Kekoa took his boat off his car in Hawaii Kai. He felt a dull ache in his left shoulder
as he brought the boat down.  When paddling his regular downwind run to Kaimana beach, his shoulder pain unmistakably worsened.  It became even sharper every time he dug the paddle into the water.

Shoulder impingement is a common problem for paddlers and for anyone who participates in repetitive overhead activity (e.g. swimmers, pitchers, volleyball players).

To better understand what happens, let’s start with some basic anatomy. The shoulder is a ball-and-socket joint made up of three parts: the scapula (shoulder blade), the clavicle (collar bone), and the humerus (upper arm bone). The humerus is the ball. The upper part of the scapula, the acromion, is the socket, or roof of the shoulder. Our rotator cuff muscles connect the humerus to the scapula. This group of muscles helps stabilize the shoulder joint as it is being moved.

Impingement occurs when there is rubbing or pinching of the tendons or the bursa in the narrow space between the ball and socket. This usually does not cause prolonged pain. However, if the activity that causes the pinching or rubbing continues repetitively, as is the case with paddling (top hand), the rotator cuff muscles can become irritated and inflamed. This can result in pain, weakness, and loss of movement at the shoulder.

SOME common signs and symptoms of impingement include:
•       Difficulty raising the arm out to the side or in front of you.
•       A painful arc of motion between 60-120 degrees, especially at 90 degrees.
•       Pain with sleeping on the affected shoulder.
•       Reaching into your back pocket.
•       A catching sensation when lowering the arm.

Please note that this is not an all-inclusive list and not everyone will have the same symptoms. If you are not sure, please see a health care professional. JACO Rehab offers free injury assessments and can help direct your care.

Posture is crucial to maintain proper alignment and combat injury. It may not be the root cause of the injury, but is a major contributing factor. Below are some basic postural and stretching exercises you can do to help prevent injury.

We checked out Kekoa's shoulder and after a thorough evaluation he  started an exercise program to stabilize the shoulder joint in the socket. He had to do the exercises 5 times a day for one month and started experiencing relief after 3 weeks. He is back on the water and pain free.

Here are some stretches that can help to prevent injury.

For more information visit JacoRehab.com or call us at 381-8947 for a free screening.

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