Incidence and causes of tenosynovitis of the wrist extensors in long distance paddle canoeists

Objectives-To investigate the incidence and causes of acute tenosynovitis o f the forearm of long distance canoeists. Method-A systematic sample of canoeists competing in four canoe marathons w ere interviewed. The interview included questions about the presence and se verity of pain in the forearm and average training distances. Features of t he paddles and canoes were determined. Results-An average of 23% of the competitors in each race developed this co ndition. The incidence was significantly higher in the dominant than the no ndominant 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 week s preceding the race had a significantly lower incidence of tenosynovitis t han those who trained less. Environmental conditions during racing, includi ng fast flowing water, high winds, and choppy waters, and the paddling tech niques, 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 equ ipment used, but is probably caused by difficult paddling conditions, in pa rticular uneven surface conditions, which may cause an altered paddling sty le. However, a number of factors can affect canoeing style. Level of fitnes s and the ability to balance even a less stable canoe, thereby maintaining optimum paddling style without repeated eccentric loading of the forearm te ndons to limit hyperextension of the wrist, would seem to be important.