulders as well as help you develop a more efficient stroke. With the upper body it’s important to push down hard with the top hand as the bottom hand simultaneously guides the paddle back, making sure to implement a strong core rotation with each stroke. Keep the knees bent as the stroke is initiated, then as the paddle is pulled back toward the body bring hips forward with a little thrust off the board with your legs. For some individuals paddling with only part of the blade submerged and using shorter faster strokes works well. Faster, higher rep strokes work if you opt for a smaller blade size. Everyone has their opinion about what technique and equipment are best, but these are just the opinion of the author.
Strengthening Exercises
For the following exercises a stability ball and light dumbbells are recommended. These exercises are for individuals who are healthy and possess a strong base level of fitness. Implement one or two of these exercises into your normal weekly fitness routine up to three times per week. Change up your exercises every week and remember not to overdo it. About 65% of injuries (both athletic and lifestyle-related) come from overuse. These exercises are to help prevent that, but too much of a good thing will be problematic. Please warm up for 5-10 minutes prior to working out and check with a physician before embarking on any workout program.
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