Chalmers DJ, Morrisson Luke : Epidemiology of Non-Submersion Injuries in Aquatic Sporting and Recreational Activities (2.6 Canoeing and Kayaking, 2.7 Rafting). Sports Med 2003:33(10):756-757.

Charlopin P, Dumas P : Mal logé. Concours Med 1998;120-24:1751-1753

Sce médecine physique et réadaptation HIA desgenettes, Lyon.

Quel est votre diagnostic ? un pratiquant du canoë-kayak se plaint de douleurs chroniques d'effort de l'avant-bras gauche. La symptomatologie classique des tendinites n'est pas retrouvée et l'articulation huméro-radiale était normale. Les résultats des mesures de pressions des loges superficielles ont permis d'affirmer le diagnostic de · chronique de la loge superficielle de l'avant-bras gauche. L'aponévrotomie apporte une guérison rapide.

du Toit P, Sole G, Bowerbank P, Noakes TD : Incidence and causes of tenosynovitis of the wrist extensors in long distance paddle canoeists. Br J Sports Med 1999 Apr;33(2):105-9

Department of Physiotherapy, University of Cape Town Medical School, Observatory, South Africa.

OBJECTIVES: To investigate the incidence and causes of acute tenosynovitis of the forearm of long distance canoeists.

METHOD: A systematic sample of canoeists competing in four canoe marathons were interviewed. The interview included questions about the presence and severity of pain in the forearm and average training distances. Features of the paddles and canoes were determined. RESULTS: An average of 23% of the competitors in each race developed this condition. The incidence was significantly higher in the dominant than the nondominant hand but was unrelated to the type of canoe and the angle of the paddle blades. Canoeists who covered more than 100 km a week for eight weeks preceding the race had a significantly lower incidence of tenosynovitis than those who trained less. Environmental conditions during racing, including fast flowing water, high winds, and choppy waters, and the paddling techniques, especially hyperextension of the wrist during the pushing phase of the stroke, were both related to the incidence of tenosynovitis.

CONCLUSION: Tenosynovitis is a common injury in long distance canoeists. The study suggests that development of tenosynovitis is not related to the equipment used, but is probably caused by difficult paddling conditions, in particular uneven surface conditions, which may cause an altered paddling style. However, a number of factors can affect canoeing style. Level of fitness and the ability to balance even a less stable canoe, thereby maintaining optimum paddling style without repeated eccentric loading of the forearm tendons to limit hyperextension of the wrist, would seem to be important.

PMID: 10205691, UI: 99222405

Fiore DC : Injuries Associated With Whitewater Rafting and Kayaking.

Wilderness and Environmental Medicine: Vol. 14, No. 4, pp. 255–260.
University of Nevada School of Medicine, Department of Family and Community Medicine, Reno, NV
Whitewater rafting and kayaking are growing exponentially in popularity, with almost 10 million rafters and 2 to 3 million kayakers, yet little has been published concerning the safety or hazards of these activities. This article reviews the demographics of such injuries and the types of injuries commonly encountered. Fortunately, fatalities are uncommon in these activities, with rafting and kayaking fatalities occurring at a rate of 0.55 and 2.9 per 100000 user days, respectively. Injury rates for kayaking and rafting are 3 to 6 and 0.26 to 2.1 per 100000 boating days, respectively. Acute injuries in kayaking are usually due to the transferred force of the water on the upper extremity, most often the shoulder, or the impact on an object while “swimming.” Acute rafting injuries are more often due to contact with another rafter's paddle or other equipment; the next most common injury is the rafter hitting an object while “swimming.” Chronic injuries are very uncommon in rafting but account for 25% to 40% of all kayaking injuries and are most often either shoulder or wrist complaints.
Key Words: injury, sports, wilderness, kayak, raft

Grippon P : pathologie de l'épaule et canoë-kayak. Thèse médecine 1989, Univ. Paris Val-de-Marne, 191 p.

Après une présentation de l'activité, une description du complexe articulaire de l'épaule, est analysée la pathologie induite par le canoë-kayak sur cette articulation, au moyen notamment d'une enquête de type rétrospectif. La pathologie la plus fréquemment rencontrée a été la luxation gléno-humérale, puis la pathologie musculaire et la pathologie tendineuse. Les problèmes posés par les lésions de la coiffe des rotateurs et les luxations acromio-claviculaires ont aussi été analysés. Le canoë-kayak induit une pathologie au niveau de l'épaule non négligeable qui, sans être spécifique, présente des caractéristiques étiologiques propres. Une grande partie de ces lésions pourrait être évitée par des mesures préventives simples.

Hagemann G , Rijke A M , M Mars : Shoulder pathoanatomy in marathon kayakers. Br J Sports Med 2004;38:413-417.

Objectives: To determine the prevalence of soft and hard tissue abnormalities and their interrelations in the shoulders of marathon kayakers and to examine the pathoanatomical factors that predispose these athletes to injury.
Methods: Fifty two long distance kayakers completed a questionnaire. Their shoulders were examined for range of motion, pain, and stability using a standard set of 10 clinical tests. The shoulder was subsequently scanned by magnetic resonance imaging (MRI) in three planes and evaluated for evidence of injury or other abnormality. The relation of clinical symptoms and MRI findings was investigated with respect to kayaker's age, number of years kayaking, and number of marathon races completed.
Results: Thirty subjects were asymptomatic at the time of scanning, and twenty two showed symptoms of pain and/or instability. MRI showed ocromioclavicular hypertrophy, acromial or clavicular spur, supraspinatus tendinitis, and partial tear of the supraspinatus as the most coman abnormalities. Kayaker's age, number of years kayaking, and number of races completed did not relate significantly to symptoms or to the presence of an abnormality on MRI scan. Of all the pathoanatomical findings that are reported to predispose to rotator cuff injury, only acromial and clavicular spurs were found to correlate highly with supraspinatus muscle pathology.
Conclusions: Rotator cuff injuries make up a large portion of the injuries seen in marathon kayakers, about twice the number reported for sprint kayokers. These injuries are the result of secondary impingement factors associated with overuse, possibly specific to kayakers, and not the result of bony restrictions around the shoulder joint. Acromiodavicular hypertrophy is a common finding in marathon kayakers, but is possibly the result of portaging or a previous injury.
Correspondence to: Dr Rijke, University of Virginia, MSE-SEAS, 203 Thomtol Hall, MSE-SEAS, Charlottesville, Virginia 22903, USA;
amr@virginia.edu

JACK E. KRUPNICK, MD,a ROBERT D. COX, MD, PhD,a and RICHARD L. SUMMERS : Injuries sustained during competitive white-water paddling: a survey of athletes in the 1996 Olympic trials. Wilderness and Environmental Medicine: Vol. 9, No. 1, pp. 14–18
Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, MS.
ABSTRACT
To examine injury prevalence in competitive paddlers, a cross-sectional, retrospective, written survey of the athletes competing in the four regional Olympic canoe and kayak qualifying races for the United States Canoe and Kayak Team was conducted in the spring of 1996. A total of 375 questionnaires were distributed, of which 54 were completed and returned. Results were reported as the percentage of total injuries. A composite of 271 separate injuries was reported by kayakers during their careers. While 56% of the injuries occurred during training, 40% happened during recreation and 4% during competition. The most frequent injuries were sprains (32%), tendonitis (20%), and chronic musculoskeletal pain (14%). Simple bruises (9%) and infections (8%) occurred with moderate frequency, while severe injuries, such as dislocations (3%) and lacerations (2%), were even less common. About 10% of the paddlers noted a near-drowning event during their careers. Of the injuries noted, 70% were reported as recurrent or chronic. Treatment included rest (37%), physical therapy (23%), medical intervention (34%), and surgical intervention (6%). White-water paddling of canoes and kayaks is a potentially dangerous sport, and competitive paddlers frequently suffer a range of injuries. Most injuries occurred during training; however, the short intense work of racing produced a greater frequency of injuries.
Keywords: Olympics, canoe, kayak.

Laborieux H : C7T1 face à la vague : expérience d'un ostéopathe auprès des sportifs de l'équipe de france de Waveski de la Fédération française de canoë kayak - doc pdf 724 Ko

Maffulli N, Pintore E. Stress fracture of the sixth rib in a canoeist. Br J Sports Med 1990 Dec;24(4):247

Institute of Child Health, Respiratory and Anaesthetic Unit, London, UK.

PMID: 2097023 [PubMed - indexed for MEDLINE]

Merbs CF : Spondylolysis of the sacrum in Alaskan and Canadian Inuit skeletons. Am J Phys Anthropol 1996 Nov;101(3):357-367

Department of Anthropology, Arizona State University, Tempe 85287-2402, USA.

Spondylolysis of the lower back, particularly that involving the isthmusbetween the superior and inferior articular processes (pars interarticularis),is generally attributed to stress fracturing caused by movement of the affectedvertebra relative to the vertebra below. The finding of isthmic spondylolysisin the first vertebra of a fused sacrum is thus unusual and requiresexplanation. Although unrepresented in the clinical literature, sacralspondylolysis has been reported for archaeological specimens and appears to be especially prevalent in North American Inuit. A study of 373 Inuit sacra from Alaska and Canada produced 16 examples of spondylolysis (eight from each area).All but one of the affected individuals were male, and nearly all were youngadults, many between 18 and 20 years of age. All cases of sacral spondylolysis observed in this study were judged to have resulted from stress fracturing that occurred while S1 was still unfused, and most appear to have been in the process of healing, following fusion of S1 with S2, when death occurred. Thehigh frequency observed in these people is attributed to unusual stresses becoming concentrated in the lower back of adolescent males due to suchactivities as weight lifting, wrestling, kayak paddling, and harpooning, combined with, and perhaps even contributing to, delayed maturation (S1-S2fusion) of the sacrum.

MEDLINE - PMID: 8922182, UI: 97080847

Kouvalchouk JF, Watin Augouard L, Dufour O, Coudert X, Paszkowski A : Le syndrome d'effort chronique des loges antérieures de l'avant-bras. Rev Chir Orthop Reparatrice Appar Mot 1993;79:351-356

Nilsen R, Nygaard P, Bjorholt PG : Complications that may occur in those with spinal cord injuries who participatein sport. Paraplegia 1985 Jun;23(3):152-158

The purpose of this study was to determine the risk of developing complicationsin paraplegics taking part in sport. It is a retrospective study of patients with complete spinal cord injury at the spinal level of C7--cauda equina/conusinjury, and consists of 61 patients admitted to the BeitostolenHealthsportcenter, Norway. All of them had achieved satisfactory bladder/bowelfunction. The wheelchair dependents were all skilled in the use of thewheelchair. They participated in a training programme with an average durationof 25 days. Different activities were tried, such as weight-lifting, pulking,swimming, volleyball, calisthenics in a group, horseback-riding, archery,tabletennis, canoeing, totalling 11 955 training hours. During the trainingperiod the following complications were observed: urinary tract infections,pressure sores, and sprains and strains. There were 30 complications, most ofthem only of minor type. The incidence of complications, expressed as number ofcomplications/1000 training-hours was, for urinary tract infections--0,50,pressure sores 0,42, sprains/strains 1,33, others 0,25: in all 2,51. Sprainsand strains were the most common complications, accounting for about 55 percent of the total, all of which were successfully treated before discharge.Sport activities are an important part of the rehabilitation of the spinal cordinjured and the risk of serious complications appears to be low.

MEDLINE - PMID: 4011289, UI: 85241699

O'Driscoll SW : Intramuscular triceps rupture. Can J Surg 1992 Apr;35(2):203-207

Division of Orthopedic Surgery, St. Michael's Hospital, University of Toronto,Ont.

A 25-year-old man who had a complete intramuscular rupture of the long head ofthe triceps was treated nonoperatively and followed up prospectively for 10years. The injury occurred after 4 days of white-water kayaking without anydirect blow. Strengthening was performed by doing push-ups. Nine years ofisokinetic testing revealed that isometric strength was normal, but endurancetesting was reduced by 5% to 10%. Ruptures of the muscle belly can occur due todirect trauma or by forced elbow flexion during triceps contraction. From thisand the few case reports available it appears that nonoperative treatment iseffective and recommended for patients who do not require significant endurancestrength in elbow extension. Whether or not the results can be improved bysurgical repair is uncertain.

MEDLINE - PMID: 1562935, UI: 92224088

Pelham TW, Holt LE, Stalker RE : The etiology of paddler's shoulder. Aust J Sci Med Sport 1995 Jun;27(2):43-47

Dalhousie University, Halifax, Nova Scotia.

Training methods used in competitive flatwater paddling often lead to a common pattern of soft tissue injuries that affect the upper limb. Of particular frequency is paddler's shoulder, a condition that can become chronic and may result in permanent damage. The authors suggest that the cumulative effect of poorly structured resistance training initiates the deteriorative process and together with the repetitiveness of on-water training results in the pathologies referred to as paddler's shoulder.