How to Prevent and Deal with Shoulder Pain from Paddle Boarding
“For every 1,000 hours of SUP, there is an injury rate of 3.63%, the majority of which occur in the shoulder or upper arm. Shoulder impingement is one of these injuries…” –Sup Connect
The Most Common Cause of Paddle Boarding Shoulder Pain
By far, the most common shoulder injury among paddle boarders is shoulder impingement. I learned all about this painful condition because I have had shoulder problems for decades.
My shoulder problems started many years ago when, as a young buck, I attempted a shoulder press set with too much weight. I felt a twinge of pain and foolishly kept pressing the weight.
Over 20 years later and I am still paying for this mistake. Swimming, surfing and paddle boarding would aggravate the problem. So I had to be proactive and find a way around my bad shoulders.
I’d like to pass on to you the tips that helped me continue to paddle board despite bad shoulders.
Shoulder impingement can lead to even worse problems like rotator cuff tears and tendonitis. So take the time to address any shoulder pain you may have. If it persists you should see a doctor before it gets worse.
What is shoulder impingement?
The top of the arm bone has a ball that fits in the shoulder socket. A shoulder impingement is when inflamed shoulder material gets caught in the space between the top of the arm bone head (ball) and the acrominion (the bone above the ball).
These inflamed materials are the rotator cuff tendons and the subacromial bursa (a fluid fill sac that sits above the arm bone ball and between the ball and acrominion).
These materials become inflamed due to repetitive overhead movement. In particular, repetitive internal rotation of the shoulder. Another factor that contributes to impingement is weakened, tight and out of balance muscles that keep the ball centered in the shoulder socket.
Shoulder impingement is a common injury among swimmers, surfers and paddler boarders. And it is painful enough to stop you from participating in these activities.
To make matter worse we spend our days strengthening and tightening the internal rotators while neglecting and weakening the external rotators.
When sitting hunched over a computer, or slouched behind a steering wheel, our shoulders are rolled in (internally rotated) Think of pushups, bench and shoulder presses. These popular exercises rotate the shoulders internally. Poor posture with the shoulders hunched foreword are internally rotated.
The result is an imbalance of the small muscles that center the ball in the shoulder socket. And that contributes to shoulder impingement. Strong, tight muscles in the front that rotate our shoulders internally. And weak, loose muscles in the back of the shoulder that rotate the shoulders externally.
What is a rotator cuff?
Your rotator cuff is made up of four small muscles (and tendons) that keep the ball of your upper-arm bone centered in your shoulder socket. It also helps you raise and rotate your arm.
The names of these four muscles are supraspinatus, infraspinatus, teres minor and subscapularis. The subscapularis is used primarily for internal rotation. While the other three are used for external rotation.
Tips for Pain-Free SUP Shoulders
Use these tips to have pain free shoulders when paddle boarding.
1. The Paddle
Shorten your paddle
Shortening the length of your paddle will lower your top arm and reduce force on the entire shoulder and spine. A shorter paddle is also a shorter lever that generates less power and therefore less stress on your joints. You need to experiment to dial in the right paddle length. A paddle that is too short will put strain on your lower back
Get a flexible shaft
A flexible shaft will reduce the impact on your joints especially during the dynamic catch phase but also during the power phase. Carbon fiber is the stiffest shaft and hardest on the joints. Next is fiberglass, than wood and bamboo.
Use a smaller blade
Using a smaller blade is much easier on the shoulders as it takes less power per stroke. I prefer a smaller blade myself for that reason.
2. Proper Technique
I am not the king of paddle boarding technique. I have violated all these rules. And my technique still needs work. But these tips are valid and could save your shoulders.
Keep your top hand…below eye height
Keep your top elbow…below shoulder height
The lower your top arm the less stress placed upon the rotator cuff muscles.
Don’t over extend during the reach phase of the stroke
Over extending your top arm during the reach phase of the stroke will directly stress your internal rotator cuff.
Keep your bottom arm straight
When paddling keep your bottom arm straight which will force you to use torso. Your hands should be thought of as hooks. Your arms and shoulders are just along for the ride. The power of your stroke does not come from the shoulders. The power is generated from your feet up through your torso. Your back/core/torso should be rotating with each stroke.
Push your paddle up with your bottom hand
Don’t pull your paddle up out of the water with your top hand. Instead push it up out of the water with your bottom hand. Your top hand should be almost laying on top of the t-handle and be carried up by the lift.
Don’t use a “death grip” on your paddle
Both hands should be loose and light on your paddle as possible. A tight, white knuckle “death grip” will force a stiff, unnatural stroke that will strain your wrists, arms and shoulders.
Read: How to prevent blisters when sup boarding
Externally rotate your shoulders (slightly) wth your top hand
Externally rotate the shoulders slightly when paddling. Place your thumb on the side or above the t-handle. Never place your thumb below the t-handle. Your knuckles should be at least flat, or better yet the index finger knuckle should be raised higher than the other knuckles. You are slightly rotating your hands out and away from your body which will open up the shoulder.
Your should keep your thumb up and shoulders open throughout the stroke.
3. Mind Your Body
If you feel shoulder pain… rest
If you don’t give a shoulder impingement rest it could stop you from paddling for years, maybe forever. This is no joke.
Give yourself rest days between sup sessions
Rest does wonders for stressed out shoulders.
How do your shoulders feel the day after a sup session?
Tendons don’t always hurt when paddling. It may take a day to feel any damage. So take a day off and get in touch with your shoulders.
Warmup and cooldown with shoulder mobility exercises
Do some shoulder mobility work before and after your sup session. Super important before every swimming, surfing and sup boarding session!
4. Stretch and Strengthen the Rotor Cuff Muscles
Typically, with shoulder impingement the internal rotator (subscapularis) is tight and needs to be stretched. The pectoral (chest) and front deltoid muscles will be tight and should also be stretched. And the posterior capsule (a small muscle on the rear of the deltoid that helps keep the ball in the shoulder socket) will be also tight and needs to be stretched.
Meanwhile the three rotator cuffs responsible for external rotation (supraspinatus, infraspinatus, teres minor) need to be strengthened. The only way to strengthen these muscles is with exercises that directly target them.
Youtube is full of great videos on how to stretch and strengthen these small muscles. This step is critical. With a few exercises you can keep your shoulders healthy and even rehab already injured shoulders. These exercises are simple and easy. Don’t skip this step.
Physical therapists Bob and Brad discuss how you can heal your rotator cuff pain without surgery. Bob Schrupp and Brad Heineck have over 50 years of combined experience in the physical therapy field.
Learn More About the Shoulders
Randale C. Sechrest, MD narrates this excellent animated tutorial on the basic anatomy of the shoulder. The shoulder is a complex unit and this video explains the shoulder anatomy and function in a easy to understand way.
