Thursday, 11 February 2016

Shoulder Health Part 1

Shoulders are a valuable tool for kayakers whether flatwater touring or hucking big drops with a much higher degree of importance than any single piece of kit our shoulders are a vital component of the engine of our kayaks, over the next few posts I'm going to elaborate on my own surgery, rehabilitation and with the help of Jenny Ridley shoulder health and conditioning for paddlesports.

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Injury

An injury is one of the biggest barriers facing any athlete.
Injuries can be caused a number of different ways and preventative measures can be put in place to reduce the likelihood of sustaining an injury.

One of the biggest causes would be overuse this can be as a result of too much training but more likely poor posture and or technique whilst trading. This is most likely to happen when fatigued the body will be trying to "cheat" making the activity easier to avoid pain. This is an education by using training plans and knowing your own body rest days can be used allowing the body recovery periods.
With in paddlesport it's import to plan and take rest days when away on trips or expeditions allowing the body recovery time otherwise there will be a noticeable drop in paddling ability due to fatigue. Many people will head to the alps during the spring having only paddled occasionally beforehand think about taking a day off the water.

Accident

Injuries can be caused through accidents by yourself or another. Falls and slips are always a risk but can be minamised with correct footwear and or roped systems.
On the water accident can happen with tripping edges rocks and waves. Be sure to know your limits and understand the risks. By putting your self on rivers above your ability your putting both yourself and others at higher risk
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Understanding risk vs reward and knowing when to walk away

This is what makes a good paddler a safe paddler. Many young paddlers think they are invincible and takes a big scare to bring them back down to earth. You must learn to have both the understanding and knowledge to know your own ability level and an understanding of the consequences you face to then make an informed decision of your actions. Walking away is a perfectly acceptable option in all cases.
Paddlers will keep pushing the bar opening new lines and moves but they do this knowing their crew are solid and also understand.
Injuries sustained when pushing outside ones ability are likely to be much worse as panic will factor, causing people to forget some of the most simple things.

Swims

So swims are basically covered in the last section but being out of your boat can be one of the worst places to be, having a good knowledge of defensive swimming and knowing when to walk will lower the risk.


 

My Injury


So understanding the risks is one thing but trying to avoid them is another.

My Injury was a result of my own negligence for my body.

At the time I would neve have admitted anything but having educated myself further over the past 18 months I can look back and see the mistakes I made.

Early in 2014 I had decided I wanted to paddle everyday I got to day 94 before injury.
In hindsight I could definately have reduced the risk by actually taking rest days and listening to my body.
In early 2014 I had purchased a Gui Gui Easymix and had recaptured the love for freestyle kayaking, alongside my creeking.

With world cups coming back to Europe and friends travelling whom I had not seen in 5 years, I made plans to compete. Training hard and paddling really well again. But during a training session at Sluice a few days before traveling to king of the alps in Italy, as I set up on the feature for just one more trick.

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As I plugged for a big air loop I left a blade trailing in the water so as the boat lifted and came over the blade remained "caught" in the flow . As the tail came over the blade released with force. Earlier in the session I would of held the blade but due to fatigue the power of the water propelled the shaft towards me. Whilst midloop I felt the impact unsure what had hit me but I was upside down, disoriented and alone. Like a brick had hit my temple. A lucky recovery and I was right way up but unable to comprehend what had happened.
As I floated to the get out I struggled to just keep the boat vertical. I remember getting out of the boat and feeling instant nausea.
It turns out my helmet had lifted a little whilst inverted and I had hit myself with my hand gripping the paddle shaft in the right temple giving myself serious concussion.
I spent the next week attempting to work struggleing to even look at a computer screen unable to concentrate for any period of time and determined to fly to Italy a few days later.

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Arriving in Italy I was still having headaches and having to sleep every few hours, I couldn't concentrate for any period of time.
Physically I was in the best condition I could be, but mentally I just wasn't at the races.
On a spin in the magnificent Passer Gorge I came through onto the waterfall making the entry but pushed left and over rotated landing on the right blade putting a huge impact through my shoulder the pain was like tearing my arm and my neck unable to move and my upper chest cramped with pain.

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I continued to paddle the race and a few days away with the Pyranha team tour in Oetz but I was visibly carrying an injury at the time assuming it was just a strain some high water fun left me surfing a big hole as the strength wasn't there to pull the boat through.

Returning to Ireland I had just 7 days until heading to France for freestyle world cup 1 in Millau. During the week I had a number of sessions with a local physio who did her best to patch me up knowing I was determined to go. Her feeling was that part of the reason I had damaged my shoulder was due to protecting my head, she proved her point whilst dry needleing and applying different pressures to show that yes my head is connected to my neck! I continued training everyday working hard but the pain remained.

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Arriving in France to the town of Millau just in time for team training. Fortunately I was the only representative for Ireland so joined another team for training.
My first couple of rides just getting the feel for this new feature a small low volume hole at the top of the course. Cartwheels , loops and space godzillas were coming through nicely for the third ride I wanted to practice my tricky-woos.

I initiated on the right, splitting the tail and went to reach around for the third end as I did I realised I hadn't quite enough edge with the water pushing the boat and my blade in opposite directions, as the boat rotated I felt a pop like a balloon sucking away and exploding on my right shoulder the pain was torturous for the next second I was underwater unable to roll unable to breath a last gasp drive at the water and I was upright. I went to push the paddle and felt a pain the length of my arm releasing my grip and leaving me flapping. With some help from others I was on the bank out of the boat lying flat on my back with my eyes closed trying to comprehend what had just happened.

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Luckily medical team was on site who put me in a van and onto the local hospital. Lots of drugs and a massage later I had dislocated my right shoulder but it had dropped back in almost instantly.
The hospital were great got me checked out and into a sling to minimise use. They recommended visiting a doctor on my return to Ireland.
This left me extremely sore and unable to hold a paddle let alone get in a boat

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Unfortunately again I didn't listen. Having travelled all that way I wanted to demo a new helixir before ordering my own. I couldn't even hold a paddle yet but 4 days after the dislocation I got into the boat on the flat dropping superclean flatwater cartwheels and splits loving how the prototype felt, As I went to reach to take a stroke the pain was immense once more the arm cramped and I got out tail between my legs knowing I certainly shouldnt of been back in a boat.

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On my return to Ireland after the swelling had dropped I continued with physio sessions they recommended getting an MRI to see the extent of the damage caused as I had a lot of instability in the joint.
So off I went to visit an Irish GP unlike anywhere else in the world in Ireland you pay your €60 then basically dictate to a GP what you want them to write on a piece of paper so he sent off my letter to the shoulder specialist stating I was a high performance athlete and needed to be seen ASAP

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2 months later I got a call to go and visit the hospital.
I met Dr Hannon Mullett who is the Number 1 shoulder guy in the country he was fantastic, identifing the pain and the cause and understanding how the injury was caused, he administered a steroid injection to help relieve some of the pain.
This worked for day to day activities but paddling still hurt me a lot.

I was then booked in for an MRI scan this came through another 4 months later.
So in I went for my Arthogram whereby they inject a dye into he joint to get a contrast on the MRI. Into the big machine buzzing and humming whilst I wait with headphones on trying to relax.
Xray 3T - IMG_0759(2)_0

Another 4 months passed before I get a call to review the scans at the hospital, so in I trot, first being told that there is a small tear but that wont be causing any issue and how could Kayaking result in such an injury, a few minutes later Dr Mullett comes in and within approximately 18seconds he leaves me on the floor crying like a small child in absolute agony before pointing out to the registrar the extent of the damage and that it will require surgery.

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The MRI shows a small tear in the Labrum as well as an impingement and a lot of fluid in the shoulder joint.
I asked Dr Mullett can I paddle and what I should/Should not be doing he told me not to take up smoking but to do as much as I can as I shouldnt make it much worse - (famous last words)

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So off I trundle to Europe for 2 weeks of big creeking racing and waterfalls. Day one on the passer race course I came through a simple class 4 rapid on the exit I pulled a right hand stroke as the pain gripped me the cramped chest the same tearing pain was back I couldnt comprehend on the morning of the race I was driving around trying to buy anti-inflammatorys and physio tape.
I lined up at the start knowing that just finishing the race would be a bonus, I hadnt been training and I wasnt fit but I had a lovely paddle regardless choosing not to paddle the finals course knowing I was not strong enough for it (at last I had learnt)
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Another day and we hit the Inn in Switzerland running at huge flows I decided to go paddle another sore day and for the following day I turned down the paddle choosing to drive shuttle (twice in a week id made a good desicion)
A couple more rivers and a couple of rest days I was really getting the hang of looking after myself but unfortunately far too late.
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I returned home and waited
and waited
and waited
And went to sickline!

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not to race but to watch, I made 4 runs of the wellebrucke rapids falling down the racecourse my boat ability was there but my strength had deserted me, the pushy whitewater was too much for me as I hadnt paddled or trained.

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Then eventually 7 months on from the last appointment my date came up for surgery.
I was booked into the Cappagh Hospital at 7am ready to go into theatre I was high as a kite and out of my tree by 8am. unfortunately I then go left to wait until 2pm before it was my turn the surgery was due to take 60-90mins then a bit of time to recover from the anesthetic they said about two hours.
At 2:30pm I was looking at an ultrasound showing my shoulder and neck where they were going to push the nerve blocker in and thats the last I remember.

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I came around at 8pm having spent 4 1/2 hours in theatre.
I didnt even realise I was wearing a sling for the first hour I couldnt feel anything for nearly 2 days no pain at all all I realised was I had a nappy around my shoulder to protect the 6 incisions.

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Once in theatre they had found a lot more damage than the MRI had show this was mainly due to the fact the MRI scan was a year old at this point and I had done more damage through continued paddling.
The surgery was split into a few parts
Repair - to sew back together the tear in the labrum the small tear they were expecting had expanded hugely to a very serious Bankart Lesion Tear

A Bankart lesion is an injury of the anterior glenoid labrum due to anterior shoulder dislocation.
These labral tears make the shoulder unstable and susceptible to repeated dislocations.

bankart-repair-diagram

Stabilisation- As part of the process they then want to stabilise the joint by attaching anchors into the bone and sutures to support the joint.
Because of my level of activity I had 4 anchors each double tied to create greater support.

Decompression - this is where they basically shave off the impinging bone and then scrape away scar tissue and remove the build up of fluid in the joint.
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After surgery I spent one night in Hospital, because of the drugs I felt no pain and slept fine.
After coming home I was to wear the sling 24 hours a day for the first 8 weeks this meant no driving and not allowed to use the right arm whatsoever. Of course I did do small things but my range of motion was limited I couldnt even scratch my chin.

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Now 9 weeks out I have finally removed the sling, reporting to the hospital physio every other week to monitor progress. I am building a range of motion, still unable to life my arm above my head and in a huge amount of pain when I stretch or reach too far.

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The biggest thing now is just being able to trust the joint again as its stronger than it was originally.
From taking to people and physios the recovery is likely to be 6 month before I can get back paddling anything that moves before that I may be able to float calmly in the shallows.
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The rehab in constant and never ending. Im not great at keeping it punctual but am doing plenty and can see the improvements I can now reach my head and tie my shoelaces so coming along well.
The biggest thing is not to rush back and I feel I have learnt the self control to stop and think about whats going on.

The next step is pure rehab starting from the basics posture and balance whilst rehabing the shoulder its key to fix everything else to reduce the risk of a reoccuring injury
In the next post we will look at shoulder health some simple exercises and stretches to keep your shoulders strong and healthy

Since the injury I have paddled my new Helixir just 4 times so definately looking forward to getting her back out when im strong again

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Thanks to all the surgeons doctors and nurses whom looked after me unfortunately the 18month wait was long and slow but eventually worthwhile.

Also thanks to all the sponsors who have stayed with me whilst out injured I promise once im fixed to get some mega content out!

Yak Adventure Paddling, Keen Europe, Jack Wolfskin, Pyranha Kayaks

Thursday, 31 December 2015

2015 Wrap up

So its New Years Eve and I keep seeing wrap up videos popping up from everyone’s fantastic years, Unfortunately I’ve spent this year “injured” and awaiting surgery, Luckily tho I’m typing this one handed as I eventually got my surgery, so a poor domestic year with little paddling done in Ireland but I did manage to sneak away at any opportunity with a few big changes this year and plenty more to come next year with only 3 weeks left in a sling then onto rehab and come back bigger and stronger.

Heres some of my favourite moments from 2015!

January

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So January started in the flooded Kerry hills my first NY in Kerry with Bren, Rowan and every other paddler so plenty of paddling and a nasty pin/siphon with trees left me battered and sore on the Gaddagh luckily theres no video of this so Il leave it out and top January moment was a beautiful winters walk into Ness Country Park to check out the Famous Ness Falls

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February

As alway here come Varsities, this year back in Galway and a quick spin and dip on the Boluisce was in order

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I also managed the session in my new Gui Gui Helixir (Id had 6 month but hadnt paddled due to injury)

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March

We headed for a break in France, with some wave paddling, chilling with good friends followed by Disney land the perfect break.

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On our return it was a time for Club Champs

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April

We headed for a week in Donegal meeting the new baby Eva, Frandenbroek, some local exploring and the Inishowen Sea Kayak Symposium

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And of course Penny’s Birthday IcecreamFB_IMG_1430207072439

May

May started with the worldwide wings for life run in Dun Laoghaire

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And the Banff Film Festival walked in

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June

England football team came to town.

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And I hit Europe for a couple of weeks

Germany-Switzerland-Austria-Italy in a whirlwind tour.

King of the alps followed by some big volume Swiss fun!

 

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Still waiting for shoulder surgery I battled on with the help of my trusty Shoulder survival kit

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July

We headed to Sharm Al Shaikh in Egypt for some sun, sea and sand.

Diving, snorkelling and quad biking!

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August

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So August, I left my job at Great Outdoor……. and we got another Puppy!

Im sure everyones seen Marlon hes a French Bulldog with a spinal cord injury but hes progressing really well! nothing else really matters in August because Marlon (and Penny) are soooo Awesome!

Check out their Facebook Page ---- Marlon and Pennys adventures

 

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September

This month was all about the Liffey with first up Odyssey on the Liffey

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and then Liffey Descent

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In between we had a quick dose of KanuMesse to see the latest and greatest from the paddlesport industry.

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and a new Yak and Pyranha Delivery Landed on my door

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October

So once again back to Europe – This time by road.

Ireland-France-Switzerland-Austria-Italy-Switzerland-France-Ireland

A stop at Sickline to see lots of friends but sadly not compete due to injury.

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And home just in time for CranaFest weekend

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November

THis was a quite month with a highwater spin on the Glens and a few liffey runs to keep me wet.PhotoGrid_144709012199612279187_674355501814_4737807317139438094_n

December

At last time for surgery (another post on this soon) but after 18 months of waiting about time

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A visit from Mom And Fi

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The Annual Turkey Race

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And Christmas was a one handed affair at home with the Puppies and Jen.

 

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So to wrap up its been a pretty good year with some super highlights (Marlon) and big changes.

Now its time to start the rehab and get set for an action packed 2016

Thanks to everyone for being a part

#keen #yak #icanoe #greatoutdoors #walshyway #pyranhakayaks #jackwolfskin #mom #frenchies #jen

 

See you on the water

…………. Well about June 2016 I hope.

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