Fly Fishing Related Hand Injuries

In the last few years I have got more and more injuries after a long day or two on the salt. At first I thought it was my age slowly getting to me, but after some research it seems not the case. My main injuries are blisters & hurt tendons on my casting hand and in the case of fishing for Kingies or Tigerfish even hurt tendons in my stripping hand.

I thought it may be interesting to do some research on treatment and prevention of Tendinosis which will be most likely to affect all fly fishers at one stage or another especially after a long day on the salt or chasing tigers. Whilst Tendinitis has very similar symptoms to Tendinosis, its treatment is different and as such we will look at the difference between.

The Differences between Tendinosis & Tendinitis

Tendinitis is the inflammation of the tendon and results from micro-tears that happen when the musculotendinous unit is acutely overloaded with a tensile force that is too heavy and/or too sudden. Tendinitis is still a very common diagnosis, though research increasingly documents that what is thought to be tendinitis is usually tendinosis(1,2,3,4,5).
Tendinosis is a degeneration of the tendon’s collagen in response to chronic overuse; when overuse is continued without giving the tendon time to heal and rest, such as with repetitive strain injury, tendinosis results. Even tiny movements, such as clicking a mouse, can cause tendinosis, when done repeatedly.
Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/

It’s apparent from this comparison that the most likely culprit for sore hands and wrists is Tendinosis. So let’s look at the Diagnosis

Diagnosis of Tendinosis

Swelling in a region of micro damage or partial tear may be detected visually or by touch. Increased water content and disorganized collagen matrix in tendon lesions may be detected by ultrasonography or magnetic resonance imaging.
Symptoms can vary from an ache or pain and stiffness to the local area of the tendon, or a burning that surrounds the joint around the inflamed tendon. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as swelling impinges on the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain, which may contribute to the symptoms
Source: Wikipedia (http://en.wikipedia.org/wiki/Tendinosis)

Treatment

Tendons are very slow to heal if injured. Partial tears heal by the rapid production of disorganized type-III collagen, which is weaker than normal tendon. Recurrence of injury in the damaged region of tendon is common.
Physical therapy, rest, and gradual return to the activity in which tendinosis was experienced is a common therapy. There is evidence to suggest that tendinosis is not an inflammatory disorder; anti-inflammatory drugs are not an effective treatment,
Source: Wikipedia (http://en.wikipedia.org/wiki/Tendinosis)

In addition to rest and a gradual return to the activity one could use Ice Pack, braces or supports and even look at physical therapy.

Prevention

Now after reading what treatments are suggested you can note that these will take some time to take effect? The best solution is to try preventing any injuries but if it’s your tendons that get hurt what can be done to prevent these injuries?

1. Correction of Technique and Ergonomics.

If for example your casting hand is taking strain try an alternative grip style or look at the amount of pressure you put in the grip whilst you cast, ideally you only want to really put force on the grip at the end of your casting stroke to give you that abrupt stop at the end of each cast back or forth. You could also try out alternative rod grips or get once custom made to suite.

The best solution to injuries on your stripping hand is to try keeping your wrist straight throughout your strip (a wrist support could help), I am fond of stripping and giving the line a last jerk by twisting my wrist at the end of the strip to give the fly that extra movement. This technique works wonders for Tigerfish and Kingies, but not for my wrist.

You can also use double-handed retrieves for fish species with less bony mouths, this also aids guys new to saltwater fly fishing in not trout striking (lifting the rod up). But don’t try Double handed retrieves for bony mouthed fish like Tigerfish or Tarpon, you need the extra leverage of the rod plus fast reactions to set the hook and just holding onto your line or line striking will put you at a disadvantage.

One last thing related to this that I practice is constantly changing retrieve (single to double-handed) and casts every few minutes. This comes naturally whilst fishing as you search water and try different retrieves. But something worth keeping in mind.

2. Exercising & Stretching

The act of exercising will help build muscles that will be able to take some of the force off your tendons and help you better take the force and load you endure whilst fishing.

Athletes always stretch before an event, why shouldn’t we? Stretching maximizes the range of motion of your joints. This can help to decrease repetitive micro trauma on tight tissues and tendons.

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