Injuries in Sprint

Canoeists and Kayakers:

Etiology, Mechanisms of
Injury, Treatment Options,
and Practical Applications
Thomas W. Pelham, PT, MSc, CSCS,1 Michael G. Robinson, BSc,2 and Laurence E. Holt, PhD3
1
Private Practice, Halifax, Nova Scotia, Canada; 2Calgary Canoe Club, Alberta Sprint Racing Canoe Association, Calgary,
Alberta, Canada; and 3School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided
in the HTML and PDF versions of this article on the journal’s Web site (http://journals.lww.com/nsca-scj).

ABSTRACT
On-water and dry-land training pro-
grams for sprint canoeists and kayakers
are physically demanding. Musculo-
mental Digital Content 1, http://links. body for sprint canoe and kayak) has
lww.com/SCJ/A275. grown to more than 150 member
countries (7). As a truly international
sport, the competitiveness among
INTRODUCTION
countries has resulted in a significant
t the Olympic Games and

skeletal injuries particularly to the
shoulder, thoracic, and scapula regions
are common. Overtraining can lead to
muscle imbalances, glenohumeral and
scapular kinematic dysfunctions, soft-
tissue damage, and pain. Preventive
programs are required. However,
objective research-based evidence for
sprint canoe- and kayak-specific pre-
ventive programming is lacking. This
study will discuss common injuries
sustained by paddlers, the mechanisms
of these injuries, treatment and pre-
vention approaches, and practical ap-
plications highlighting the need for
coaches, clinicians, and strength and
conditioning professionals to take
a proactive approach in addressing
high-risk injury factors. For a video
abstract of this article, see Supple-
Address correspondence to Thomas W.
Pelham, tom_pelham@yahoo.ca.
A
World Championships, men
and women in the sport of
sprint canoe and kayak may compete
in the canoe single (C1), 2 person (C2),
kayak (K1), K2, and K4. Race distances
vary between competitions; 200, 500,
and 1,000 m have been common
events. In past games and champion-
ships, competition among elite,
international-level paddlers has been
intense. The performance margin
between victory and finishing off the
podium has been within fractions of
a second. At the 2019 world champi-
onship in Szeged, Hungary, the win-
ning time for the Men’s K-1 200-m A
Final was 34.86 seconds, whereas ninth
place was 35.81 seconds (8); all 9 final-
ists were within 1 second.
As a long-standing Olympic sport,
sprint canoe and kayak have continued
to grow in popularity worldwide. Over
the past 85 years, the International
Canoe Federation (the sport governing
increase in the pressure on athletes to
train harder with the accompanying
increased risk of injury.
In the drive for excellence, the techni-
cal and conditioning coaches and the
athlete’s health care team members
must be aware of the negative conse-
quences of poorly designed training
programs. Overtraining or contraindi-
cated exercise protocols often lead to
serious injuries, forcing athletes from
competition, and in many cases short-
ening the career of the paddler.
To fully explore the injuries sustained
by paddlers, the mechanisms of these
injuries, treatment options, and practi-
cal applications available, this article
has been systematically divided into
several sections. The following
KEY WORDS:
paddling; overuse; muscle imbalance;
training

22 VOLUME 42 | NUMBER 3 | JUNE 2020 Copyright Ó National Strength and Conditioning Association

Copyright © National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
 sections will be discussed in turn: kine-
matics and kinetics of the canoe and
kayak strokes, training of sprint canoe-
ists and kayakers, potential injuries,
mechanisms of injury, treatment op-
tions, and practical applications, high-
lighting the need for coaches and
conditioning professionals to take
a proactive approach in addressing
high-risk injury factors.
KINEMATICS AND KINETICS OF
THE KAYAK AND CANOE STROKES
This section has been divided into 2
sections: kayak stroke and canoe
stroke. Each will be discussed in turn.
KAYAK STROKE
In 1985, Logan and Holt (13) pub-
lished in the Sport Performance Series
of the National Strength and Condition-
ing Association Journal one of the first
descriptions of the kayak stroke. Using
a descriptive kinesiologic/applied
anatomy approach, Logan and Holt
(13) separated the kayak stroke into 4
phases: recovery, catch, pull, and exit
Figure 1A–D.
During the recovery phase, the paddle
travels through the air and is relatively
horizontal to the water surface. For
Figure 1. (A) The recovery phase of the kayak stroke. (B) The catch phase of the kayak stroke. (C) The pull phase of the kayak stroke.
(D) The exit phase of the kayak stroke.
Copyright © National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
a right-side power application phase,
the paddler rotates the trunk in a coun-
terclockwise direction (to the left)
moving the right side arm and paddle
to a forward position, with the elbow
near complete extension, the shoulder
joint moderately flexed, internally
rotated and horizontally adducted.
This phase ends with the set up for
the catch (13).
The catch is initiated with the prepa-
ratory subphase (set up) where the
blade of the paddle is positioned nearly
perpendicular to the water surface
which is followed by the blade enter-
ing the water and quickly being fully
submerged (13). In the pull (or propul-
sive phase), the blade travels parallel to
the boat in a posterior direction. Dur-
ing propulsion, the athlete attempts to
generate maximum power through the
paddle with the goal of peak boat
acceleration. This is accomplished by
rotating the torso in a clockwise direc-
tion while adducting the scapula and
extending the shoulder joint. This is
accompanied by extension of the
stroke side hip and knee joints. Elec-
tromyographic (EMG) recordings of
the supraspinatus, latissimus dorsi,
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and upper trapezius were found to be
active during propulsion (29). The
upper trapezius was believed to assist
in the stabilization of the scapula that
in turn facilitates the stabilization of the
humeral head by the supraspinatus
(29). The phase terminates with the
initial removal of the blade from the
water (13). When the blade is fully
removed from the water, the next
stroke begins with the recovery phase.
Kinematically, the kayak stroke is
a bilateral cyclic movement (13). De-
pending on the boat (single versus
crew), race distance, and environmen-
tal conditions among others, stroke
rates can range from less than 90 to
over 120 strokes per minute. The
stroke rate is the primary variable to
increase 200-m performance times in
subelite kayakers (16). Duration of
a race can range from less than a minute
to several minutes.
From a kinetic standpoint, the paddler
must maintain stroke displacement
(maintain force production per stroke)
during the propulsive phase of the
stroke while increasing stroke rate to
achieve an increase in boat velocity
(12). An abrupt departure or deviation
23
 Injuries in Paddling
in race velocity is highly physiologi-
cally and psychologically demanding
on the athlete and not an effective race
strategy (12). In any phase of the
stroke, unwanted boat movement
(pitch, roll, and yaw) can occur that
will increase lift and drag forces. Drag
forces can increase as much as 14% in
kayaks and 22% in canoes (9). The
maximum application of propulsive
force and minimizing of unwanted boat
movement is a function of the technical
efficiency of the paddler and the team-
work of the crew.
CANOE STROKE
In a second publication in the Sport Per-
formance Series of the National Strength
and Conditioning Association Journal, Pel-
ham et al. (21) described the flatwater
canoe stroke using an EMG analytical
approach. Findings from the study sug-
gested that the canoe stroke had similar
phases to the kayak stroke. Most impor-
tantly, the canoe stroke could be divided
into 4 phases: exit, recovery, entry, and
propulsion (25) (Figure 2A–D). There
are several distinct and important dif-
ferences between the phases. First, the
canoeist is kneeling not sitting. Second,
the athlete steers the canoe by manipu-
lating the paddle (J-stroke). In the kayak,
Figure 2. (A) The exit phase of the canoe stroke. (B) The recovery phase of the canoe stroke. (C) The entry phase of the canoe stroke.
(D) The propulsion phase of the canoe stroke.
24 VOLUME 42 | NUMBER 3 | JUNE 2020
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the paddler uses a rudder to direct the
boat. Third, unlike the kayak stroke, the
canoe stroke is an asymmetrical rhyth-
mic activity (21). The canoeist exclu-
sively paddles on the right or left side of
the craft.
One continuous abduction move-
ment of the stroke side shoulder joint
performs the exit of the blade from
the water. Once completed the blade
travels forward as a consequence of
trunk rotation away from the stroke
side (recovery phase). At a predeter-
mined point of trunk rotation with
the blade usually at a 60-degree angle
to the water surface, the canoeist pla-
ces the blade in the water. Once fully
submerged (end of entry phase), the
blade of a technically elite canoeist is
forcefully drawn backward using the
following sequence. Concentric con-
tractions of the stroke side hip flexors
and the opposite side hip and knee
extensors, while the trunk, shoulder
girdle, arm, and hand are contracting
isometrically transferring the forces
of the leg contractions to the body
resulting in displacing the trunk and
the paddle backward. This is fol-
lowed by concentric contractions of
the trunk, shoulder girdle, and arm
musculature that results in rotation
of the trunk and ends with hyperex-
tension of the shoulder joint. EMG
data from Pelham et al. (21) showed
that the stroke side middle trapezius,
rhomboids, and serratus anterior
were highly active during the entire
propulsion phase, working together
to first stabilize then to move the
scapula. During the propulsion phase,
the boat travels past the blade, with
the entire force production being
accomplished through drag forces.
The top hand, regardless of the side
preferred, is the stabilizing force, the
bottom hand is the motive force, the
water is the resistance force, and the
blade is the propulsive surface creating
a third-class lever system (21). From
a biomechanical standpoint, interna-
tional class canoeists have used the
third-class lever system to maintain
60 strokes per minute with boat veloc-
ity of 4.17 m per second over the course
of 500- and 1000-m C1 races (21).
TRAINING OF SPRINT KAYAKERS
AND CANOEISTS
To prepare for competition, a compre-
hensive regimen of sport-specific train-
ing is essential. To reach the pinnacle
of the sport (compete and win at the
international level), athletes train
 without interruption on- and off-water
several hours per day for many years.
On-water training includes technique
sessions, interval training, longer aero-
bic sessions, and combinations to fully
condition the athletes. Dry-land pro-
grams are intended to condition the 3
energy systems, oxidative (aerobic),
glycolic (anaerobic), and phosphagen
(anaerobic).
All training programs for paddlers
should follow 2 important training
principles: specificity and individuality
(27). Each will be discussed in turn.
The principle of specificity suggests that
a training program must adhere to spa-
tial and temporal and dynamic charac-
teristics of the sport. Adjunct
conditioning such as dry-land training
in the sport of sprint canoe and kayak
must reproduce the muscle-specific
movement patterns and contractions of
the sport. The use of a canoe (21) or
kayak (13) simulator is ideally suited
for paddlers in northern climates unable
to access open water during winter
months. Dry-land neuromuscular exer-
cises must match the spatial and tempo-
ral kinetic and kinematic characteristics
used during a race. Any positive carry-
over from generalized non–sport-specific
conditioning to sprint canoe and kayak
race performance has never been scien-
tifically demonstrated.
On-water training should focus on the
race distance (200, 500, and 1,000 m).
Although the 3 energy systems are
involved, the concentration of each
during the race, that is, the bioener-
getic demands of the various distances,
is unique. Therefore, the on-water
physiological training of paddlers rac-
ing 200 m will differ considerably from
athletes racing at both of the longer
distances. An understanding of each
individual’s energy profile should also
be taken into consideration when plan-
ning on-water programs. These indi-
vidual differences should be
considered when designing race tactics
for each distance and should be built
into the training program.
Overall, every aspect of a training ses-
sion must take into consideration the
Copyright © National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
movement patterns used while propel-
ling the craft (kayak or canoe) during
a race. As well, the training session
must carefully consider the physiolog-
ical demands of the race distance and
the unique psychophysiological
strengths and weaknesses of the pad-
dler in designing a race plan.
Using the principle of individuality is
crucial if a training program is to be
successful. Cookbook programs have
long been discredited. Indeed, a one-
size-fits-all approach can be harmful to
the paddler that could lead to injury. A
training program must be designed for
the individual.
The current trend of designing pro-
grams that span several weeks or
greater must have built-in mechanics
that account for the dynamic biopsy-
chosocial nature of training for a sport.
Although an individualized training
program must be well organized with
specific short- and long-term goals, the
ability to adjust the program to the
athlete’s health status and lifestyle is
essential.
Overall, a training program must be
designed to improve those character-
istics that are amenable to improve-
ment that are known to be an
essential part of the performance and
to maintain those characteristics that
are already at an optimal level.
TEST PROTOCOLS
For many years, testing has been an
integrative part of the evaluation of ca-
noeists and kayakers (22,26,30). Vari-
ous testing methods have been
designed ranging from aerobic capacity
testing using dry-land canoe and kayak
simulators (22) to on-water race trials
using sport-specific accelerators (26).
Regular sport-specific testing can be
a valuable tool for the athlete
and coach.
POTENTIAL INJURIES
Information on injuries among
kayakers and injuries among canoeists
will be presented. Given the fact that
there is a paucity of published research
on injury rates among sprint kayakers
and canoeists (18), injuries among
Strength and Conditioning Journal | www.nsca-scj.com
athletes in related paddle sports will
complete the section.
INJURIES AMONG KAYAKERS
In a study of Swedish sprint kayakers,
Johansson et al. (11) found 54.8% of the
subject pool with shoulder pain. In the
study, kayakers with shoulder pain had
reduced shoulder internal rotation
range of motion.
Hensel et al. (6) found musculoskeletal
injuries were common among female
Brazilian kayakers. Most athletes
(87.50%) reported a musculoskeletal
injury. In fact, each paddler, on average,
reported 4.88 injuries. The top 5 ana-
tomical sites for injury were thoracic
and thoracolumbar region, 35.90%,
lumbar spine region, 20.51%, shoulder,
17.95%, forearm, 15.39%, and wrist,
5.13% (6).
In a survey of 145 Greek sprint
kayakers, 39.4% reported at least 1
sport-related injury during the com-
petitive season (20). Shoulder injuries
were the most prevalent, 21.1%, fol-
lowed by the low back, 7.7%, and the
wrist, 7.7%. Tendopathologies were
41.9%, strains 25.8%, and sprains 6.55%.
From the available literature, it would
appear that the shoulder girdle com-
plex (particularly the glenohumeral
and scapular regions), low back, and
elbow/forearm/wrist were the com-
mon sites of injury in sprint kayakers.
Complaints of soft-tissue injury were
frequent.
INJURIES AMONG CANOEISTS
There is a void of published research
on the incidences of soft-tissue injuries
among sprint canoeists. Pelham et al.
(23,24) have suggested that shoulder
pathology is a major problem among
sprint canoeists. However, comprehen-
sive research is required.
INJURIES AMONG ATHLETES IN
RELATED PADDLE SPORTS
Injury data were found for other pad-
dle sports. Injury profiles of male and
female dragon boat competitors were
similar to those found with sprint pad-
dlers. The lumbar spine region, shoul-
der, and wrist were the top 3 injury
25
 Injuries in Paddling
sites (19). In a New Zealand study
involving Waka Ama paddlers, 52%
of the respondents reported at least 1
injury (1). Paddlers chief complaints
were sprains and strains of the low
back and shoulder. The rotator cuff
was the predominant site for overuse
injury in marathon kayakers (5).
In an online survey of participants of
paddle boarding, 14.3% reported
shoulder injuries, 11.8% low back,
and 32.9% elbow/forearm (4). Soft-
tissue injuries were common.
MECHANISMS OF INJURY
In this section, the following will be
presented: faulty on-water technique,
on-water overtraining, flexibility defi-
cits, and muscular imbalances. Each
will be discussed in order.
FAULTY ON-WATER TECHNIQUE
Even proper stroke mechanics have
been criticized. In the canoe stroke,
the lumbar spinal, pelvic, and hip re-
gions are flexed forward, with the tho-
rax laterally flexed and rotated away
from the stroke side during the prepa-
ratory and catch phases of the stroke.
From a biomechanical standpoint, this
combination is a highly effective kine-
matic mechanism that places the
prime movers in position to generate
maximum power output that translates
into maximum boat velocity. However,
since this is an asymmetrical pattern of
movement needed for propulsion and
is not repeated on the opposite side, it
creates an inherent increased risk of
injury (28). The boney structures and
soft tissues of these regions experience
high torque stresses from the catch
through the early propulsive phase,
rendering them vulnerable for injury.
Repeated strokes increase the physical
stresses on these tissues eventually
leading to fatigue, overload, and
breakdown.
Further during the catch, the gleno-
humeral joint on the nonstroke side
(top hand) of the canoeist can be
highly vulnerable for impingement
(for the purposes of this article, the
terms: shoulder impingement and
rotator cuff–related pain syndrome
26 VOLUME 42 | NUMBER 3 | JUNE 2020
Copyright © National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
shall refer to the same set of signs and During the exit of the kayak stroke, the
symptoms of the shoulder). Pelham shoulder movement sequence begins
et al. (23) have suggested that the with abduction, followed by horizontal
anatomical position of this joint during adduction and external rotation (13),
the catch can reduce the joint’s sub- together with the scapula abduction
acromial space and increase the chance and posterior tilt (11). During this
for soft-tissue trauma, dysfunction, and action, paddlers with muscular or cap-
pathology (Figure 3A and B). sular tightness of the shoulder can be
During propulsion in the kayak, the vulnerable for shoulder impingement.
nonstroke side shoulder joint is at its Similar mechanisms of injury have
greatest degree of forward flexion been found in other paddle sports.
(really horizontal adduction), internal Among injured male and female
rotation, and adduction (5), potentially dragon boat competitors, overuse
reducing the subacromial space (23). while training was suggested to be
To maintain or increase the subacro- the predominant contributing factor
mial space, the scapula upwardly ro- (19). Paddling techniques and training
tates, elevates, and posteriorily tilts volumes in dragon boats are compara-
(32). Without the upward rotation ble with those used by sprint canoeists.
and posterior tilt of the scapula, the The repetitive actions of long distance
soft-tissue structures in the subacromial on-water training sessions were sug-
space would be at greater risk of gested as risk factors for injury among
impingement (5). As suggested in sev- Waka Ama paddlers (1). Overuse was
eral studies (6,11,14,17,31), training- the mechanism of injury for rotator cuff
induced muscle imbalance could alter pathology found in marathon kayakers
scapula kinematics. (5). The volume of paddling was the
A downwardly rotated anteriorly tilted major mechanism of injury in partici-
scapula will decrease the subacromial pants of paddle boarding (4).
space. This will increase the risk of In sum, abnormal movement patterns of
soft-tissue microtrauma potentially the scapula have been associated with
leading to the pathological condition a variety of pathologies of the shoulder
referred to as “Paddler’s Shoulder” girdle including rotator cuff tendopa-
(23) (Figure 4A and B). thologies, shoulder impingement, and
Figure 3. (A) At the initiation of a simulated catch phase of the kayak stroke, the
glenohumeral joint on the nonstroke side of the kayaker is forward flexed,
abducted, and externally rotated. (B) At the initiation of a simulated catch
phase of the canoe stroke, the glenohumeral joint on the nonstroke side is
forward flexed approaching maximum range potentially reducing the
joint’s subacromial space and increasing the likelihood of impingement.
 Figure 4. (A) Tight pectoralis minor tissue will increase internal rotation of glenohumeral joint. Tight myofascial tissue of the levator
scapula and rhomboid tightness will result in downward rotation and an anterior tilt of the scapula that will increase the
risk of shoulder impingement. (B) Although it would appear that the scapula is mildly upward rotated, excessively active
upper trapezius, levator scapula, and rhomboid coupled with an internal rotated glenohumeral joint will lead to an
anterior tilted scapula.

tears to soft-tissue structures of the gle-
nohumeral joint (11). Muscular dysfunc-
tion related to altered neuromuscular
recruitment patterns and limitations in
flexibility could prohibit normal actions
of the glenohumeral joint and various
structures of the scapulothoracic region
(11,15). Addressing these issues is para-
mount during clinical intervention.
ON-WATER OVERTRAINING
Hensel et al. (6) found elite Brazilian
female kayakers were involved in per-
forming 964 hours of “paddling related
activities” during a competitive season
leading to their suggestion that expo-
sure to prolonged and excessive work-
loads increased the risk of injury. There
are several distinct and important dif-
ferences between the phases (e.g., vol-
ume and intensity of the on-water
versus off-water training programs)
that were given.
FLEXIBILITY DEFICITS
Insufficiencies in soft-tissue flexibility
could confine key actions of the canoe
and kayak strokes (11). Several studies
(11,17) found reduced internal range of
motion of the shoulder in sprint
kayakers. In the studies by Johansson
et al. (11) and McKean and Burkett
(17), a goniometer was used to measure
internal and external rotation range of
motion. In both studies, 908 external
rotation and 708 internal rotation were
considered normal. Passive internal
and external rotation was measured
by a physiotherapist in the study by
Johansson et al. (11). Rotator cuff mus-
cular and posterior capsular tightness
were suggested as the underlining fac-
tors increasing the risk of shoulder
impingement (11). Researchers (17)
attributed the above limitations in
shoulder range of motion to on-water
training and not off-water training.
MUSCULAR IMBALANCES
Neuromuscular adaptations occur with
repeated actions of the canoe or kayak
stroke. Neural motor recruitment pat-
terns and adaptive shortening of
exposed soft tissues could alter joint
kinematics. The thoracic and shoulder
regions would be the most susceptible
to arthrokinematic dysfunctions, mus-
cle imbalances, and soft-tissue damage.
Lovell and Lauder (14) found signifi-
cant differences in bilateral upper-body
strength profiles (left versus right)
between injured and noninjured com-
petitive flatwater kayakers. Muscle im-
balances were associated with injuries.
However, structural damage did not
reach the threshold of interfering with
the 5 times per week training program
of members of the injured group. It was
not clear whether members of the
injured group received restorative ex-
ercises to correct the imbalances.
Muscle imbalances were found in elite
Portuguese canoeists. The assessments
of posture and anthropometrics (using
infrared thermography) revealed that
lean body mass, particularly the latissi-
mus dorsi, was larger on the stroke
side of these canoeists (31). As a conse-
quence, paddlers demonstrated asym-
metrical postures. Vieira da Silva (31)
suggested that the degree of variance
from the standard postural alignment
was related to the volume of training.
TREATMENT AND PREVENTION
APPROACHES
In a published case study (18), a young
female canoeist complained of right
shoulder (top hand) and upper back
pain to her health care providers. She
reported that the pain was progres-
sively getting worse and interfering
with her on-water training. An unsuc-
cessful program of manual therapy,
acupuncture, exercise, and pharmaco-
logic intervention eventually lead to an
MRI that revealed an intraosseous gan-
glion cyst of the humeral head. Surgery
was performed followed by physical
therapy that involved range of motion
exercise, postural taping, and a gradual
return to paddling. The authors did not

27
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Copyright © National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
 Injuries in Paddling
state the etiology or the mechanism of
injury.
Vieira da Silva (31) put forward the
notion that preventive measures to
reduce the potential risk of injury
because of the asymmetrical nature of
the canoe stroke should be used. These
tools should target the musculature of
the nonstroke side with the goal of re-
establishing correct alignment and
reducing asymmetry. This would
include having the canoeist learn and
train using the opposite side. However,
since this has not been documented,
there is no evidence demonstrating this
would have a positive effect on the
muscular imbalance nor whether it
would lead to injuries to the competi-
tive side paddling.
McKean and Burkett (17) found
kayakers with reduced internal and
external range of motion in the shoul-
der joint. These investigators stressed
the importance of coaches designing
and implementing programs to address
these shoulder range of motion deficits.
Glenohumeral and scapular kinematic
dysfunction would appear to be the
recurring theme surrounding injuries
to the shoulder complex of paddlers.
An exercise regime of scapular stabili-
zation training and re-establishing
proper sport-specific scapula move-
ment patterns has been advo-
cated (11).
Among paddlers, scapula movement
dysfunction could include excess
downward rotation (23), conversely,
a constraint in upward rotation. And,
a deficit in upward rotation of the scap-
ula could contribute to a shoulder
impingement condition (5).
American osteopath (10) and Cana-
dian sport physical therapists (2) have
offered a variety of rotator cuff
strengthening and scapular stabilizing
exercises. Although not overtly ex-
pressed, a number of the exercises pre-
sented by the clinicians may address
movement dysfunctions of the scapula.
Several corrective/preventive exercises
that focus on scapula action include
activities that placed an emphasis on
scapula setting (2) and the lower and
28 VOLUME 42 | NUMBER 3 | JUNE 2020
Copyright © National Strength and Conditioning Association. Unauthorized reproduction of this article is prohibited.
middle trapezius (10). However, the
clinical efficiency of Jenkinson (10)
and Colebrook and Redman (2) ap-
proaches was not expressed.
Fisher (3) conducted a 10-week exer-
cise program that focused on selected
muscular flexibility, strength, and
motor control with the goal to address
intrinsic injury risk factors. All kayakers
of the exercise group were found to
have scapula dyskinesis. During post-
testing, participants in the exercise
group showed improvements on
selected flexibility scores, speed while
performing a pull activity (simulated
propulsive phase of the kayak stroke),
and scapula kinematics. Although the
findings are promising, the subject pool
was small, 19 subjects, and should be
considered a limitation while interpret-
ing the results of the study.
Motor control training may be benefi-
cial for individuals with shoulder and
scapular dysfunctions. A 10-week
manual therapy coupled with an exer-
cise regimen designed to correct mus-
cle activation sequencing of scapular
kinematics was successful in reducing
pain and increasing function among
young adults with shoulder impinge-
ment (33). A similar line of attack
may be fruitful in a controlled random-
ized investigation using a sample of
sprint kayakers and canoeists with
shoulder and scapular dysfunctions.
PRACTICAL APPLICATION
Errors in technique and faults in train-
ing methods are high-risk factors for
orthopedic injuries among sprint rac-
ing canoeists and kayakers. Coaches
and strength and conditioning profes-
sionals responsible for the design and
implementation of on-water and dry-
land training programs must be vigi-
lant in the identification of signs and
symptoms of overtraining. In efforts
to address errors in technique, coaches
must be proactive and insert regular
skill sessions within the paddler’s on-
water training program providing
advice where needed. Finally, in the
spirit of adhering to a proactive
approach, coaches, clinicians, and
strength and conditioning
professionals should have a mechanism
to analyze factors responsible for inju-
ries and their level of risk specific to the
individual. Injury risk analyses con-
ducted on a regular basis would reduce
the likelihood of orthopedic injuries,
decreasing the need for the athlete to
engage in the reactive clinical treat-
ment milieu.
Conflicts of Interest and Source of Funding:
The authors report no conflicts of interest
and no source of funding.
Thomas W.
Pelham is
a practicing
physical therapist.
Mike G.
Robinson is the
head coach of the
Calgary Canoe
Club, Alberta
Sprint Racing
Canoe Association.
The late
Laurence E.
Holt was an
adjunct professor
at Dalhousie
University.
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