| Shoulder Injury in Surfing |
| Tuesday, 08 January 2008 | |
 The
shoulder joint is a complex system which is easily strained with
overuse and repetitive motion. One thing surfers do, more than anything
else, is paddle. The repetitive motion of paddling can strain the
shoulder joint if one is not careful. Previous injuries to the neck or
shoulder also increase the likelihood of injury. If an injury is not
fully rehabilitated, the shoulder is more vulnerable to re-injury. To
avoid this, one needs to be educated in shoulder joint care.The muscle group affected in the shoulder region is the rotator cuff group. It is comprised of the supraspinatus, infraspinatus, teres minor and subscapularis muscles. These muscles form a “cuff” surrounding the shoulder joint that serve to protect it and enable the arm to rotate freely. Typical injuries to the shoulder joint include shoulder impingement syndrome, rotator cuff strain, and subscapularis syndrome. These three problems arise from a common biomechanical asymmetry of the internal rotators versus the external rotators. When these muscle groups are out of balance, the rotator cuff tendon can become trapped, placing stress on the muscle that attaches to it. This can be painful. Over time, inflammation and inactivity of the arm can further affect the bony components of the shoulder joint making healing more difficult. The key to any injury is to understand it, so it can be managed quickly and effectively. Visiting a sports medicine practitioner for a thorough examination is usually the best way to come to terms with an injury and begin the process of recovery. The paddle stroke in surfing makes use of the shoulder’s internal rotators (rotating the thumb downward). These muscles are often overused in daily activities like reaching for items, tucking in a shirt, or taking lifting a surfboard off a car. The shoulder’s external rotators (thumbs rotate outward) are usually underdeveloped and consequently deconditioned. To avoid injuries, one should have balance in the rotator cuff muscle group. Once the shoulder is injured, rest, ice and rotator cuff exercises should all be applied to expedite healing and return to surfing. The healing process of the shoulder joint is dependent on a few things. First and foremost is the general health and overall well being of the injured individual. No matter what the injury, stress, diet and exercise greatly influence the healing process. Specific to the healing of the shoulder is the state of the neck and back. A strong healthy spine will assist the shoulder in healing promptly and efficiently. And neck mobility dictates how much motion can occur at the shoulder. The nerves that exit the neck also have a close connection to the rotator cuff muscles. Thus, back and neck care is vital when nursing a shoulder injury. Finally, to assist in the healing of the shoulder area, doing the correct exercises at the correct time of healing is essential. Doing too much work too early can cause further complications down the line. Returning to surfing after an injury is very individualized. Those who have undergone shoulder surgery should follow their surgeons’ specific return-to-surfing protocol with all precautions applied. Those with less serious shoulder injuries should base their decision to get back in the water on the following rough and ready timelines. Mild strains usually heal well enough with a brief 1 week off with the healing protocols all applied. More moderate strains to the shoulder (for example, those that cause daily pain and require pain or anti-inflammatory medications) may need 2 – 4 weeks rest to provide the shoulder with the time necessary for recovery. This break is worth every ounce of patience one can muster, for if one is impatient with a shoulder injury it can easily become more severe or possibly even surgical. For more specific timelines of healing, see your sports medicine practitioner for a complete evaluation of your particular injury. Finally, when the shoulder is well healed and all surfing has resumed, be sure to take care of the rotator cuff muscle group from that point onward. More than likely, it is vulnerable to re-injury. And also if it happened to one shoulder, it can happen to the other. The biomechanics of your body or your lifestyle might predispose your shoulders to injuries. So try to become more aware of any asymmetries in your lifestyle and body and train for symmetry. Continue to strengthen both shoulders at all times as part of a preventative strategy. Stephanie Hoffman MS, PT La Jolla Shores Physical Therapy |
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