I don't know much about your other questions, but for flat water trips I think the paddle leash is nice to have. However, it is not a good idea to have one if you are doing any type of whitewater, I learned that last summer. I also like having the paddle holder but neither are absolutely necessary. As far as padding for your knees, I would say if it's hurting your knees then it's probably a good idea. You want to be comfortable.
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