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  • Phil Keetley

Paddling Injuries: Wrists #1

Updated: May 31, 2021

I paddled several thousand kilometres with clients last season, and one common observation was how many paddlers have poor anatomical wrist alignment. Poor wrist alignment can easily result in tendonitis, which occurs when a tendon (a chord of tissue that connects muscles to bones) becomes inflamed as a result of irritation or stress. Tendonitis often manifests itself initially with tenderness in the wrist and forearm, with swelling of the surrounding soft tissues. Symptoms tend to worsen during and after physical activity, and they may worsen over time. 

If left untreated it can result in significant swelling and pain, with associated loss of the normal range of motion that can ruin a paddle day, or more seriously, compromise an entire expedition.

Do you check your own wrist alignment? Are you attuned to checking other peoples wrist alignments? How do these wrists look?

The most common alignment issue is to hyper-extend or hyper-flex the wrist on the top arm:

Wrist hyeprflexion & hyperextension

Correct alignment should look like this, with the forces being transmitted directly through the strong skeletal system, minimising the forces on soft tissue, tendons and ligaments.

Correct paddle and wrist alignment

An open and relaxed hand with a light grip go a long way to avoiding tension, even assisting with balance and blade control. Paddlers should also consider learning some wrist stretching exercises, certainly prior to hard paddling in challenging conditions.

Early identification and correction are always the best treatment. All paddlers should observe for correct wrist alignment in each other, and take seriously any complaints about sore wrists. Once a problem is identified, we probably need to stop paddling, get ashore and conduct a detailed assessment of the issue. The following treatment plan is for an acute injury, professional medical attention should be sought for ongoing treatment or serious injuries.

1. Assessment: Get to skin to compare both sides and make an assessment of the damage. Key things to check with any musculoskeletal injury:

- Circulation: Evaluate the colour, temperature and capillary refill beyond the point of injury to ensure that we have no vascular or nervous impairment. Is the skin all the same colour on both hands? All the same temperature? Squeeze a nail bed for five seconds and watch it blanch. Good capillary refill should take place within two seconds (if hands not too cold).