WORDS:
ELAINE FARQUHARSON
DORSET SUP COACHING AND GUIDING

Photos:
Elaine Farquharson
Howard Shep

Elaine’s Bio

Elaine owns and runs Dorset Sports Physio, based in Weymouth community college sports centre. She offers sports physiotherapy, biomechanics and coaching to the Dorset communities. Elaine’s specialist interest is tri sports and SUP, not only as a competitor but also through her work as a coach and physio. Elaine’s specialist work with the lower quadrant has helped her achieve advanced practice recognition in hip and pelvis and works closely alongside Dorset’s expert hip surgeons and lower limb specialists. Elaine’s facilities offer a large private treatment room, three sports halls, a fully equipped gym, sports pitches, and also racquet courts across the two sites. Elaine also has a hydrotherapy pool and Pilates studio off campus. @dorsetsportsphysio

SUP inspiration

For many of us, we take our bodies and movement control for granted. It’s effortless to put one foot forward and navigate our bodies around our daily lives. When we start as SUP paddlers, it’s fun, just like being a baby all over again, learning to balance and coordinate our movements. We laugh and enjoy the plenty of splashes from falling off. Over time, we gradually learn to adjust to our watery environments by developing the coordination to stand up and explore the world on our paddleboards.

Just imagine, though, if you had one leg, no sight, or that your brain coordinated movement differently from the altered sensations it incorrectly perceives. It must be challenging to move when the programming of human motion doesn’t sequence correctly. As a coach, I am privileged to work with some fantastic superhuman people who adapt and overcome their restrictions to enjoy SUP as a sport despite barriers complicating their movement control. I wanted to share some of their achievements with you and help you as coaches or paddlers to see that anything can be possible with the right imagination and determination.

When we think of movement, we tend to think of the muscles and joints; however, every body system affects how we move. Whether that be how our heartbeats, our lungs breathe, how we process movement in our brains, how we receive sensation from our eyes or ears, or even how well our skin stretches over our bodies. All of these amazing systems give us the unique way that we move, and as we go through our life journey, we pick up problems and compensations along the way that, as a coach, we need to understand and adapt to enable us to enjoy SUP.

Vision

There are so many different types of barriers to movement. Let us first look at sight. I have worked with many paddlers who have mild vision problems like short-sightedness, to people who are partially sighted and to those who are completely blind. Vision helps us with our head righting reactions and is a major contributor to our balance and perception of space. Without it, we can be very disorientated and unsteady. When starting a blind paddler, it is essential to help them familiarise themselves with the size and texture of the equipment. Let them feel the paddle to understand the orientation of the drive face in relation to the t-grip. Paddles with different shape t-grips help this but also anti-slip grip can also help orientation.

Before going out onto the water, establish reference points due to sound, swell and wind direction in terms of north, south, east or west or naming landmarks so that the paddler can understand their environment and location. This will allow them to be more independent but also give them confidence. Plus, for you as a coach, it will help you when directing the paddler. Establishing different forms of communication before going out on the water is also helpful as the wind can change the sound on the water. Tethering can be helpful in the early stages of paddling but is tricky and requires good communication as the jolts from taking up the slack are very off-putting to someone who can’t see.

blind paddler

A blind paddler once they gain confidence can perform all the skills we can do from footwork, pivot turns, catching bumps or racing. Still, they will require a guide paddler using sound or kinaesthetic techniques facilitating movement to help them do this.

Partially sighted paddler

For the partially sighted paddler, it affects their depth perception, so changing onto moving water can be more challenging initially. It also creates asymmetry and over-dependence of one side of their paddling. They often will have less confidence moving onto the visually restricted side with crossbow techniques or changing their foot position. They can also find it more challenging in group dynamics, and it’s easier for them to paddle on the outer side of the group on their stronger visual side.

Amputation

A person following amputation will often use a prosthesis. Clever systems are being developed for the upper limb amputee, but you are more likely to see below-knee amputees coming for paddling lessons. They usually wear a prosthesis that requires a suspension via a strap, suction socket or internal pin. They will be required to wear a specialist sock to help comfort and fit of their prosthetic limb, all of which can be problematic in their own way when we introduce water-based activities.

There are specialist swimming limbs; however, these often have less mobility or are less comfortable. It’s best to work out with the amputee or their’ prosthetist for more specialist advice. The lower the level of amputation, the more balance and ability they often will have. A below-knee amputee can often utilise a prosthetic foot with some ankle movement, whilst a higher level might need a more rigid foot or knee. Initially, the amputee will need to increase their weight into a normal midline alignment so that they put even weight through the board. Often their uninjured limb is dominant, so confidence exercises and balance retraining may be necessary to improve symmetry and help them on their board.

The amputated limb can often still be very sensitive, and the nerve endings will need to make new sense of the new activity. This may require desensitisation of the residual limb due to pressure changes, and care should be taken not to cause trauma to the skin due to other redistribution of pressures. Any new discomforts should be discussed with their prosthetist and the limb adjusted to enable optimal weight-bearing. It may take several weeks and attempts to help the amputee feel comfortable with the added weight-bearing pressures, and it should be built up slowly over time.

Different board types will have a different effect on the prosthetic foot and alignment of the leg for normal paddling biomechanics. An ISUP may allow more flex options softening the leg for paddling, but it can cause added balance issues whilst a hardboard can give the paddler greater reference and trust, but this can cause increased pressure. Initially, some paddling should be done sitting to allow some crossing of the midline and increasing the way the body transfers weight during the paddle stroke over the affected side before this is attempted in standing.

Moving around the board is more challenging, so more emphasis is needed on learning support strokes and utilising the paddle like an outrigger for added stability and support. This is again compromised due to a lack of foot bend and knee bend in the prosthesis, which might require a longer paddle length to compensate for the lack of opportunity to get low for sweep strokes and support strokes.

Neurological impairments

There are so many different types of neurological impairments, and it will be impossible to go through them all here with you today, but I will try to give you some basic similarities. Most people will have problems with the resting tone of the muscles, either creating too much tension or not enough. This will change posture and movement. Some people will not be able to sit unsupported, let alone stand. It is kinder to start with cross-training in an outrigger canoe first to enable greater stability for the paddler. Some people won’t be able to stand but will have some ability to control their trunks. We can add a special seating system for these people to support prolonged sitting or use a wider board for greater stability.

The skin is at risk of injury due to altered sensation and circulatory changes due to muscles not firing correctly. They often cannot get the correct information from the environment, for example, the temperature, where they might not be aware of the cold, or pressure they might not feel if their skin is being rubbed. This means extra vigilance is needed to protect the individual during the sport as abrasions can stop a wheelchair user from being active. If they develop a sore they will need to sustain long periods of bed rest, therefore, it is recommended we protect the skin with protective clothing such as a wet suit or other thicker material. Specialist matting or cushions on the board can also be utilised for pressure relief as we should be conscious to not have them on a hard surface in one posture for too long. This might also make you opt for an iSUP over a hardboard, where pressure on the skin is more significant.

Be aware they can get involuntary contractions in their muscles from tone issues; these are called spasms. This may result in an involuntary jerk or reflex response when you least expect it. So please be vigilant as it can create a capsize or make it difficult for the paddler to maintain their balance or posture, and if they are strapped into a seating system, this can be very nerving for the paddler who is putting all their trust in you. I find it best to be in the water with them rather than on my board myself, and I usually choose a very sheltered environment which is torso depth, for the first few sessions. Also, make sure there are enough team members available from a manual handling point of view for the level of disability.

If the person is less neurologically impaired, they may be able to control their sitting balance themselves. This will make things a lot easier, but they can still experience the same fluctuating spasms, weakness, altered patterns, or muscle tightness; they just have a higher balance and postural control level. Some people might not have a weakened side of their body; others a tight arm with normal leg control or weak legs but normal arms; each person is unique in their issues. I am lucky as a physio to understand the complexities and can adapt the environment and skill to the complexity of the neurological problem. I would highly recommend that either a physio or specialist coach be involved in helping you identify how best to help the paddler utilise their movements for paddling. However, water safety and support to build up their confidence might be all they need in mild conditions. Start in accessible sheltered environments with wider and more stable boards and get some training in rescues and systems to help the paddler back on their board.

For those with upper limb impairments, the grip may be a problem that might require a specialist splint to help. This means the paddle cannot be changed from side to side, so a kayak paddle might be more appropriate, or training to paddle on one side through trim, edge control and utilising more combined paddle strokes is essential. The smaller the blade size, the easier the resistance combined with a lighter weight paddle will make it easier for those with upper limb weakness. Sometimes in higher tone cases, a hard pressure to the palm of the hand causes a grip reflex which increases tone throughout the arm, making it harder to move. Utilising foam around the paddle shaft to make the grip less tight or hard can help to reduce this.

The most significant disability

I hope this has given you some insight into physical barriers that we can overcome out there in our paddling communities. Though the most significant disability of all, which restricts us physically, isn’t a physical condition; it’s our minds. We can be so influenced by peers, social pressures, insecurities and a misconception of culture or belief systems that we restrict our abilities and tighten our comfort zones. We let others influence us in what we can do or allow fear of the unknown to control and limit our imaginations. Time pressures and responsibilities drain our energy and affect our motivation to grow in the sport we love.

Positive people

My tips to help you gain a positive mindset are to write down your dream but then set small, realistic goals that feel possible. Reach out for support through coaching or guiding to help develop you and support you to reach your potential. Professionals have the tools to help you mentally, physically and tactically to get the technical skills to live your dreams. Also, surround yourself with positive stories and people who will inspire you and motivate you. I hope that through this article, you can see that anyone can achieve amazing things with grit, determination and a positive inner belief to overcome the imagined barriers of the impossible.