White-water paddlesports medicine: Canoeing, kayaking and rafting

White-water paddlesports are outdoor activities which are growing in popularity worldwide. As with most sports, the incidence of white-water injuries rises with increased exposure. Whilst injuries and illnesses in white-water paddlesports are relatively rare, a range of acute and chronic injuries as well as environmental illnesses can occur. Studies report that lacerations, contusions, fractures and dislocations are common acute injuries. In canoeists and kayakers, injuries to the shoulder joint are frequently reported. In contrast, injuries to the lower limbs are common in commercial rafters and novices who fall out of their craft and collide with submerged obstacles. Chronic overuse injuries such as tendinopathies of the wrist and forearm are relatively common amongst frequent and intensive paddling. Environmental illnesses including hypothermia, GI complaints and ear infections are risks for paddlers. As paddlesports are popular in remote locations, where there is limited access to medical assistance, accurate assessment of risk by experienced paddlers using appropriate equipment and trained in first-aid training is recommended to mitigate the risk of incidents occurring.