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James
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Sum Dum Guy

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  Quote James Replybullet Topic: Rotator Cuff
    Posted: 13 Nov 2007 at 11:59am
As some of you know the Rotator Cuff is one of the paddling injuries no one wants to get. It is a sensitive part of your paddling anatomy that does not get much constant workout during paddling but does get occasional large strains. That means that if your not working it out off the river your not working it out on the river either!!!

Now that I am aware I have a sensitive rotator cuff, my Physical Therapist has recommended that I start doing excersises to strengthen it. When you get this type of injury you have either usually torn or strained one of the 4 muscle/ligament groups that connects to your cuff. Sometimes its hard to tell if its strained or torn and MRI's are the method used to make the call. Unfortunately MRI's cost thousands of dollars and are quite expensive. So in my case I have decided to re-hab it as much as I can to determine by recovery time if I have a tear or just a strain.

I am going with just a strain!!!! In the meantime I figured I would post the different exercises I have been given to work on so folks out there can use the information to prevent their own injury or re-hab one if they have it.

************************* Copied from E-mail ******************************

Before you start

The exercises described below can help you strengthen the muscles in your shoulder (especially the muscles of the rotator cuff--the part that helps circular motion). These exercises should not cause you pain. If you feel any pain, stop exercising. Start again with a lighter weight.

Look at the pictures with each exercise so you can use the correct position. Warm up before adding weights. To warm up, stretch your arms and shoulders, and do pendulum exercises. To do pendulum exercises, bend from the waist, letting your arms hang down. Keep your arm and shoulder muscles relaxed, and move your arms slowly back and forth. Perform the exercises slowly: Lift your arm to a slow count of 3 and lower your arm to a slow count of 6.

Keep repeating each of the following exercises until your arm is tired. Use a light enough weight that you don't get tired until you've done the exercise about 20 to 30 times. Increase the weight a little each week (but never so much that the weight causes pain). Start with 2 ounces the first week. Move up to 4 ounces the second week, 8 ounces the next week and so on.

Each time you finish doing all 4 exercises, put an ice pack on your shoulder for 20 minutes. It's best to use a plastic bag with ice cubes in it or a bag of frozen peas, not gel packs. If you do all 4 exercises 3 to 5 times a week, your rotator cuff muscles will become stronger, and you'll get back normal strength in your shoulder.

Exercise 1

Start by lying on your stomach on a table or a bed. Put your left arm out at shoulder level with your elbow bent to 90° and your hand down. Keep your elbow bent, and slowly raise your left hand. Stop when your hand is level with your shoulder. Lower your hand slowly. Repeat the exercise until your arm is tired. Then do the exercise with your right arm.




Exercise 2

Lie on your right side with a rolled-up towel under your right armpit. Stretch your right arm above your head. Keep your left arm at your side with your elbow bent to 90° and the forearm resting against your chest, palm down. R
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  Quote Guests Replybullet Posted: 13 Nov 2007 at 12:04pm
Thank you James, usefl stuff. Get better fast so you can get back on the water.
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  Quote jojo Replybullet Posted: 13 Nov 2007 at 12:11pm
 thanks for posting these exercises.  I think I may have a similar problem and I don't want to get a MRI.  Lately my shoulder hurts after paddling.  I can't say that it bothers me while I boat but when I get home my shoulder is very sore.  Thanks for the post.  Does anyone know if doing general weightlifting is bad for a shoulder that may have a damaged rotator cuff?  Is it better to only rehab exercises or is it ok to do other exercises like bench press or pull ups?
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  Quote PowWrangler Replybullet Posted: 13 Nov 2007 at 12:45pm
Hope that works for ya James and you heal up well.
 
I'm paranoid about shoulder injuries so I do most of these plus a couple others at the gym every week.  If you have access to one, I recommend a cable machine as they are a little easier to use.  (or elastic bands, but I've never used those)
 
Two others I'd recommend for shoulders are:
 
With right arm, lift from left hip to right side above head until arm is fully extended with cable machine (or weights).  Vice versa with left arm.  This motion is similar to lifting a sword from opposite side and extending above head.
 
Also, take bench press bar (about 25lbs)or light dumbells and extend out from body parallel to floor and hold, gradually lower and repeat.  Also try raising another 45 degrees and slowly lowering to parallel to floor position. Keep arms straight throughout all movement.  This exercise definitely helps increase muscular endurance when paddling difficult, extended rapids.
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  Quote James Replybullet Posted: 13 Nov 2007 at 12:55pm
Jojo, I am no doctor and I don't know if I would trust just any ole E-vice but for what its worth my doctor told me that PT (Physical Therapy) would not exacerbate a torn cuff however it would be painful without the possibility of rehabilitation until it is properly repaired. The Physical Therapist I am going to told me that a good sign between the two is recovery time. If you feeling better and see signs of improvement your most likely not working with a torn muscle group. But if it is sprained you can have the same amount of pain as a tear but a totally different recovery timeframe. That excites me because I am starting to feel a change in range of motion and I am thinking I just had a good strain or sprain.

I was also told that if I did the PT, got it to the point where I felt it was 95-100% recovered and then it suddenly started relapsing easily it could be a tear that is going to continue to open back up when pushed. If thats the case $$$ up for the MRI and get it done right.

I will let you know how mine ends up in the next few weeks. Thanks for the thoughts guys, hope I'm out there quick like too!
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  Quote arnobarno Replybullet Posted: 13 Nov 2007 at 4:09pm
Well, as someone that is also going to PT for a rotator cuff injury, I would just add that these are pissy little muscles that are easily injured.  My doctor said that he is constantly amazed at how seemingly small events - like reaching for something in the back seat of a car - can lead to big tears.

After two months of not getting better, I had an MRI and it identified a partial tear, bursitis and arthritis.  The arthritis is just a sign of getting old and unrelated.  I've been fortunate that I've been able to continue paddling as long as I don't do too much bracing and rolling (like I can completely control that!).  In fact, "normal" paddling actually makes it feel good (as does running).

But, I've had to go very slowly with the exercises - all with therabands, slowly increasing the resistance.  From what I've been told, is very easy to add too much weight, too quickly, and make this type of injury much worse.  Before I had the MRI, I had tried to rehab this myself and I think that I added too much weight too soon.

My best advice is to see a doctor or a PT.  There are a number of muscles involved here along with other structures and they will be able to target a program for you that works.  The exercises that James posted seem to be the standard starting exercises but the shoulder is very complicated and all of those exercises can be done in other degrees of internal/external rotation as well as further away from the body depending on where you are in the recovery program.  I've been working with a good PT here in Belltown and I'd be happy to forward contact information if anyone is interested.

Good luck all.
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  Quote Pixie Replybullet Posted: 13 Nov 2007 at 8:53pm

Ok, I am a fan of this website but have never posted until this thread. I'll admit, I am a rubber pusher. Prefer a raft or cataraft but also am a newbie IKer. Translation: Paddle hard, swim class 2.

However, I am a PT and have worked with hundreds of people with shoulder problems in the past 12 years. While I think providing some basic exercises online is helpful, please realize that some exercises may not be appropriate for certain conditions. Just because you have pain in your shoulder does not mean it's your rotator cuff. It could be due to a capsular restriction, ligament sprain, labral tear, strain of another muscle group. People can even feel pain in their shoulder that is referred from their neck or an organ (e.g. gallbladder.)

Yes, your rot cuff helps to stabilize the shoulder joint; but many other muscles are equally important (shoulder blade muscles, chest, lats, and, of course, your core.) Your body has to work on a system of balance. If you concentrate on one muscle and ignore it's antagonist, you're setting yourself up for problems.
 
If you had no history of trauma or can't recall a mechanism of injury and your pain decreases significantly with rest/ice, you're probably safe to begin a basic conditioning program when the inflammation resolves. If the above doesn't apply, then you need to see a specialist...which is usually a PT. Most PT's should be competent in treating a shoulder injury. Yet, it does help to work with one that understands the mechanics and demands involved in WW boating...or swimming, as that may be.
 
If anyone would like more info, feel free to post or contact me via email. I work for an agency so don't have a permanent place of employment. But would be happy to pass on info on other PT's in your area.
 
Happy Boating!
Peggy aka RiverPixie
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  Quote dragorossinw Replybullet Posted: 14 Nov 2007 at 9:09am
I have battled the dreaded shoulder monster for years.  After dislocating it in the finals at Bobs Hole Rodeo in 2000, I have taken several steps to keep it safe.  The excersizes James posted are great, I do versions of them 2-3 times a week, along with weights that do not pressure the shoulder, and for muscle building, resistance (rubber tubbing) excersizes.  Besides that, changing your paddling style is a must.  I used to paddle an agreessive form of the ACA instructed 'paddle box' which gave me a lot of power.  That style also kept my shoulders wide open to water pressure on the blade. 
 
It only takes 9lbs of force to pull an average shoulder out of socket, while a standard whitewater kayak blade produces 35+ lbs of force per pull, translating into- if your shouler is lined up just right, pop.  I have modified my style.  I now paddle with a more closed, protected paddler blade 'box' and over infisize torso rotation and posture.  A rased seat gives me more leverage and using 85%+ hips and knees to controll/ turn the boat.  A more agressive kayak will force you to stay on your game. 
 
I also found a shoulder brace used by a lot of pro motocross riders.  The EVS Shoulder Brace is neoprene and velcro.  It pulls my shoulder in tighter, and the neoprene keeps it a little extra warm.  It seems to work for me, or gives me an added sense of comfort.  Check it out, you can get one online for around $30.
 
I have had the MRI's, physical theropy, orthopedic surgeons, and the whole sha-bang, but am fighting surgery tooth and nail.  It is only a matter of time that I will need it, but until Glucosomine and Ibeprophin no longer help with pain and irritation, thats when I will take myself out of commission for over a year.
 
Oh yah, I also gave up Class V Creeking, that helps too.
Tony Z
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  Quote dave Replybullet Posted: 14 Nov 2007 at 9:48am
James? I didn't know you were injured? What happened? Didn't see any report filed, get better soon dude.
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  Quote James Replybullet Posted: 14 Nov 2007 at 11:52am
Just got back from the MRI... I went through with it...

It is still hurting too much and I want to know what it is for sure. 2 days time and I will have my results.

:(
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  Quote dave Replybullet Posted: 14 Nov 2007 at 9:57pm
Dam dude, your not getting any younger, take it easy for a while!
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  Quote huckin harms Replybullet Posted: 15 Nov 2007 at 9:09pm
James,
Sorry to hear of this.  Our heart felt sympathies. 
 
 
BY THE WAY!  DOES GLUCOSAMINE REALLY WORK?
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  Quote James Replybullet Posted: 24 Nov 2007 at 4:45pm
Shoulder Exercises

Like Pixie said this is not stuff that replaces any recommended advice from a doctor, and you should see your doctor before doing these, but if you don't have money or for some reason just want to build strength it can't hurt to try these.

More Range of Motion Ones



Edited by James - 24 Nov 2007 at 4:47pm
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  Quote James Replybullet Posted: 20 Feb 2008 at 6:51pm
Just a little feedback for the Pixinator -

My MRI turned out not to be the rotator cuff ... it was rather a superior anterior tear in my labrum and followed swelling... Slap Lesion is what the "cool guys" call it. And thank goodness that I am not joining team schertzl in the bankhart movement .... that one is most definitely more involved ....

Last piece of advice... Run from Group Health (aka Group Death) or to make it less painful just pull your wallet out, burn all your cash and then break your watch...
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  Quote STLboater Replybullet Posted: 20 Feb 2008 at 9:46pm
my mom just tore her rotator cuff paddling in the DR :(
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