Shoulder Injuries in Young Female Paddlers - Shoulder Injuries in Young Female Paddle

[kendall chew]

Be interested to hear who does sports or works out and doesn't stretch. Not because I dispute Dave's comment but because I wonder, statiscally, what the ratio would be.

Interested too if Kendall has a comment?

I'm spending too long on here!

On the issue of warm up, the research is pretty clear, and has been for possibly 15 years+. Warm up exercise, warm down, stretch. Why? Well, we are full of little thinga called proprioceptive organs which are what allow me to shave in the dark without slitting my throat. They tell me where I am in space ( close your eyes pull your hankerchief out and blow your nose- If you cannot do this you really do need to see a neurologist soon!). If I stretch, I distort the proprioceptive organ so that it does not quite know where it is ( a bit like a clumsy teenager) so you end up being a little inaccurate, a little late in reacting, a bit slow on the snatch - BANG - one overstretched joint. So this is why you do not sretch. Pulse raising on the other hand increases blood volume to skeletal muscles, which is just what you need just before a race. Don't do this more than 15 minutes prior to an event as it has a paradoxical effect as the body cools, thus performance is reduced. Stretching is important for maintaining joint health, range of movement, blood flow and a whole raft of other things, just do not do it before activity/race/sport.

Kendall

[MikeR]

As a stroke, the bow rudder is very effective and efficient, but too far back over the head and its two years out for the athlete.

This is a common criticism especially from recreational coaches, however I have never seen an injury resulting from doing this, nor can I grasp how such an injury could occurr. It is an appropriate stroke in certain circumstances and has measurable benefits to the paddlers performance.

Yes, using bow rudders with the arm behind the head does have many benifits, however, this again has to be used with correct technique. Here the aim is to essentially 'wrap' the arm round your head, so that you elbow stays toward your forehead, and your forearm+ hand extend backward, giving the paddle position.

I also know of one other paddler who has injured his shoulder this way; it is mainly on white water where this is an issue due to the power of the water pushing the arm past the joint's 'natural' range of movement.


One issue that I have been wondering about; if you are training to reduce a muscle inbalance/training muscle to support a joint, how should you train? Should it be:
a) Training for muscle bulk (hypertrophy)?
b) Training for muscle strength (minimal hypertrophy)?
c) Or training in similar ways to postural muscles (strength-endurance)?

I've personally been told to train in all three ways by various different people, for different sporting injuries, and I assume it's a case of which applies best for the shoulders/movement patterns ?

[C2leo]

As a stroke, the bow rudder is very effective and efficient, but too far back over the head and its two years out for the athlete.

This is a common criticism especially from recreational coaches, however I have never seen an injury resulting from doing this, nor can I grasp how such an injury could occurr. It is an appropriate stroke in certain circumstances and has measurable benefits to the paddlers performance.

The position of the top arm is very rarely relevant, however if the bottom arm goes behind the hips then this is in a very dangerous position (and also the stroke is ineffective)

[oldschool]

sorry guys but if you don't use your top arm in a bow rudder your doing it wrong! if your arm is behind your head you have a very unstable joint with very little power availible to do what needs doing with the stroke. I have no problem with rolling the top wrist to find that bit extra, but to just hoy your elbow behind your head and Wang it round is something we should avoid teaching begginers.

[roodthomas]

some interesting stuff coming out.

I have to point out though that like has been stated the arm behind the head can get that little more out of the stroke, but the arm has to be in a vertical position. You can feel that your arm has the potential to pop out when you twist the joint either left or right while it is raised!! I've nearly pulled my shoulder out before because this movemet happened whilst taking off a tight rash vest.

As for the bottom hand, Leo is right, pushing the blade back towards the hips then the joint can become unstable.

[davebrads]

Thank you Nathan for letting us know of your experience, I truly wasn't aware of such a case.

I have not been comfortable with putting the hand behind the head for bow rudders, and consequently I have never coached it. However you see top paddlers using this technique so it must be of benefit in a race, and consequently I have not actively stopped paddlers from using the technique either. Mike has studied it closer than me (he is using the technique and we spoke about it a month or two ago) and what he says above seems to fit with observation of the top paddlers.

The difficulty we coaches have is that it is difficult to get good information on how these injuries are happening. It is no good having a blanket ban on putting the hand behind the head if that means the paddler is going to be at a disadvantage in a race, we need to know how this stroke can be performed safely. Similarly the high brace support - this can be used to describe three quite different things, only one of which is really dangerous. A lot of recreational coaches are only coaching the low brace support, but how does that leave the paddler when a high brace support is more appropriate? Surely it would be better that the coach teach the safe ways of using a high brace support than not coach it at all.

I think that Kendalls study could throw up some useful information that can be diseminated to all coaches, the only issue I have is with his theory that fast progression promotes injury.

[roodthomas]

I think the theory should be more that a lack of training experience on big water is putting young people at risk when they race on big water.

[MikeR]

I think the theory should be more that a lack of training experience on big water is putting young people at risk when they race on big water.

Hmm, I'm not too convinced by that, at a lower level, is racing really that diss-similar to training on the white water? Surely it would be possible to put more force on a joint while training than fatigued later in a race?

It's surely perfectly possible to injure your-self in training; I would say that an issue is insufficient training of techniques on flat(ish) water before they are taken onto white water.

[roodthomas]

Either way . . . the progression needs to be
1. get the correct technique on the flat through training
2. race on the flat
3. transfer the technique onto slightly bigger water in training (i.e. Matlock/Marple/Sowerby . . .)
4. race on the slightly bigger water
5. transfer the technique to bigger water in training (i.e. HPP)
6. Race

Its a simple progression. You don't learn to race the 100m sprint before you learn to walk . . .

[jjayes]

Either way . . . the progression needs to be
1. get the correct technique on the flat through training
2. race on the flat
3. transfer the technique onto slightly bigger water in training (i.e. Matlock/Marple/Sowerby . . .)
4. race on the slightly bigger water
5. transfer the technique to bigger water in training (i.e. HPP)
6. Race

Its a simple progression. You don't learn to race the 100m sprint before you learn to walk . . .

Thomas I could not agree more. As I said before.....

What is needed is good coaching practice and athlete education that emphasizes gradual progression, overload, intensity of physical training, technique work and water used. Even for elite athletes these principals are extremely important when training on the knife edge that is high performance or failure.

It seems to be very much in many athletes nature to push themselves until they break. I know of very few "would be" elite athletes who train too little but I know many who push too hard for too long and consequently break down with injury and sometimes have to finish with the sport before realizing their full potential.

I think the important point to remember is that white water is a chaotic environment and the forces that are encountered are not always predictable and this why controlling progression every way we can is vital if the athletes are not too get hurt to often. Unfortunately even with the greatest care accidents will still happen. When it happens and I mean WHEN, it is important to recognize what has happened and seek advice and treatment immediately. More intense paddling on a painful shoulder rarely helps a speedy recovery.

Good debate from everybody, I hope it helps to keep everybody healthy.
Jim.

[davebrads]

Either way . . . the progression needs to be
1. get the correct technique on the flat through training
2. race on the flat
3. transfer the technique onto slightly bigger water in training (i.e. Matlock/Marple/Sowerby . . .)
4. race on the slightly bigger water
5. transfer the technique to bigger water in training (i.e. HPP)
6. Race

Its a simple progression. You don't learn to race the 100m sprint before you learn to walk . . .

This progression only works in preventing injury if you assume that injuries are occurring because developing paddler haven't developed the strength to cope with the stresses of big water, which is implied in Kendall's introduction.

I think that there is a parallel with the difference between children falling over playing games, and adults falling over in later life. When a child falls over (s)he automatically rolls over, preventing injury. When an adult falls over, particularly if they aren't very active, they will automatically put their hand out to prevent the fall. This is the most common cause of broken collarbones.

If a paddler learns on bigger water, falling in becomes part of the sport and they learn to deal with it effectively. If a paddler trains on flat water, they are unlikely to fall in very often, and therefore don't develop the techniques needed to prevent injury.

I had been paddling about 3 months when I first raced on the Serpents Tail. I think I swam every run, and I continued to push myself over the following season, swimming most of the courses in the UK. As a result falling in never became a big issue, plus I quickly learnt how to swim safely too!

[Fup Duck]

I think I might have added an element of ambiguity here.

Reading back through the chain I clearly mentioned warming up, as I had in separate mails to Kendall.

However, my who doesn't stretch comment seems to have taken it on a different tangent. Partly I think because I misread Dave's previous comment. I was talking about stretching down and Dave had been talking about as a part of warm up.

When I mentioned the ratio what I meant was are there a number of old school people out there who stretch before a race and if so what is the percentage to those exercising to warm up. Or do some do both.
Out of those statistics I'd be interested to know who had suffered injury or not.

Don't know if that makes sense

That's all

Clearly you guys are in the knowledge far more than I but I look on with interest.

[roodthomas]

Either way . . . the progression needs to be
1. get the correct technique on the flat through training
2. race on the flat
3. transfer the technique onto slightly bigger water in training (i.e. Matlock/Marple/Sowerby . . .)
4. race on the slightly bigger water
5. transfer the technique to bigger water in training (i.e. HPP)
6. Race

Its a simple progression. You don't learn to race the 100m sprint before you learn to walk . . .

This progression only works in preventing injury if you assume that injuries are occurring because developing paddler haven't developed the strength to cope with the stresses of big water, which is implied in Kendall's introduction.

The progression works for anyone coming into the sport. If injuries are taking place then there will either be something wrong in the training (coach not picking up on bad habbits) or its going to be related to underlying physical conditions. (Generally)

Of course there are always going to be the odd time when there are freak accidents though.

[kendall chew]

Either way . . . the progression needs to be
1. get the correct technique on the flat through training
2. race on the flat
3. transfer the technique onto slightly bigger water in training (i.e. Matlock/Marple/Sowerby . . .)
4. race on the slightly bigger water
5. transfer the technique to bigger water in training (i.e. HPP)
6. Race

Its a simple progression. You don't learn to race the 100m sprint before you learn to walk . . .

This progression only works in preventing injury if you assume that injuries are occurring because developing paddler haven't developed the strength to cope with the stresses of big water, which is implied in Kendall's introduction.

The progression works for anyone coming into the sport. If injuries are taking place then there will either be something wrong in the training (coach not picking up on bad habbits) or its going to be related to underlying physical conditions. (Generally)

Of course there are always going to be the odd time when there are freak accidents though.

This is very interesting. I am an assistant coach, so have no qualifications in this department. I am, however a mechanic ( osteopath) so I look at things from a slightly different viewpoint. Watching these arguements and discussions move back and forward is helping me ( and hopefully us as a sport)build a far better picture of people view training, which leads me to suggest that perhaps there is a variance in coaching methods. Is this an age related thing. I, as will some other paddlers still use a "High Telemark" because I was taught it as a recovery stroke. At 48, it is quite difficult to get rid of the technique, particularly when all goes squiffy and I need to react fast! Is variation in technique taught an age related thing?

Kendall

[davebrads]

High brace support strokes have only recently been recognised as a cause of shoulder injuries. The new BCU 2* though still has a requirement that the student should demonstrate Preventing a Capsize.

In the assessor notes it says: Candidates should show an efficient low recovery stroke, on both sides.

But in the trainer notes it says students should experiment with high recovery.

A lot of recreational coaches have been around quite a while, and though the syllabus has changed, are still coaching the same techniques they were taught when they first started paddling.

I believe that recovery strokes can only be taught safely and effectively once the paddler has developed to the point that they don't mind getting their head wet, and in most circumstances this comes after they have learnt to roll. Traditional brace strokes that are taught on flat water, whether high or low, are irrelevent when the paddler gets onto turbulent water, the skills required to stay upright are quite different.