Paddle Board Shoulder Impingement: Causes, Relief & Prevention

Key Insights

• The shoulder and upper arm account for about 33% of injuries in stand up paddle boarding, mainly from muscle and tendon strain during endurance paddling.
• Subacromial impingement often stems from repetitive overhead strokes, incorrect paddle length, poor technique, and muscle imbalances.
• Most cases improve with rest, physical therapy, targeted exercises, and better form—surgery is uncommon.
• Prevention includes proper warm-ups, rotator cuff strengthening, correct equipment sizing, and gradual training increases.

Shoulder impingement affects many stand up paddle board users due to repeated overhead arm movements.

What Is Shoulder Impingement in Stand Up Paddle Boarding?

Shoulder impingement, or subacromial impingement, occurs when rotator cuff tendons and the bursa get compressed under the acromion bone during arm elevation. In SUP, the paddling stroke repeatedly lifts the top arm overhead, pinching these structures and causing irritation over time. This leads to inflammation, pain, and reduced mobility if not addressed.

Primary Causes

Repetitive overhead paddling is a main trigger, but several factors combine to increase risk.

According to a study on SUP injuries, the shoulder/upper arm region makes up 32.9% of reported issues, often linked to muscle/tendon strain from endurance sessions.

Common contributors include:

• Paddle too long, forcing excessive reach and elbow elevation above shoulder level.
• Technique flaws, such as pulling mainly with arms instead of torso rotation or raising the top elbow too high.
• Muscle imbalances where stronger pulling muscles overpower weaker rotator cuff stabilizers.
• Poor posture on the board, like rounded shoulders or forward head position.
• Overuse without adequate recovery, especially in longer paddles.

Recognizing the Symptoms

Pain usually starts gradually and worsens with activity.

You may notice:

• Ache or sharp pain at the front or side of the shoulder during strokes or overhead reaches.
• Weakness when lifting the arm or holding the paddle.
• Stiffness that limits full range of motion.
• Increased discomfort at night, particularly when lying on the affected side.

Early recognition helps avoid progression to more serious issues like tendon tears.

Diagnosis Steps

Consult a doctor or physiotherapist for accurate assessment.

They perform a physical exam checking range of motion, strength, and pain triggers. Imaging like ultrasound or MRI may confirm compression or rule out other problems.

Treatment Options

Most SUP-related impingement responds to non-surgical care.

Start with rest from aggravating strokes to let inflammation settle. Apply ice and use over-the-counter anti-inflammatories as needed.

Physical therapy plays a central role by addressing imbalances through:

• Rotator cuff strengthening.
• Scapular stability work.
• Posture correction.

In stubborn cases, corticosteroid injections provide temporary relief. Surgery to remove bone spurs or decompress the space remains rare.

Essential Exercises for Relief and Strengthening

Targeted exercises build rotator cuff strength and improve shoulder mechanics. Perform them 3–4 times per week, starting with light resistance.

Here is a basic routine:

1. External Rotation with Band – Anchor a resistance band at waist height. Keep elbow at side, bent 90 degrees. Rotate forearm outward against resistance. Do 2–3 sets of 12–15 reps.
2. Scapular Squeezes – Sit or stand tall. Pinch shoulder blades together without shrugging. Hold 5 seconds, release. Repeat 10–15 times.
3. Pendulum Swings – Lean forward, let affected arm hang. Gently swing in small circles. 1–2 minutes per direction.
4. Wall Angels – Stand against a wall, arms in "W" position. Slide arms up to "Y" while keeping contact with wall. 10 reps.
5. Doorway Chest Stretch – Place forearms on door frame at shoulder height. Step forward gently to stretch chest. Hold 20–30 seconds, repeat 3 times.

These focus on stability and mobility, drawn from common physical therapy approaches for overhead athletes.

Prevention Strategies

Build habits that protect shoulders long-term.

Follow this step-by-step approach:

1. Warm up with arm circles, shoulder rolls, and light torso twists before paddling.
2. Use correct paddle length—typically your height plus 8–10 inches for all-around use, so the handle reaches wrist level when arm is raised overhead.
3. Focus on technique: rotate torso, keep top elbow below shoulder, engage core, and use a relaxed grip.
4. Strengthen regularly with the exercises above.
5. Progress gradually—increase session length and intensity slowly.
6. Choose stable boards to avoid overcompensation.

Proper equipment supports these habits. Check the Loco carbon SUP paddle range for adjustable options that fit your height and style, or browse the full stand-up paddle board accessories collection.

Final Thoughts

Shoulder impingement from paddle boarding stems mainly from overuse and form issues but improves with targeted care. Listen to early pain signals, prioritize technique and strength work, and select gear that matches your body. For boards and paddles built for comfort and performance, head to the Loco Surfing homepage and explore collections like inflatable stand up paddle boards or hard stand up paddle boards. Stay consistent, and most paddlers return to pain-free sessions.