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Poor paddling posture and DeQuervain’s Tenosynovitis


Most people know I’ve taken up kayaking very enthusiastically over the last few months.  This sport has consistently challenged me physically and mentally. I find that I start out a new task pretty nervous but I finish that task feeling accomplished, energised and ready for more!

A lot of people who don’t kayak think that the paddler’s arms move the boat – but aside from holding the paddle in a healthy and effective position,  paddling momentum is driven from torso rotation. As a beginner I am sure I’m missing parts of this equation, but it seems ideal if you hold your paddle with hands approximately shoulder width apart and just below or at shoulder height (not bringing elbows above the shoulder) – and then from there, you drive the paddle into the water at the side of the boat near your toes. Rather than pull the paddle through the water with your arms, you plant the blade and rotate your body torso whilst maintaining a straight arm until you are almost to your side. This uses the strong muscles of your core to pull you through the water below.  You then can bend your elbow at some point around your hip (which wants to happen naturally anyway), and your paddle flicks out from the water without much wrist movement. Very handily, the blade on the other side is up and in position to be driven into the water on the opposite side.

I’m used to paddling at our basin sessions which last an hour and a half or so, with teaching and instruction to break up the paddling itself.  This Saturday we went on a trip – a little way up the Thames, and then along canals continuously for about an hour and a half or so in each direction. This was much more paddling than I have done at one time.  It was a cold, sunny and beautiful day, and I was having an enjoyable and relaxing time.  For a while I paddled alongside our group lead and he commented on what I called my ‘lazy’ posture.  I had my arms down low, and was sweeping the paddle more with my arms.  After he told his own story about paddling posture, I attempted to maintain a better posture for the rest of the trip.  I’m glad I did.  I woke up a bit sore on Sunday – but if I had been ‘lazy’ about my paddling through the whole trip it could have been worse.

When your arms are bent and high and you rotate through your torso, your wrists stay pretty neutral throughout the whole paddle stroke. The problem with holding your arms low and driving the power through your arms instead of your torso is that you need to use your wrists to help the paddle clear the water at the hip.  To do this, you need to extend and abduct your wrist at the same time.

What does that position look like if you aren’t holding a double bladed paddle?  Look down at your hand and hold a fist. Then bring back your clenched thumb as close to the back and near side of your forearm as possible.  The thumb tendons are doing the bulk of this movement on the thumb side, and they are moving and holding that position in a space that is compressed by their own movement. Also, across the back of the wrist is a strip of connective tissue called a retinaculum.  That retinaculum holds the tendons down to prevent bowstringing and making movement more efficient. Without it, the tendons would spring into the air and make us look like we had a flipper! Compressed repetitive motion in this area can create irritation in the tendon sheathes and against the underside of the retinaculum and cause a repetitive strain injury called ‘DeQuervain’s tenosynovitis’.  I’ve helped treat people with DeQuervain’s – and it really isn’t something that you want to have!

This is a risk for everyone.  I have a benign tumour in my right wrist that limits my wrist’s extension on that side, so my thumb tendons had to work particularly hard to help the paddle clear the water when my posture was poor.   This gave me a very mild DeQuervain’s tenosynovitis.

Being a self employed osteopath, any loss of use of my dominant hand is a serious issue.  I’ve often spoken to patients about injury risk whilst working at desks for long hours – but lazy upper limb posture for extended periods can have consequences regardless of the setting.

Let this be a reminder to always listen carefully to coaches about efficient paddling – they are not just giving you advice about efficient paddling, but safe paddling!! Safe paddling is not just about getting out of the water safely if you fall in – it is about being safe above the water so you can work and enjoy your sport pain free!

Update:  flexible positional taping of the thumb and wrist with a spica and ladder cross for 36 hours has helped significantly.  Relative rest, night splinting and eccentric exercise is the way to approach this particular tenosynovitis.




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