Preventing Dragon Boating Injuries (Two Part Physio Series): Part One

Preventing Dragon Boating Injuries (Two Part Physio Series): Part One

Alongside the fun, adrenaline-filled nature of dragon boating comes some large physical demands on the body, with forceful, repetitive paddling motions that must be sustained for several minutes if not longer, depending on the length of the race. Ask any of our Hong Kong based physiotherapists and they’ll quickly tell you that any sport with this type of movement pattern can quickly predispose you to overuse injuries, if you don’t have the right training, technique and strength - and this applies to both beginner paddlers and seasoned athletes alike.

In fact, research that looked at dragon boating injuries in 95 university-based dragon boaters over the period of one year found they sustained 104 musculoskeletal injuries - that’s more than one per person on average. This tells us that the risk of sustaining an injury while dragon boating is significant - and that taking steps to prevent paddling injuries should be a priority for anyone participating in the sport. So how can you prevent dragon boating and paddling injuries? Here’s a look into what we’ve learned from our years of supporting those involved in paddling sports, including some of the many recommendations we make to our clients.

Most Common Dragon Boating Injuries

In order to know how to best protect yourself, it’s important to know your risks. The study of 95 dragon boaters showed that the most common injury sites were, unsurprisingly, the:

  • Lower back (22.1%)
  • Shoulder (21.1%)
  • Wrist (17.3%)

Over half (56%) of these injuries were due to overuse, with an incomplete muscle-tendon strain being the most prevalent type of injury (in 50% of cases). 99% of these injuries occurred during training, as opposed to a paddling event itself. Outside of musculoskeletal injuries, a significant majority of the dragon boating participants also incurred non-musculoskeletal injuries, with 9 in 10 people sustaining some abrasions, and 4 in 5 getting blisters.

An Australian study that also evaluated the injury risk in paddle sports (various competitive paddle sports in general) looked at 583 participants, and found the most commonly injured areas were the:

  • Shoulder (31%)
  • Low back (23.5%)
  • Wrist (16.5%)
  • Neck (13.7%)
  • Elbow (11.0%)

This study also found that the injury risk for specific injuries (like wrist injuries) was higher for those with reduced flexibility, the relative risk of shoulder and low-back injury was significantly increased in those with lower training volumes, and that younger athletes had a lower risk of wrist and shoulder injuries.

Tips To Prevent Dragon Boating Injuries

While the best way to prevent injuries in sports are to learn your weaknesses and vulnerabilities with a comprehensive physiotherapy assessment and follow a personalised training plan to address any imbalances and dysfunction present, as well as correct any problems with technique, there are several key steps you can start taking at home, starting today. These include:

Prioritise Strength Training Early

As your body has to manage significant forces and pressure during dragon boating, a good strength training regime can go a long way with injury prevention. Strength training helps build the necessary muscle endurance and resilience to withstand the forces on the body during training and events, helping you power through without getting to the point of injury.

Aim to strength train 2-3 times per week, focusing not only on the large muscle groups but also on the smaller stabilising muscles, as this will lead to better stability and control during strokes. Strengthening the rotator cuff muscles, for example, can help prevent shoulder impingement syndrome, a common injury among paddlers. External rotations and scapular retractions are also good in being able to target these smaller, yet critical, muscle groups.

Overall, your strength training plan should include working on your shoulders (deltoids, rotator cuff muscles and scapular stabilisers), your arms (biceps, triceps and brachialis), forearms (flexors and extensors), core (rectus abdominis, obliques and transverse abdominis), your back (lower, middle and upper), chest (your pecs), hips, glutes, legs.

Practically, examples of simple exercises you can start doing today include:

Shoulders: shoulder presses, lateral raises, front raises, external rotations

Arms: bicep curls, tricep dips, hammer curls, tricep extensions

Forearms: wrist curls (and reverse wrist curls), grip strength exercises

Abdominals: planks, bicycle crunches, leg raises

Lower back: back extensions, bird-dogs, superman exercises

Upper back: rows (seated, bent-over), shrugs

Middle and lower back: lat pulldowns, pull-ups, deadlifts

Chest: bench presses, push-ups, chest flies

Hips and glutes: squats, lunges, hip thrusts, lateral band walks

Legs: leg presses, step-ups, calf raises

Getting The Technique Right, Every Time

Focusing on correct paddling mechanics can go a long way in helping minimise stress on muscles and joints, reducing the risk of overuse injuries. Consider:

Your trunk rotation

Effective trunk rotation allows for a more powerful and efficient stroke, reducing strain on the lower back, neck, and shoulder joints. When training, your trunk should be slightly rotated towards the inside of the boat, leaning forwards from the hips. To test your oblique muscles during rotation, follow these simple steps:

  • Sit on a stable, hard surface like a table. Make sure your feet are off the floor.
  • Keep your spine straight and in a neutral position. Your knees should be shoulder-width apart with a small gap between the back of your knees and the table edge.
  • Place your arms across your chest.
  • Slowly twist your upper body to one side, then the other. Aim to turn your shoulders 45 degrees each way.
  • Ensure your knees stay still and do not move sideways, forward, or backward.

You shouldn't feel cramping in your mid-back when you twist. If you do, it means your oblique muscles aren't activating properly. If your knees move or you experience cramping, limit your twist to the range where you can keep your knees stable and avoid cramping. Gradually increase your range of motion over time, and aim to twist the full 45 degrees without knee movement or cramping. Keeping your obliques properly activated will help provide stability and power during each stroke.

Your shoulder mechanics

Proper coordination between the humerus (upper arm bone) and the scapula (shoulder blade) is also important in helping prevent shoulder impingement injuries. Focus on keeping the shoulders relaxed and the paddling motion smooth. You want to avoid excessively lifting your shoulders, as it can encourage the pinching of the rotator cuff tendons. Regularly stretching the chest and rotator cuff muscles can also help maintain flexibility and reduce the risk of injuries.

Your hand and wrist position

To maintain a good grip on the paddle, you want to hold it firmly but not too tightly, as this will help reduce the likelihood of developing forearm tendonitis and carpal tunnel syndrome. The wrists should be in a neutral position, avoiding excessive flexion or extension. Don’t forget to incorporate exercises to strengthen the forearm muscles and regularly stretch the wrists.

Your leg and hip alignment

Proper leg and hip alignment contribute to your overall stability and power in dragon boating. Most dragon boaters prefer to sit with one leg extended forward and the other bent beneath the bench, maintaining a stable base. This position helps in transferring power from the legs through the torso to the paddle. Here, strengthening the gluteal muscles and hip flexors can enhance stability and reduce the risk of lower body injuries​​.

Your breathing technique

Coordinating your breathing with your strokes is a good tip to help improve efficiency and reduce fatigue. Inhale deeply during the recovery phase and exhale forcefully during the power phase of the stroke. Proper breathing helps maintain a steady rhythm and ensures that your muscles receive adequate oxygen​.

Don’t Skimp On Stretching Or Maintaining Flexibility

Regular stretching helps maintain muscle elasticity, improves your range of motion, and reduces the risk of musculoskeletal injuries. Here are a few key points to consider:

Dynamic stretching before paddling

Dynamic stretching prepares the muscles for the physical demands of dragon boating. Dynamic stretches involve moving parts of your body and gradually increasing reach, speed of movement, or both. Examples of effective dynamic stretches include:

  • Arm circles: extend your arms out to the sides and make small circles, gradually increasing their size. This warms up the shoulder joints and muscles.
  • Torso twists: stand with your feet shoulder-width apart and twist your torso from side to side, keeping your hips facing forward. This activates the core and improves trunk rotation.
  • Leg swings: swing one leg forward and backward in a controlled manner, then switch to the other leg. This helps in loosening up the hip flexors and hamstring.

Static stretching after paddling

Static stretching helps in muscle recovery and prevents stiffness post-training. These stretches should be held for 20-30 seconds without bouncing. Try:

  • Shoulder stretches: bring one arm across your body and hold it with the opposite arm, keeping the elbow straight. This targets the shoulder muscles and helps in preventing shoulder impingement.
  • Triceps stretch: raise one arm overhead, bend the elbow, and use the opposite hand to gently push the elbow down. This stretches the triceps and shoulders.
  • Hamstring stretch: sit on the ground with one leg extended and the other bent. Reach towards the toes of the extended leg to stretch the hamstrings. This helps in maintaining lower back and leg flexibility.

Specific stretches for key muscle groups

We’d also recommend performing stretches that specifically targeting key muscle groups used in dragon boating, such as:

  • Chest and rotator cuff stretches: stand in a doorway with your arms out to the sides and your elbows bent at 90 degrees. Lean forward slightly to stretch the chest and rotator cuff muscles, which can help in reducing shoulder injuries.
  • Lower back stretches: lie on your back and pull your knees towards your chest. Hold this position to stretch the lower back muscles, reducing the risk of strain.
  • Hip flexor stretches: kneel on one knee with the other foot in front. Push your hips forward gently while keeping your back straight. This stretches the hip flexors, which are crucial for maintaining a stable paddling position.

Incorporating stretching into your training routine

Consistency really is a key in a stretching routine. Incorporating stretching exercises into both pre- and post-training sessions goes a long way in helping enhance flexibility and with injury prevention. We recommend spending at least 10-15 minutes on stretching exercises both before and after paddling.

We have several more injury prevention tips for dragon boating that we’ve shared in part two of this article here. These include looking at the importance of having a gradual training progression, checking the ergonomic status of your paddling equipment, the role of good hydration and nutrition, the benefits of physiotherapy throughout your season, and an interesting note on the relationship between mental health and physical performance. Read it here.