I paddle on the right side, last few summers I've been experiencing pain on my left side, seems like it originates under or very near my left shoulderblade. This spring has been mild in the Rockies, I've been paddling a lot, and now have the pain running from the back of the left shoulder down the left arm into my forearm. The pain can be extreme, and does not require activity to start.
Went to the doctor two days ago, he thinks it is originating from a "pinched nerve" in my neck. He could be right, but I have to wonder if paddling might have something to do with this. I'm on celebrex now as well as muscle relaxants and hydrocodone; so far, no improvement.
Here's the question: Is anyone else experiencing similar symptoms that are brought on by paddling? I'm not completely buying the "pinched nerve", so I thought I'd better check with the people who'd know about things c-paddling related.
Thanks in advance,
Dennis
Shoulder/Arm Pain Question
Moderators: kenneth, sbroam, TheKrikkitWars, Mike W., Sir Adam, KNeal, PAC, adamin
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oregonmatt
- Pain Boater
- Posts: 55
- Joined: Thu Aug 21, 2003 9:49 pm
- Location: Portland, OR
I went through this same thing over the last couple of years. I didn't get it looked at soon enough, however, and one day it flared up so bad i had to hold my head in place while getting out of bed (or doing any other similar motion), and i lost all of the feeling in my index finger on my onside hand (that really sucked - i couldn't write or anything for awhile). I went to a doctor who prescribed physical therapy. I found a great physical therapist who gave me a series of stretches and exercises to perform throughout the day. It took five months, but now I am almost back to normal.
My condition arose not through paddling, but mostly through bad posture at the office. However, for whatever reason, i felt the pain more when paddling than at other times. I thought i had messed up my shoulder (the pain went from my right shoulder blade down to my hand) and never thought it was a nerve issue. The bad flare-up that sent me to the doctor occurred b/c i was carrying my son on my shoulders, and the head-forward position this put me in caused my c6-c7 disk to bulge and more severely impinge the peripheral nerve root at these vertabrae.
Recovery can take awhile - it took two months of stretching before i regained any feeling in my finger and before the pain began to abate, and i didn't paddle for over three months. However, i didn't want to go through surgery (apparently scar tissue from surgery can also impinge the nerve root and cause permanent problems), so i stuck with it. Regarding drugs, i only used ibprofen.
I recommend finding a good physical therapist and getting on a stretching regimen - it did wonders for me. Definately do so before your fingers go numb. Also, there is a helpful book called "treat your own neck" by Robin Mackenzie - i'd pick up a copy of that as well, as the stretches that worked for me are described in this book.
Good luck with your recovery.
Matt
My condition arose not through paddling, but mostly through bad posture at the office. However, for whatever reason, i felt the pain more when paddling than at other times. I thought i had messed up my shoulder (the pain went from my right shoulder blade down to my hand) and never thought it was a nerve issue. The bad flare-up that sent me to the doctor occurred b/c i was carrying my son on my shoulders, and the head-forward position this put me in caused my c6-c7 disk to bulge and more severely impinge the peripheral nerve root at these vertabrae.
Recovery can take awhile - it took two months of stretching before i regained any feeling in my finger and before the pain began to abate, and i didn't paddle for over three months. However, i didn't want to go through surgery (apparently scar tissue from surgery can also impinge the nerve root and cause permanent problems), so i stuck with it. Regarding drugs, i only used ibprofen.
I recommend finding a good physical therapist and getting on a stretching regimen - it did wonders for me. Definately do so before your fingers go numb. Also, there is a helpful book called "treat your own neck" by Robin Mackenzie - i'd pick up a copy of that as well, as the stretches that worked for me are described in this book.
Good luck with your recovery.
Matt
If you have pain going from the shoulder down the arm, you most likely have a problem of a pinch or irritated nerve in the first place. The nerves that goes to the arm originates in the lower C-spine, from C5 to T1. It is impossible to have a shoulder problem or arm problem without having a neck problem in the first place even if it is asymptomatic. If it takes so long to recover, it's because the cause (neck problem) has not been fixed. If there is a blockage in the lower neck (even if the nerve is not pinched yet), the muscles innervated by that same nerve will be weaker. But because you don't know that, you keep doing the same as usual and the body to be able to do the same, will often cheat with other muscles that are not meant to do that specific movement and makes you more prone to injury or muscle pain or strain.
The only professionnal that will treat the cause and not only the symptoms (pain and inflammation) is a chiropractor. If you don't fix the problem, you'll take anti-inflammatories for a long time and it won't get better very quick, or it will come back. If you like boating, go see one, fix the problem and go back paddling. If you can find a chiropractor that uses kinesiology would be even better as they work a lot also on the muscles, not only on the spine and it would get fixed faster. Then you can get onto stretching and technique corrections which is often a cause of shoulder problems in paddling. And remember that the more you wait before you get it treated, the more inflammed it's going to get and the longer it will take to get better. Waiting is not saving time or money!
Good luck!
Gigi
OC1 boater
Chiropractor
The only professionnal that will treat the cause and not only the symptoms (pain and inflammation) is a chiropractor. If you don't fix the problem, you'll take anti-inflammatories for a long time and it won't get better very quick, or it will come back. If you like boating, go see one, fix the problem and go back paddling. If you can find a chiropractor that uses kinesiology would be even better as they work a lot also on the muscles, not only on the spine and it would get fixed faster. Then you can get onto stretching and technique corrections which is often a cause of shoulder problems in paddling. And remember that the more you wait before you get it treated, the more inflammed it's going to get and the longer it will take to get better. Waiting is not saving time or money!
Good luck!
Gigi
OC1 boater
Chiropractor
all good responses
When you first mentioned the area of origin i thought romboid muscles, but with the full discription yes it is an impingement . After you visit the chiropracter the issue will be to reduce the swelling around the nerve. You can,t do any thing till it is no longer inflamed . When you are done with your chiropracters treatments and have a good stretching program , begin a regular work out program. Your spine is only as strong as the muscle tissue suporting it. A strong body is a healthy body. And when ever you start to fell muscles beginning to feel tight or short ( atriphea) just do some stretches to lengthen them again. JIM
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oregonmatt
- Pain Boater
- Posts: 55
- Joined: Thu Aug 21, 2003 9:49 pm
- Location: Portland, OR
It's interesting how many different views there are on this. However, i strongly disagree that a chiropractor is the only path to recovery. As i said in my prior post, i just went through a severe c6-c7 nerve pinch, and have achieved an essentially total recovery through physical therapy, rather than through chiropractic treatment. You can google "cervical radiculopathy" to find lots of information on pinched cervical nerves and different treatment options.
My physical therapy focused on both strengthening the muscles supporting the spine in a balanced fashion and performing repetitive neck motions/stretches to move the herniated disk away from the nerve root. The techniques i learned are nice b/c i have been able to take care of any minor occasional flare-ups myself, without having to book another therapy appointment.
Incidentally, while it looks like c-boating didn't cause my injury, the physical therapist did mention that my right collar bone was about 1/2 inch higher than my left. Possibly due to years of paddling as a righty?
My physical therapy focused on both strengthening the muscles supporting the spine in a balanced fashion and performing repetitive neck motions/stretches to move the herniated disk away from the nerve root. The techniques i learned are nice b/c i have been able to take care of any minor occasional flare-ups myself, without having to book another therapy appointment.
Incidentally, while it looks like c-boating didn't cause my injury, the physical therapist did mention that my right collar bone was about 1/2 inch higher than my left. Possibly due to years of paddling as a righty?
radiculopathy
Hi oregonmatt (and others),
Do you have any additional information on radiculopathy? Treatment, symptoms, any other information. I came here looking for radiculopathy related posts.
Do you have any additional information on radiculopathy? Treatment, symptoms, any other information. I came here looking for radiculopathy related posts.
- rela
radiculopathy
Radicle refers to a nerve root (Latin: radix=root) and pathy refers to suffering or disease (Greek: pathos=suffering) so radiculopathy refers to any disease afflicting a nerve root or roots. Nerve roots emerge from the spinal cord along its length and join together to form nerve trunks, divisions, cords and branches.
The spinal cord runs through the spinal canal, and is largely encased by bony elements of the vertebral bones of the spine. In order for the nerve roots to exit they have to pass through little "windows" or foramina in those bony elements. The space is pretty tight, however, and the nerve roots are prone to compression or entrapment due to various disease processes.
Radiculopathy can affect any nerve root and the term does not refer to a specific disease process. The most commonly afflicted nerve roots, however are those exiting the vertebral bones of the neck (cervical radiculopathy) or lower back (lumbar radiculopathy). The most common cause of radiculopathy are "degenerative diseases" of the vertebral bones or the intervertebral discs.
Arthritis can cause development of bone spurs that impinge on the nerve roots. Intervertebral discs are prone to rupture and when they do their softer inner core often herniates out and impinges on the adjacent nerve root(s) or spinal cord.
A nerve that is compressed and irritated often produces "referred pain" that is not felt right at the point of compression, but is referred down the length of the nerves that that particular nerve root contributes to. Typically a single nerve root contributes to multiple different peripheral nerves through complex branching patterns (called nerve plexi). A single irritated nerve root may therefore cause pain referred to multiple different regions. For example, radiculopathy affecting the mid to lower cervical (neck) nerve roots often causes pain referred to the rhomboid area deep to the scapula (shoulder blade) AND pain referred down the arm.
If you have a pain in your shoulder or arm which does not seem to be aggravated by position or motion of the shoulder or arm, it could well be referred pain due to cervical radiculopathy.
In more severe cases, the nerve starts to lose function which means a loss of sensation or motor function (muscle strength) or both. A badly irritated nerve root may trigger involuntary muscle contractions called "fasiculations" like when you shiver.
Nobody on this forum is going to be able to tell you what the best treatment would be without seeing you and knowing your symptoms. As a general rule, milder cases of radiculopathy not involving loss of strength or sensation are first treated with physical therapy. This includes neck and shoulder girdle strengthening exercises, improvement in posture, range of motion exercises, often home traction and sometimes warm applications or other techniques. Sometimes manipulative therapy by a chiropractor or by a Doctor of Osteopathy (D.O.) are beneficial but not always.
If there is a herniated disc or a bone spur directly compressing a nerve root, the only solution may be removal of that disc material or bone spur, and that means some type of surgery.
Plain X rays will show bones and bone spurs but not soft tissue. An MRI (which does not involve X ray) will also show the nerve roots, spinal cord and intervertebral discs. If your symptoms are severe, and a physician recommends an MRI, you shoud not hesitate to have one done, regardless of what others here may say. A nerve root that is badly compressed long enough will permanently lose its function resulting in permanent loss of sensation AND strength, and at that point, any therapy is too late.
The spinal cord runs through the spinal canal, and is largely encased by bony elements of the vertebral bones of the spine. In order for the nerve roots to exit they have to pass through little "windows" or foramina in those bony elements. The space is pretty tight, however, and the nerve roots are prone to compression or entrapment due to various disease processes.
Radiculopathy can affect any nerve root and the term does not refer to a specific disease process. The most commonly afflicted nerve roots, however are those exiting the vertebral bones of the neck (cervical radiculopathy) or lower back (lumbar radiculopathy). The most common cause of radiculopathy are "degenerative diseases" of the vertebral bones or the intervertebral discs.
Arthritis can cause development of bone spurs that impinge on the nerve roots. Intervertebral discs are prone to rupture and when they do their softer inner core often herniates out and impinges on the adjacent nerve root(s) or spinal cord.
A nerve that is compressed and irritated often produces "referred pain" that is not felt right at the point of compression, but is referred down the length of the nerves that that particular nerve root contributes to. Typically a single nerve root contributes to multiple different peripheral nerves through complex branching patterns (called nerve plexi). A single irritated nerve root may therefore cause pain referred to multiple different regions. For example, radiculopathy affecting the mid to lower cervical (neck) nerve roots often causes pain referred to the rhomboid area deep to the scapula (shoulder blade) AND pain referred down the arm.
If you have a pain in your shoulder or arm which does not seem to be aggravated by position or motion of the shoulder or arm, it could well be referred pain due to cervical radiculopathy.
In more severe cases, the nerve starts to lose function which means a loss of sensation or motor function (muscle strength) or both. A badly irritated nerve root may trigger involuntary muscle contractions called "fasiculations" like when you shiver.
Nobody on this forum is going to be able to tell you what the best treatment would be without seeing you and knowing your symptoms. As a general rule, milder cases of radiculopathy not involving loss of strength or sensation are first treated with physical therapy. This includes neck and shoulder girdle strengthening exercises, improvement in posture, range of motion exercises, often home traction and sometimes warm applications or other techniques. Sometimes manipulative therapy by a chiropractor or by a Doctor of Osteopathy (D.O.) are beneficial but not always.
If there is a herniated disc or a bone spur directly compressing a nerve root, the only solution may be removal of that disc material or bone spur, and that means some type of surgery.
Plain X rays will show bones and bone spurs but not soft tissue. An MRI (which does not involve X ray) will also show the nerve roots, spinal cord and intervertebral discs. If your symptoms are severe, and a physician recommends an MRI, you shoud not hesitate to have one done, regardless of what others here may say. A nerve root that is badly compressed long enough will permanently lose its function resulting in permanent loss of sensation AND strength, and at that point, any therapy is too late.
I had a similar problem that resulted from the muscles that hold down the shoulder blade getting weak. This resulted in one shoulder blade sticking up more than the other and in order to compinsate the muscles between the neck and shoulder get inflamed and can cause this type of pain. Have someone look at both shoulders as you lift your arms in front of your chest to above you head. If the shoulder blade looks like it is poping up, this could be your problem too. The good or bad news is that physical therapy can strengthen the muscles, but you must continue to keep the muscles strong with therapy if you want to keep boating. If this is you problem see a therapist that treats injurys to athletes, not one that tends to treat 80 year old hip fracture patients. You will get much better treatment for what you are looking for. I hope that helps, and good luck.
Well, I went to Emory Sports Medicine for symptoms that were obviously due to auricular nerve impingement, but because the dummies couldn't see the impingement on x-ray, they really didn't believe me. That I had been a researcher in the Emory rehab medicine department for many years did not seem to impress them.
Any neurologist would have quickly seen that it was an auricular nerve problem.
So, I don't think that sending people to sports medicine specialists is necessarily good advice. Send people to professionals who know how to assess very clear evidence.
Any neurologist would have quickly seen that it was an auricular nerve problem.
So, I don't think that sending people to sports medicine specialists is necessarily good advice. Send people to professionals who know how to assess very clear evidence.
Another comment
To all the well-founded comments & replies posted here, I would like to add one more: find a good physiatrist (aka Physical Medicine specialist).
I tend strongly to Sports Med specialists-- whether MD, physical therapists, or whatever, because obviously they specialize -- and they "get it". (Ie, they understand that "Stop doing xxxx" is not an option with boaters. We will do it until it breaks. My own preferred shoulder OS is a 2x college All American as well as a nationally known OS, and he "gets it".) However, my own "primary" is a physiatrist. Physical Med is a small specialty, and the big advantage (IMHO) is that they are not surgery-oriented in situatations where orthopedists tend to be, plus they often have close working relationships with very good PT's. Mine is very good at diagnosing "soft/connective tissue" problems and finding non-surgical solutions, but he is not "religiously" opposed to surgery either. I have no personal experience with chiropractors, so can't evaluate, but I have had multiple injuries and surgeries on both shoulders from boating, skiing, and mt biking, and my own pathway of choice at this point is physiatrist first, PT if possible, sports-med OS next, and then you choose.
Just my 2c
I tend strongly to Sports Med specialists-- whether MD, physical therapists, or whatever, because obviously they specialize -- and they "get it". (Ie, they understand that "Stop doing xxxx" is not an option with boaters. We will do it until it breaks. My own preferred shoulder OS is a 2x college All American as well as a nationally known OS, and he "gets it".) However, my own "primary" is a physiatrist. Physical Med is a small specialty, and the big advantage (IMHO) is that they are not surgery-oriented in situatations where orthopedists tend to be, plus they often have close working relationships with very good PT's. Mine is very good at diagnosing "soft/connective tissue" problems and finding non-surgical solutions, but he is not "religiously" opposed to surgery either. I have no personal experience with chiropractors, so can't evaluate, but I have had multiple injuries and surgeries on both shoulders from boating, skiing, and mt biking, and my own pathway of choice at this point is physiatrist first, PT if possible, sports-med OS next, and then you choose.
Just my 2c
I am currently experiencing a similar problem.
My problem started back in March when my paddle jammed during a high brace and the boat and my body continued downstream. I noticed the jolt right away but the persistant pain didn't show up until the next day.
I couldn't move my left arm out to the side or front more than 20 degrees without severe pain
After 3 weeks of no improvement I went to a physiotherepist. I've been in treatment for 3 weeks now and I'm seeing solid improvement. I have an inflamed tendon, that's being pinched under my sholder blade when my arm moves.
I'm planning to be at Palmerfest in 2 weeks. I don't want to miss anymore paddling.
Whatever you do, take care of it, and don't do activities that aggrevate the pain.
My problem started back in March when my paddle jammed during a high brace and the boat and my body continued downstream. I noticed the jolt right away but the persistant pain didn't show up until the next day.
I couldn't move my left arm out to the side or front more than 20 degrees without severe pain
After 3 weeks of no improvement I went to a physiotherepist. I've been in treatment for 3 weeks now and I'm seeing solid improvement. I have an inflamed tendon, that's being pinched under my sholder blade when my arm moves.
I'm planning to be at Palmerfest in 2 weeks. I don't want to miss anymore paddling.
Whatever you do, take care of it, and don't do activities that aggrevate the pain.