At our Kauai Therapy Clinic, we know well ocean sports related injuries. Assessing and treating water sports related injuries ‘shoulder overuse pain and injury’ is one of the most common complaints we see. This is particularly true for water sport enthusiasts in the 30-60 age bracket. It is understandable that with anything you are passionate about, not being able to engage in it due to pain/injury is something we can empathize with. The key with shoulder pain is to understand why we get it and how to manage, treat and prevent it from coming back. Below I have provided all the info you will need to understand this problem and the principles of how to get yourself back in the water without pain.
The action of paddling in water sports strengthens the larger muscles around the shoulder including the deltoid and pectoral muscles. These muscles when strong tend to apply upward force/pressure on the ball of the arm bone. The rotator cuff muscles when strong will apply a downward force/pressure on the ball of the arm bone.
Because of regular paddling we tend to become strong in the muscles that apply this upward force/pressure and relatively weak in the rotator cuff muscles that apply downward force/pressure. This can result in the ball of the arm bone sliding upwards in the shoulder joint compressing the space between the bones above. This places direct pressure on the rotator cuff tendons that sit in this space.
This pressure on the rotator cuff tendons is known as ‘Shoulder Impingement’. If this impingement is allowed to go on for an extended period of time it can cause small tears in the rotator cuff tendons, reduce blood supply and important nutrition to the shoulder joint. Over time this leads to chronic inflammation of the rotator cuff tendons, causing pain & discomfort.
Common symptoms with these injuries are shoulder pain when the arm is lifted upwards. Common examples of this are repeated shoulder pain as you lift your arm during paddling with each stroke and in general lifting objects above your head.
Signs this injury is worsening include persistent shoulder and upper arm ache even when the shoulder is not lifted. Another sign of shoulder inflammation is when pain is persistently worse at night.
This sounds familiar? Here is some tips on treating & managing this pain is to gradually restore the strength to the rotator cuff muscles which allows the ball of the arm bone (humerus) to move downwards to a point where there is no more impingement. This then results in a gradual reduction in pain until the shoulder is back to full function.
• Early Pain Reduction: Avoiding positions and activities that cause ‘your’ shoulder pain is the first key step to the healing process. If you have pain while performing water sports you will need to stop them temporarily (I know, so sorry!).
•the shoulder is effective in the presence of localised shoulder pain.
• The introduction of pain free specific rotator cuff strength exercises, shoulder blade stabilization exercises and specific pain free shoulder stretches needs to be initiated as soon as possible.
• Identifying other areas of the body that may be weak, tight or dysfunctional that contribute to the shoulder pain. For example tightness/stiffness in the muscles and joints of the neck, upper back and chest can all increase the likelihood of shoulder impingement and tendinopathy. The exercise programs at Kauai Therapy & Wellness have been based on this scientific research that identifies what muscles, joints and other structures are at risk of becoming weak, tight or damaged through repeated shoulder movement. Therefore completing the programs @ Kauai Therapy & Wellness helps prevent the risk of contracting ‘Shoulder impingement/tendinopathy’. All of our programs contain exercises to strengthen the rotator cuff muscles and stretch/open the previously mentioned muscles and joints that can increase the likelihood of this injury.
It is advised that you consult one of our shoulder specialists at Kauai Therapy & Wellness for an accurate assessment to ascertain whether in fact you are suffering from ‘Shoulder Impingement’. If this is diagnosed you can then initiate a rotator cuff strengthening and stabilization program to restore strength, function and get you back ripping. The time that this takes can range from 2 weeks to several months depending on the severity of your symptoms and how long you have been suffering pain before seeking treatment.
One of our licensed physical therapists will perform an initial examination to identify the exact cause of the pain. At Kauai Therapy & Wellness one of our main goals is teaching our patients with shoulder pain how to address the issue so it will go away forever. Several tests are performed to identify the problematic areas in strength, flexibility, and muscle function.
Protection of the shoulder is initially a must to prevent further damage. This may include rest for a period of time and education about damaging activities and movements.
Flexibility movements to increase mobility without pain or discomfort are included. These should be gentle and progressive with emphasis on proper mechanics of the shoulder.
Progressive strengthening exercises for different muscle groups. Examples include specific rotator cuff exercises and shoulder blade strengthening (known as scapular stabilization).
Advanced techniques such as massage, mobilizations, manual therapy under the expert supervision of the therapist can be effective ways to decrease shoulder pain.
In addition to the above treatments, Kauai Therapy & Wellness utilizes the ML830 Cold Laser. The 830Laser is designed to decrease pain, decrease inflammation and increase tissue healing. This treatment does not wear off like heat, ice, or medications. If you don’t reinjure the area, the pain should not return. Our clinic in Puhi has Laser Certified Physical Therapists.
At Kauai Therapy & Wellness, we are committed to helping our community live a healthy and pain free life. We always work closely with your physician and insurance company to make sure you have the best care available. In most cases we do not require an MD referral to get started with helping you. Give us a call 808.333.3688