Journey through my shoulder injury

Shoulder Injuries and kayaking

Ill start this blog post by explaining what happened to me. On the 28th of December I was unlucky enough to have injured my shoulder on poll gorm on the Flesk river. This river is my home run and I have run this rapid many times before but this time I wasn't so lucky. I had a subluxation of my shoulder. I flipped at the top of this rapid, my shoulder was in a very bad position and well the rocks took care of the rest.

Poll Gorm 

A shoulder subluxation is similar to a shoulder dislocation, the difference being that a subluxation is temporary and partial. It can be described as shoulder joint instability. A study of over 4,000 West Point cadets showed that shoulder subluxations are much more common than dislocations, and often happen in conjunction with other injuries such as Bankart lesions. (http://www.mmarmedical.com)

Just back from the hospital

I was told in the hospital that I needed to rest for the first week and then visit the hospital physio. I spent that week talking to friends via Facebook, E-mails, Face to Face, etc too try and find out as much as possible about this injury. Obviously as a kayaker and with a dream job with Love it Live it and Kayak the Nile starting in July I needed to make sure my shoulder was going to be as strong as possible after this injury. I heard some horror stories which freaked me out to be honest but I tried to ignore them. 

I went to the hospital physio and I was given some basic exercises to help me get my shoulder moving again. These included, pushing my hand against the wall (fig 1) and using my other arm to help the bad one move (fig 2).

 

Push against the wall (fig 1)

Before I continue I feel its important to make sure people know that if you do get a shoulder injury like this, find a sports physio who will take you seriously, has experience and knows what they are talking about. What I am showing you is what worked for me, remember everyone is different. Don't try and self treat, its not worth it. 

I found a physio, who came highly recommended and also very new school. By new school I mean her exercises are based very much on new research and she had no problem dry needling tight and knotted muscles. 

Words from my physio - "you should come back from injury strong than before" (true!!)

My healing process

Week 1 28-12-12

• Rest 
• Pain killers 
• Depressed 
• No driving
• College work
• No training basically a shit time and no fun.

Week 2 4-1-13

• Basic exercises as above given from the hospital pyhsio
• Research into shoulder injuries
• Found my physio
• Still no training.

Using my good arm to help lift the injured arm (fig 2)

Week 3 11-1-13

• 3 physio sessions
• New exercises
• Back in the gym cycling to keep fit
• Dry needling to loosen tight muscles and release knots
• Exercises done twice a day 
• Foam rolling done 3 times a day
• Introduced to the importance of setting my shoulder (shoulder back and down) i focused on this throughout my rehab and still do in my training 
• Back using my right arm gently throughout the day.

Stand up press ups against the wall

Doing the alphabet with my hand on the swiss ball.

(notice the shoulder is set)

Foam Rolling middle back (10 times, dont roll over the lower back)

Foam rolling lats (10 times do both sides)

Week 4 18-1-13

• 2 physio sessions
• Dry needling, new exercises
• Foam rolling 3 times a day
• Carrying on with some exercises from last week
• Back in the gym (Im very lucky to have a strength and conditioning coach who was also in contact with my physio)
• 20 minute kayak erg session
• Driving again safely!

Progression from last weeks stand up press up to a kneel down press up

Single arm bent over row (before the injury i was using 36kg dumbbells after the injury i started with 3kg dumbbells)

Kayak ergometer 

Week 5 25-1-13

• 2 physio sessions
• Foam rolling 3 times a day
• Keeping same exercises
• 40 minute kayak erg session 2 x 20 minutes (these sessions were done at the easiest setting and not at a high tempo).

Theraband exercise (making sure the shoulder is set to use the rotator cuff)

Same as above but the band is on the other side (notice the elbow is slightly under the shoulder and the shoulder is set)

Week 6 1-2-13

• 2 physio session
• First flat water session (in my creek boat, technique and endurance session, stern rudder, bow rubber, forward, backwards, sweep, reverse sweep, hanging stern draw, draw stroke, stopping. all strokes were done back at a very basic level, slow steady strokes Thanks to the CIT boys for keeping me company and carrying my boat) When doing these focus on counting the strokes and structure the session, e.g. 10 x sweep stroke right hand, 10 x sweep stroke left hand, full focus on technique.
• Pool session practising rolling
• Foam rolling 3 times a day
• Keeping exercises going
• 40 minute kayak erg session 2 x 20 minutes
• Back into the squad gym sessions lifting very light. 2 days a week

Bend over row (set the shoulder slow steady lifting, keep the core strong, light weight)

Floor press (slow steady lifting, make sure you have someone to spot, light weight)

Week 7 8-2-13

• 2 physio sessions
• Foam rolling 3 times a day
• Squad gym sessions (upping the weight) 2 days a week
• Kayak varsities (endurance race 6k)
• Rest days before the race
• Warm up includes Theraband exercises
• Progression onto fast movements for the shoulder.

7 weeks and I had a good race the shoulder felt good throughout but I was still very aware of it

Week 8  15-2-13

• Down to 1 physio session a week
• Foam rolling 3 times a day 
• Kayak erg session (2 x 20mins raising the tempo)
• Squad gym session ( power exercises, box jumps, goblet squats) 2 days a week
• Started pull ups again (make sure you dont fully extend at the end of the pull up and slowly come down)
• Freestyle session for 30 minutes.
• Still going with physio exercises.

Very happy to be back on moving water (this session went well however i was aware of the shoulder)

Week 9  22-2-13

• 1 physio session
• Foam rolling 3 times a day
• Kayak erg session (20 minutes)
• Squad session the weight  raising quickly
• Galway fest (extreme race grade 3)

Galway fest final rapid, 3rd place (6 mins 09 secs)

Even decided to take part in the reverse boater x (shoulder felt great throughout the day much less aware of the injury)

Week 10 1-3-13

• 1 physio session
• Foam rolling 3 times a day
• Kayak erg session (2 x 20 min session)
• Starting to get back lifting good weight in the gym
• NSR in the UK no kayaking or training
• Bad hangover after this week 
• Got the all clear from the physio

Week 11 8-2-13

• Back front squatting (4 x 80kg) and power cleaning (92.5kg 1 rep max) in the gym 
• Finding over the head exercises still difficult
• Wacko on the Jacko extreme race (class 3) this race included 1 timed race (8mins 41secs 3rd place) boater x (2 rounds) teamed race.

Wacko race (shoulder feeling good all weekend even less awareness of the injury)

Above is a short account of my recovery from my shoulder. I am currently in my 12th week and still working hard at trying to make a full recovery. After 12 weeks I still have slight pain in the shoulder and movements over the head have to be done carefully. 

First visit to the Physio

When I first met my physio I explained my injury and the way it happened. It does sound kind of far fetched when you explain you fell upside down in your kayak and hurt your shoulder. What I did was send her footage of myself creek boating and freestyling and explained that I needed to do that again and at the same level. After this my physio changed her approach in terms of respect for the sport and the exercises she gave. The one thing that stood out to me after this visit was her telling me that I should be stronger and better coming back from this injury if I play my cards right and do what is needed. 

After 12 weeks i have noticed my lifting technique is better in the gym and my over all flexibility have improved hugely.

A few tips and advice from my experience.

1. Dont use this to self treat, I left out loads of exercises on purpose so know one can.
2. Find a good physio and stick religously to what they tell you to do.
3. Try not to go on the piss your muscles tighten up and your physio will dry needle them and it hurts like hell (thank you NSR)
4. Stay positive throughout your whole recovery, don't let anyone tell you, your shoulder will never be the same.
5. Dont let your shoulder in the sling for too long, don't be afraid to move it.
6. SET YOUR SHOULDER
7. SET YOUR SHOULDER
8. Dont rush into anything take your time
9. Dont do nothing!!
10. Make sure you train both shoulders don't let the good shoulder get weak!!

Any questions please comment bellow and i will do my best to answer.

I will add to this as much as possible.

Check out the comments bellow, some interesting articles placed up there, thank you!