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Shoulder pain. Help needed

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Created by dk78 > 9 months ago, 22 Dec 2014
dk78
141 posts
22 Dec 2014 4:12AM
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Hi guys, Merry Christmas to all
I would like some help if it is possible please. For the last 2 years i have had some pain in my right shoulder which i managed with stretching and some band exercises for strengthening. One month ago i decided to do a MRI and the result was that i had an inflammation in the AC Joint. I took one month off from paddling and did some physiotherapies as my doctor advised me.
Few days ago doc told me that i could start some easy paddling which i did yesterday, but i felt a discomfort in my shoulder again.
The problem occurs when i have my hand on top position. I have my paddle short, a V-Drive 91, i try not to apply power with my top hand and i use more hips and core than hands. I can not understand what is wrong when i have my hand on top.
Has anyone had a similar problem or could you provide some advise which could help me?

Thanks a lot
Dimitris

moyzie
SA, 135 posts
22 Dec 2014 10:13AM
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check out Cris Mills on FB surf strength coach he is a great dude no BS and he really knows his stuff he does surf (prone) and uses surprisingly simple equipment to help you out
www.facebook.com/groups/surftrainingsuccessmembers/
my brother put me onto hime because I had a shoulder injury and it's much better now

CarterSUPhysio
QLD, 179 posts
22 Dec 2014 9:47AM
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Hey Dimitris!

that's a bummer about your shoulder! There is an orthopaedic test we physio's use to stress the AC joint to see if it's sore and it involves lifting your arm up the front and then horizontally across your body - exactly like the top hand in your stroke! Now it's unavoidable to change this position huuuugely as well, we have to paddle. One quick thing I might suggest is to really really stack your shoulders as in when your right hand is on top, really bring your chest around to the left. This will reduce how much horizontal adduction (shoulder across the body) occurring and reduce compression on the AC joint. For this to occur you will need a good amount of thoracic rotation - which a lot of paddlers lack.One simple thing to improve your mobility in your thoracic spine is to roll up a towel into a cylinder, place it under your shoulder blade horizontally across your back, and ly over the top of it.The above things WILL NOT completely resolve your issue, but may help you get through.

What do you think caused your AC joint injury in the first place? Do you remember any event like falling on an outstretched arm etc?Strengthening your rotator cuff as it sounds like you have been is important with the therabands - but what position is your arm in when you're doing these exercises? Elbow tucked in by your side? arm up out the the side? We need to build strength in a position that we are challenging the rotator cuff in - so while it's important to start with your arm by your side, elbow tucked in... this is not the position we paddle in and we need to progress that on. I might do up a post in the near future with some shoulder related stuff. Let me know what you think of the above.CheersJosh

Stephenseals
QLD, 90 posts
22 Dec 2014 11:48AM
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Select to expand quote
dk78 said..
Hi guys, Merry Christmas to all
I would like some help if it is possible please. For the last 2 years i have had some pain in my right shoulder which i managed with stretching and some band exercises for strengthening. One month ago i decided to do a MRI and the result was that i had an inflammation in the AC Joint. I took one month off from paddling and did some physiotherapies as my doctor advised me.
Few days ago doc told me that i could start some easy paddling which i did yesterday, but i felt a discomfort in my shoulder again.
The problem occurs when i have my hand on top position. I have my paddle short, a V-Drive 91, i try not to apply power with my top hand and i use more hips and core than hands. I can not understand what is wrong when i have my hand on top.
Has anyone had a similar problem or could you provide some advise which could help me?

Thanks a lot
Dimitris


hello Mate.

I was watching Kalama's video which is on this forum and he was saying to keep the top arm bent when paddling to spread the load through your shoulder, I tried this the last few days no shoulder pain at all check the video out.

Cheers.

marcus
WA, 219 posts
22 Dec 2014 2:04PM
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I was off the race board for 8 months trying to sort my shoulder out. One of my problems was the same as yours. I had cortisone injected into my ac joint. Definitely helped and I'm also doing a lot of rehab stuff similar to what your already doing by the sounds of it.
If your lucky enough to know a physio who paddles and knows what their talking about (in both physio and paddling) you should get them to film or watch you paddle and find out what your doing wrong to cause this injury.
Then the hard part is to re train your muscles to paddle with a new technique.
Good luck.

PTWoody
VIC, 3982 posts
22 Dec 2014 5:29PM
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Select to expand quote
Stephenseals said..
I was watching Kalama's video which is on this forum and he was saying to keep the top arm bent when paddling to spread the load through your shoulder, I tried this the last few days no shoulder pain at all check the video out.

Cheers.


The bent elbow could definitely help but it's important to keep the bent elbow low, otherwise you're still putting the load on the shoulder.

rockmagnet
QLD, 1458 posts
22 Dec 2014 5:24PM
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I'm sure all of those things will help as suggested by the experts but I had the same problem and found doing a slow dip as deep as I could and holding it for 10-20 seconds really cured the problem . I had all the treatments but this really worked for me.
You know what a dip is don't you. Put your hands behind you on a table and slowly lower yourself. You will feel where it hurts and try and take it slightly past that point.
Hope this helps.
to

Kami
1566 posts
22 Dec 2014 4:20PM
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Follow what CarterSUPhysio says in first .
Have been in shoulder surgery 4 years ago, surgeon told me 4 years to cure . He was right. But at the end of relief the best have done as re-education was to do kayaking. In fact, kayak paddling reinforces your shoulder muscles without pulling off on shoulder or stressing cap ligaments.
Later on you will paddle on a SUP painless.
Hope this helps.

rockmagnet
QLD, 1458 posts
22 Dec 2014 8:03PM
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Select to expand quote
Kami said..
Follow what CarterSUPhysio says in first .
Have been in shoulder surgery 4 years ago, surgeon told me 4 years to cure . He was right. But at the end of relief the best have done as re-education was to do kayaking. In fact, kayak paddling reinforces your shoulder muscles without pulling off on shoulder or stressing cap ligaments.
Later on you will paddle on a SUP painless.
Hope this helps.



Select to expand quote
rockmagnet said..
I'm sure all of those things will help as suggested by the experts but I had the same problem and found doing a slow dip as deep as I could and holding it for 10-20 seconds really cured the problem . I had all the treatments but this really worked for me.
You know what a dip is don't you. Put your hands behind you on a table and slowly lower yourself. You will feel where it hurts and try and take it slightly past that point.
Hope this helps.
to



You might want to know that I do know what I'm talking about. It's just one of those cases that work well in practice better than it does in theory.

dk78
141 posts
22 Dec 2014 6:29PM
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Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.

Sharper
QLD, 82 posts
23 Dec 2014 8:57AM
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Select to expand quote
dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.


Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.



CarterSUPhysio
QLD, 179 posts
23 Dec 2014 6:58PM
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Definitely video analysis from someone who know's paddling would be ideal! For someone with AC jt degenerative changes I probably wouldn't go with dips - but what works for some doesn't for others (the way rockmagnet describes doing it makes me think you may have had a biceps tendinopathy or tendinopthy of some sorts, perhaps? maybe not..)


Select to expand quote
Sharper said..

dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.



Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.





ok so don't take this as the 'douche guy correcting everyone' that's not my intention haha!!!! but just to share some love and knowledge of anatomy so it helps everyone:


Bursitis relates to a bursa (a fluid filled sack that is a friction buffer anywhere in the body a tendon joins onto a bone) so bursitis is inflammation of a bursae itself (it's own condition)Rotator cuff ligaments don't exist - tendons do! and you're 100% smack on with supraspinatus - it's probably the most common rotator cuff muscle for its' tendon to develop tendinitis/tendinopathy. It typically is sore when you lift your arm up the front, definitely, but so can at least 10 other things around the shoulder joint - the difficulty of giving advice over a screen!!! Without a physical assessment, I'd start with the obvious (Ac jt) and then move onto looking for other things like a supraspinatus tendinopthy. Again, not being a douche bag, hope no one takes it that way! just offering a bit of help :)

husq2100
QLD, 2031 posts
23 Dec 2014 7:02PM
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rockmagnet
QLD, 1458 posts
23 Dec 2014 9:16PM
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Select to expand quote
Sharper said..




dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.






Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.





HI Sharper Please read what I said slowly. God I hate it when people misquote.You have totally distorted what I said. I did not say do dips. It is total disrespect if you do not take the time to read things properly. Grrr

Brenno
QLD, 891 posts
23 Dec 2014 9:58PM
Thumbs Up

Hey dimitris. Had really bad shoulder pain from manual labour over many years. Just surfing SUP has really alleviated the pain by building up my shoulder muscles and strengthening the joints.

Sharper
QLD, 82 posts
23 Dec 2014 10:00PM
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Select to expand quote
CarterSUPhysio said...

Definitely video analysis from someone who know's paddling would be ideal! For someone with AC jt degenerative changes I probably wouldn't go with dips - but what works for some doesn't for others (the way rockmagnet describes doing it makes me think you may have had a biceps tendinopathy or tendinopthy of some sorts, perhaps? maybe not..)


Sharper said..

dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.



Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.





ok so don't take this as the 'douche guy correcting everyone' that's not my intention haha!!!! but just to share some love and knowledge of anatomy so it helps everyone:


Bursitis relates to a bursa (a fluid filled sack that is a friction buffer anywhere in the body a tendon joins onto a bone) so bursitis is inflammation of a bursae itself (it's own condition)Rotator cuff ligaments don't exist - tendons do! and you're 100% smack on with supraspinatus - it's probably the most common rotator cuff muscle for its' tendon to develop tendinitis/tendinopathy. It typically is sore when you lift your arm up the front, definitely, but so can at least 10 other things around the shoulder joint - the difficulty of giving advice over a screen!!! Without a physical assessment, I'd start with the obvious (Ac jt) and then move onto looking for other things like a supraspinatus tendinopthy. Again, not being a douche bag, hope no one takes it that way! just offering a bit of help :)


Whoops definitely meant tendon not ligament.

Sharper
QLD, 82 posts
23 Dec 2014 10:06PM
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Select to expand quote
rockmagnet said...
Sharper said..




dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.






Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.





HI Sharper Please read what I said slowly. God I hate it when people misquote.You have totally distorted what I said. I did not say do dips. It is total disrespect if you do not take the time to read things properly. Grrr


Sigh ... egos huh.
Yeah I wouldn't be doing that DIP (singular) with shoulder issues and the arms around behind. Or a tricep dip as we refer to it. Too much strain.
I'd stick to some chest stretching, rest and when it settles down work on some rotator cuff exercises and scapular stabilisation. But an exam by a physio is the way to go to try and rule out the maybes.
I read it slowly for your benefit Rockmagnet and still came to a same conclusion. Thanks.

dk78
141 posts
23 Dec 2014 10:10PM
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Hi guys thanks again for your thoughts. My rotator cuff is clear as the MRI showed. The only problem is in the AC joint. I do strengthening exercises and that has help me along with the physiotherapies. I was thinking also to try a paddle with a little flex in the shaft.

CarterSUPhysio
QLD, 179 posts
24 Dec 2014 8:32AM
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A softer shaft will more than likely help. Also smaller blade sizes are all the rage now which will take some load off.

Worst comes to worst you can investigate an ultrasound guided cortisone injection

Stephenseals
QLD, 90 posts
24 Dec 2014 9:25AM
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Select to expand quote
husq2100 said..


Your a funny guy like it!

surfgrub
NSW, 105 posts
25 Dec 2014 7:39PM
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Try more input from your lower hand throughout the recovery phase. ie: lift the paddle up from the water with the lower hand (a little) so as to relieve the stress on top hand A/C joint. It works for me & I've had my left a/c ripped apart twice, then screwed, glued & taped back together with next to no favourable result. I don't have a/c joint problem when paddling....

Check Connor Baxter's paddle stroke. He keeps the recovery phase quite vertical as he appears to engage the bottom arm more than most other paddlers do (IMO)...

BigLump
NSW, 55 posts
25 Dec 2014 8:59PM
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Select to expand quote
Sharper said..

rockmagnet said...

Sharper said..





dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.







Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.






HI Sharper Please read what I said slowly. God I hate it when people misquote.You have totally distorted what I said. I did not say do dips. It is total disrespect if you do not take the time to read things properly. Grrr



Sigh ... egos huh.
Yeah I wouldn't be doing that DIP (singular) with shoulder issues and the arms around behind. Or a tricep dip as we refer to it. Too much strain.
I'd stick to some chest stretching, rest and when it settles down work on some rotator cuff exercises and scapular stabilisation. But an exam by a physio is the way to go to try and rule out the maybes.
I read it slowly for your benefit Rockmagnet and still came to a same conclusion. Thanks.


Do what works best for you! I have suffered rotator cuff problems for years after a misspent youth weightlifting , bench pressing and overhead pressing and the most aggravating one, the infamous "Press Behind the Neck". I can no longer bench press or for that matter perform push ups without my shoulders instantly flaring up.
I can however perform cable push downs, similar to an extreme version of a decline bench press and I have progressed to assisted dips (Nautilus machine). I have no pain when performing the above exercises. During my last training foray, some years ago, I even progressed to unassisted dips.
Each injury is specific to an individual, likewise with the recovery process.
It great to take other opinions on board but my advice is to DO WHAT WORKS FOR YOU

dk78
141 posts
25 Dec 2014 9:15PM
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Select to expand quote
BigLump said..


Sharper said..



rockmagnet said...



Sharper said..







dk78 said...
Hi guys, thank you all for the replies,
CarterSUPphysio i think the problem caused by backward overstretch in the surf, imagine when you do a top turn and you put all your body weight to the paddle not to fall in. I can not imagine any other way that i hurt it. If i do the test that you are saying i have some discomfort at the end range of motion.I saw the video with Dave Kalam and indeed keeping the elbow down and low the pain is noticeable less. I will follow your advice as well as Rocketmagnet’s and and i hope that it will become better as soon as possible. Thanks again
D.









Hey DK78. Sounds a lot like bursitis of one of your rotator cuff ligaments possibly the supraspinatus. I have had a similar problem. The raising of your arm up front on giving the pain is a bit of a give away.
Can I ask what other activities you do exercise wise? It's important to try and limit any aggravating causes. No disrespect to the the chap you mentored dips but I'd stay away from that activity. Some people can get away with dips no problems but I've found is frequently mentioned as an aggravation. It is a great builder of deltoid muscle but it can jarr the rotator cuff muscles and ligaments which is usually where the issue lies.








HI Sharper Please read what I said slowly. God I hate it when people misquote.You have totally distorted what I said. I did not say do dips. It is total disrespect if you do not take the time to read things properly. Grrr





Sigh ... egos huh.
Yeah I wouldn't be doing that DIP (singular) with shoulder issues and the arms around behind. Or a tricep dip as we refer to it. Too much strain.
I'd stick to some chest stretching, rest and when it settles down work on some rotator cuff exercises and scapular stabilisation. But an exam by a physio is the way to go to try and rule out the maybes.
I read it slowly for your benefit Rockmagnet and still came to a same conclusion. Thanks.




Do what works best for you! I have suffered rotator cuff problems for years after a misspent youth weightlifting , bench pressing and overhead pressing and the most aggravating one, the infamous "Press Behind the Neck". I can no longer bench press or for that matter perform push ups without my shoulders instantly flaring up.
I can however perform cable push downs, similar to an extreme version of a decline bench press and I have progressed to assisted dips (Nautilus machine). I have no pain when performing the above exercises. During my last training foray, some years ago, I even progressed to unassisted dips.
Each injury is specific to an individual, likewise with the recovery process.
It great to take other opinions on board but my advice is to DO WHAT WORKS FOR YOU





Select to expand quote
surfgrub said..
Try more input from your lower hand throughout the recovery phase. ie: lift the paddle up from the water with the lower hand (a little) so as to relieve the stress on top hand A/C joint. It works for me & I've had my left a/c ripped apart twice, then screwed, glued & taped back together with next to no favourable result. I don't have a/c joint problem when paddling....

Check Connor Baxter's paddle stroke. He keeps the recovery phase quite vertical as he appears to engage the bottom arm more than most other paddlers do (IMO)...




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"Shoulder pain. Help needed" started by dk78