Shoulder Injuries: Why Kayakers Are Prone to Them and What to Do About It
If you're an avid kayaker, you know the sport can be demanding on the body, particularly the shoulders. Whether you're tackling rough waters or just paddling on a calm lake, the repetitive motion of paddling can lead to strains and injuries over time. In this blog, we'll share information about the prevalence and types of shoulder injuries that kayakers have, how they’re caused, and what products can help keep you paddling despite these injuries.
The Prevalence of Shoulder Injuries Among Kayakers
Shoulder injuries are common among kayakers, with research suggesting that they may account for a significant portion of all kayaking-related injuries. Shoulder injuries made up about 29% of all kayaking injuries among a group of Italian kayakers according to a study published in the Journal of Sports Medicine and Physical Fitness. Another study from the Journal of Orthopaedic & Sports Physical Therapy found that shoulder injuries accounted for about 36% of all kayaking injuries in a group of Canadian kayakers.
Not surprisingly, competitive kayakers experience a significant amount of shoulder injuries. According to the British Journal of Sports Medicine, rotator cuff injuries make up a large portion of the injuries seen in marathon kayakers, about twice the number reported for sprint kayakers. These injuries are the result of secondary impingement factors associated with overuse, possibly specific to kayakers, and not the result of bony restrictions around the shoulder joint. They also found that acromioclavicular hypertrophy (i.e., joint degeneration) is common in marathon kayakers but may possibly be the result of portaging or a previous injury.
Research published in the British Medical Journal (Holland, Torrance, & Funk, 2018) revealed that up to 6% of sea paddlers may experience a shoulder injury during their lifetime. The study analyzed 55 shoulder injuries in 52 kayakers and found that shoulder injuries were more common among white-water and competitive paddlers. Researchers also discovered that patients with shoulder injuries took the second longest time to return to paddle sports (spinal injuries had the longest recovery periods).
In 2016, kayaker and outdoor writer John Nestler distributed a survey to primarily white water kayakers asking about their shoulder injuries, how they were incurred, and what type of paddle shaft they used. He received 2700 responses, and many of their responses (lightly edited for clarity) are included in this article.
What Causes Shoulder Injuries Among Kayakers?
Several factors contribute to the high rate of shoulder injuries among kayakers. One of these is the repetitive strain that kayakers experience while paddling. Paddling for long periods of time or using improper technique can put excessive strain on the shoulder muscles and tendons, leading to overuse injuries such as rotator cuff strains or impingement syndrome.
In addition, kayakers may be at increased risk of shoulder injuries due to the rough or white-water conditions they often encounter. Falls from a kayak or impacts with rocks or other obstacles can cause acute injuries such as dislocations or sprains.
Interestingly, one study published in the British Medical Journal found that 79% of the paddling injuries occurred while trying to prevent a capsize or rolling after a capsize.
"I have a rotator cuff tear due to repetitive motion, including overuse of rolling and bracing for 25 years." Male, 40-50 years old
There are also certain populations of kayakers who may be more prone to shoulder injuries. For example, older kayakers may be at greater risk due to the natural decline in muscle strength and flexibility that occurs with age. Kayakers with pre-existing shoulder conditions, such as rotator cuff tears or impingement syndrome, are also be more likely to experience injuries while kayaking.
Kayakers with Arthritis
Arthritis is another common condition that can cause pain, stiffness and swelling in the joints. While it is often associated with older adults, people of all ages can develop arthritis, including kayakers. Research suggests that kayakers may be at increased risk of developing arthritis due to the repetitive strain and impact that kayaking can place on the joints.
One study published in the Journal of Orthopaedic & Sports Physical Therapy found that kayakers were more likely to develop arthritis in the wrist and hand joints compared to non-kayakers. Another study in the American Journal of Epidemiology found that kayakers were more likely to develop osteoarthritis (a type of arthritis that results from wear and tear on the joints) in the shoulder compared to non-kayakers.
The true extent of arthritis among kayakers is difficult to determine, as it can vary widely depending on factors such as age, genetics and overall health. However, research suggests that kayakers may be at increased risk of developing arthritis, especially in the wrist, hand and shoulder joints.
Common Kayaking Shoulder Injuries
There are several types of shoulder injuries that kayakers typically experience, each with its own unique set of symptoms and treatment options. Here are some of the most common:
Rotator Cuff Injuries: The rotator cuff is a group of muscles and tendons that attach the shoulder blade to the upper arm bone. These muscles and tendons are responsible for rotating and lifting the arm. Rotator cuff injuries are often caused by repetitive strain or overuse and can range from mild to severe. Symptoms of a rotator cuff injury may include pain when lifting the arm, weakness in the arm, and a clicking or popping sound when moving the arm.
Shoulder Dislocations: A shoulder dislocation occurs when the upper arm bone (humerus) becomes separated from the shoulder blade (scapula). This can be a painful and debilitating injury that may require immediate medical attention. Symptoms of a shoulder dislocation may include severe pain, numbness, and difficulty moving the arm.
"(My first of three shoulder dislocations happened when I) impacted a rock whilst setting up for a roll on the river." Male, 20-30 years old
Shoulder Sprains: A shoulder sprain occurs when the ligaments that support the shoulder joint become stretched or torn. Shoulder sprains can be caused by a sudden impact or strain on the shoulder joint, such as when falling from a kayak or hitting a rock. Symptoms of a shoulder sprain may include pain, swelling, and difficulty moving the arm.
Shoulder Impingement Syndrome: Shoulder impingement syndrome occurs when the tendons or bursae (small fluid-filled sacs) in the shoulder become inflamed or pinched. This can cause pain and difficulty moving the arm. Shoulder impingement syndrome is often caused by overuse or poor posture and may be more common in kayakers who paddle for long periods of time or use improper technique.
"There was no specific incident. I was paddling a lot at the time and developed an overuse injury that slowly got worse until the shoulder was impinged. It required six weeks of PT an anti-inflammatories." Female, 30-40 years old
Rehabilitation is an important part of the recovery process for all these injuries. Working with a physical therapist, getting surgery and/or following a rehab plan can help reduce pain, improve mobility and strength, and prevent future injuries. It’s also important for kayakers to take precautions to prevent shoulder injuries, such as using proper technique and taking breaks to rest and stretch.
Shoulder Injuries: A Long Recovery with Good Prospects
Recovering from a shoulder injury can be a long and difficult process, taking anywhere from several weeks to several months for a shoulder injury to fully heal, depending on the severity of the injury and the type of treatment. The good news is that one study published in the Journal of Bone and Joint Surgery found that about 85% of patients who underwent surgery for a shoulder injury reported good or excellent results after two years. Another in the American Journal of Sports Medicine found that approximately 77% of individuals who received conservative treatment for a shoulder injury, such as physical therapy, were able to return to their pre-injury level of function.
"(After my rotator cuff tear, I) recovered fully after a full year off the water plus, along with PT and weight training. I made some changes in technique and have paddled complaint-free +/- 150 days a year since." Male, 40-50 years old
Paddling Products for Kayakers with Bad Shoulders
Not all kayakers with shoulder injuries fully recover. Arthritis, for instance, is a degenerative joint disease that causes inflammation and damage to the joints. Though there are treatments available that can help to reduce pain, improve mobility and slow the progression of the disease, it can’t be cured. For others, even with physical therapy or surgical intervention, shoulder pain never goes away.
For the lucky few, altering their paddling technique or switching to a different paddle may provide enough relief to keep on them water. There are thousands of paddles to choose from, but kayakers with shoulder and joint issues should look for three features: weight, shaft design and balance.
Weight is primarily affected by the shaft material, but the blade material can also play a role. So, moving from an aluminum shaft to a carbon fiber one may feel like night and day, reducing the overall weight of the paddle as well as stress on the joints.
Steve Dawson, an administrator of the Facebook group, Church of the Double Bladed Paddle, notes that smaller paddle blades and "soft" carbon shafts with more flex are often recommended in marathon and ultramarathon circles to reduce loading. Paddle blade shapes with a less aggressive catch -- generally those with a small tip and long parallel blade edges -- may also be helpful. He advises that to prevent stress injuries, it's important to build distance slowly, increasing no more than 10% per week. He's seen many strain injuries occur at the start of marathon season when paddlers launch into competition training after an extended break.
Switching from a straight shaft to a bent shaft may be helpful to those with wrist injuries. A bent shaft kayak paddle is indexed, meaning that the bends in the shaft make it easier to keep your hands in proper position on the paddle. Many paddlers find this bend allows a more comfortable grip that can help prevent wrist injuries. A bent shaft paddle may also maximize forward thrust allowing you to move faster without putting unnecessary strain on your shoulders and elbows.
"I have been dealing with a recurring impingement situation. I'm doing PT exercises to try and overcome it. The first time I had issues, I dealt with it via acupuncture and it was successful for several years. I've been paddling for about 20 years. I've used a bent shaft for the majority of those years, carbon fiber AT. I just find them much more comfortable than straight shaft." Female, 40-50 years old
Many kayakers will tell you that a Greenland paddle is also helpful in reducing stress on the shoulders. This is in large part due to its smaller surface area, relative to a “euro” paddle. It therefore creates less resistance in wind and water, resulting in a more energy-efficient stroke.
The balance and swing weight of a paddle also play a role in determining your kayaking experience. Paddles with poor balance or those with an inefficient swing weight (i.e., the effort required to lift the paddle out of the water and swing it) demand more effort and therefore tire you out sooner. Swapping out your current paddle for a more balanced one may result in less joint strain.
When those modifications don't cut it, Angle Oar offers solutions for kayakers who want to keep kayaking despite their shoulder or mobility issues. The Gamut Paddle Holder and Versa Paddle mount to most kayaks to support the weight of the paddle while it’s in use. This reduces stress on kayakers’ shoulders and joints and allows them to paddle comfortably for longer without experiencing pain.
The mounts feature a rotating fulcrum that holds the paddle and allows it to pivot in all directions, simulating a normal paddle stroke. In addition, the device eliminates some of the torso rotation that occurs with a traditional stroke.
The Gamut Paddle Holder is popular among kayakers with rotator cuff injuries, arthritis and other conditions that limit their flexibility. In addition to its stress-reduction features, it requires less grip strength to propel the kayak, making it great for paddlers with wrist, hand or finger pain or stiffness.
"The Gamut works well for me. It's a more relaxing paddle experience, and I can paddle farther. I do not have to grip the handle much since it's "resting" on the device. When I'm done, my shoulders do not feel as much pain as I used to." Leon, 60-70 years old
The Gamut is compatible with most sit-insides and many sit-on-tops and can be used with your own paddle. The paddle can be left in the mount for the duration of your outing or easily removed and used like a regular paddle.
The Versa Paddle works with the same mounts as the Gamut, but the paddle was engineered to be used straight or angled downward on both sides. This makes it well-suited for paddlers who have limited range of motion or can’t comfortably raise their arms above shoulder height. It’s used extensively in adaptive paddling programs and by people with disabilities that impact their strength and mobility. It can even be paddled by people with only one limb.
Physical and recreational therapists have said that the Versa Paddle’s ability to angle downward has other benefits, including better grip and wrist positioning. To hold a straight paddle a person must have reasonable wrist extension and pronation, yet some people have trouble attaining a neutral position and can’t grasp a paddle in its traditional, straight position.
A recreational therapist from Washington ordered a Versa Paddle for a client who had this very issue. Though he couldn’t hold a regular paddle, the client could lightly grip the Versa’s angled shafts at the "2 and 10 o'clock positions" and use a gentle push-pull motion to propel the kayak.
"As far as the Versa Paddle, I love it. I’m a disabled veteran and only have limited use of my right shoulder and arm. I never thought I’d be able to use a kayak. That thing has really made a difference. I love it, and I really appreciate that you guys created something so amazing!" Tracy, age unknown
Both the Gamut Paddle Holder and the Versa Paddle bring renewed hope to kayakers with shoulder injuries and other conditions that they can continue to kayak for years to come.
Shoulder injuries are a understandably a big concern for kayakers. To prevent them, be sure to keep your muscles in good shape throughout the season, warm up before hitting the water, take regular rest breaks, and maintain proper form while paddling,
In the event you do experience an injury, know that with physical therapy and other treatments you have strong possibility of recovering. And should you not fully recover, there are some great paddling products available to help you manage your condition.
Angle Oar is dedicated to helping people with limited strength or mobility experience the joy of kayaking for the first time, and to support experienced paddlers in continuing to participate in the sport. We offer a range of adaptive equipment, including Versa Paddle, Gamut Paddle Holder, outriggers and more, specifically designed for individuals with physical disabilities, shoulder injuries, or reduced upper body strength due to age, injury or other conditions.