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Monday 23 November 2020
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Let’s Talk Shoulders

As a kayaker I am sure you have either experienced or know someone who has experienced a shoulder injury. It could be high brace that leads to a shoulder dislocation, hitting a rock that separates your AC joint, or overuse giving you tendinitis. The shoulder takes a beating when you are in your kayak.
Let’s start with the anatomy of the shoulder. The shoulder, or glenohumeral joint, is a ball and socket joint made up of 3 bones (scapula, humerus, and clavicle). It is one of the most free moving joints in the body which also makes it susceptible to injury. Surrounding the shoulder joint is a labrum, a fibrocartilaginous rim that helps secure the humerus into the socket, numerous muscles/tendons (the rotator cuff), ligaments, and connective tissue. The rotator cuff is 4 different muscles that help stabilize the shoulder during movement.

COMMON SHOULDER INJURIES:
My favorite kind of patient to work with are non surgical shoulders. That means you’ve got some pain, but it isn’t enough to warrant surgery. These injuries include tendinitis or bursitis (inflammation of the tendon or bursa) and sprains/strains of the labrum, rotator cuff, or ligaments. Some of these non surgical injuries are related to shoulder impingement. Impingement usually means the humerus is sitting up and forward in the socket so it irritates all those shoulder structures.

The unfortunate shoulder injuries involve surgery. Surgical injuries may include labral tears, rotator cuff tears, or bicep tears.

CAUSES, TREATMENT, AND PREVENTION:
Sometimes shit happens and no matter how hard you’ve tried you still injure your shoulder. However, there are some steps you can take to help keep your shoulder healthy.
First is flexibility. Kayaking in such a forward movement, that our shoulders start rolling forward. We get tightness in our pects and the muscles of the posterior capsule. Tightness in the shoulder can hold the humerus in an elevated position creating impingement type symptoms. My two favorite stretches are a doorway or a ½ foam roll stretch and the sleeper stretch.

 

Doorway stretch
Stand in a doorway and brace your forearms against its sides. Make sure you have both of your arms at a right angle–your body should look like a football goal post. Place one foot in front of you and one in back. Keeping your upper arms at shoulder level, tense your stomach and straighten your back. Lean your upper body forward until you feel a stretch inside the chest. Hold for 30-60 seconds and repeat 3-5 times.

Sleeper Stretch
Lie directly on affected shoulder with head well supported by pillows. Slide your arm up to 90 (level with collar bone) and bend your elbow to 90. Place the hand of the unaffected side just below wrist of affected side and slowly push the forearm down towards the bed/ floor. Hold 30-60 seconds and repeat 3-5 times. Stop if you have pain in the front of the shoulder.
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Next is stability. Shoulder stability exercises strengthen the rotator cuff, lower and mid trapezius, rhomboids, and post deltoid. Stability will help control the powerful movements required in kayaking. Here are some exercises to incorporate in your workouts to help stabilize the shoulder. You may need some exercise bands or small weights for these exercises.

 

Shoulder External/Internal Rotation with Resistance Bands
Secure one end of a resistance band to an object at the level of your chest. Grasp the other end of the resistance band with one hand. Position your arm straight out to the side and bend your elbow 90 degrees so that your forearm points at the object securing the band. Step to the side to create resistance in the band. Without moving your upper arm, pull the band away from the object until your lower arm points in the other direction. Return your upper arm to its original position. Repeat 3 sets of 10-15 repetition

Shoulder Flexion/Scaption
Stand with your arms by your sides. Stand on one end of the band. Keep your elbows straight as you raise your arms up slowly and with control, maintaining tension in the band. Lower your arm down to complete one repetition. Repeat 3 sets of 10-15 repetitions. Repeat for scaption with your arms at 45 degrees.

Prone Horizontal Abduction
Lie with your arm hanging over the edge of a table or exercise ball with your palms facing down. Raise arms out to the side, parallel to the floor. Repeat 3 sets of 10-15 repetitions.

Keep in mind these exercises are for a healthy shoulder. They are just a couple of my favorite general stretches and strengthening exercises that I use after over 10 years of experience as a sports physical therapist. If you experience pain or discomfort, there is no substitute for seeing a physician or sports physical therapist. Good luck and keep those shoulders healthy!!!

Jessica Yurtinus, MSPT
Team JK; Physical Therapist

“The writer of this article is a licensed physical therapist, however information contained herein has been collected from sources believed to be reliable, and every precaution has been taken to ensure its accuracy. The information provided here is for general informational purposes only, and should not be used as a substitute for professional medical care.”