Rowing has a reasonably high incidence of lower back and overuse injuries through the upper back and shoulders, the ribs and through the low back and pelvis regions. Rowing injuries can also come in the form of muscle strains in the arm or as elbow tendinitis.
Poor technique associated through physical dysfunction is common and leads to injury. To avoid rowing injuries you should ensure you undertake mobility, flexibility, core and strength training that will provide you with the physical balance to cope with the demands of the sport.
Common Rowing Injuries
Low Back Pain
One of the main contributors of low back pain (LBP) comes from the physical limitation of the pelvis. If this area cannot move properly, then the load is spread to the low back region, increasing the load upon the musculature.
The rowing stroke puts extraordinary pressures on the low back. The back begins the stroke flexed, and during the middle of the stroke the back opens up, but remains flexed, in a motion similar to an incomplete dead lift or mid-range squat. Loading the back in flexion places large forces on both the back muscles and the disks. Taking this movement into account, we have found that many rowers who suffer with LBP do not have a great ability to squat or dead lift well – so no wonder that at some point, pain develops.
Treatment for LBP in rowers is often frustrating, and many rowing careers have ended because of persistent low-back symptoms. Working with a movement specialist to address these issues has a carry over to both the pain generated and as a medium to improving performance. A typical treatment program of low-back strengthening, range-of-motion exercise, rest as appropriate, and modalities such as ice.
Knee Pain
The rowing stroke puts the knee through its full range of motion, with a significant load exerted to the fully flexed knee at the start of the stroke. There is, therefore, a fairly high incidence of patellofemoral knee pain in rowers. Like patellofemoral pain in other sports, this is more common in women, whose anatomy predisposes them to patellar tracking problems that are further exacerbated by the fixed position of the shoes in the rowing shell. If the shoes are spaced or twisted incorrectly for the individual’s anatomy, knee pain may persist and worsen despite appropriate treatment. Knee pain may also be caused or exacerbated by other activities used for cross training, such as running and weight training.
Patellofemoral pain can be treated with specific mobilisation of the pelvis, strengthening of the muscles that surround the knee, especially the vastus medialis muscle to improve patellar tracking, and by use of modalities, such as ice, in the acute phase. Modifying the position of the shoes in the boat can have a significant impact by encouraging better positioning of the knee during the rowing stroke. By having a camera analysis of your rowing stroke, we are able to ascertain any movement faults and physical restrictions that may be present.
Lateral knee pain may also be a common injury due to friction of the iliotibial band passing over the outside of the knee, that is exacerbated by the repeated flexing and extension required for the rowing stroke. Individuals with varus knees (a deformity of the knee) are at increased risk for this problem. Again, changing the position of the shoes in the boat can help alleviate symptoms. Other treatments consist of ice, stretching, and other modalities as appropriate.
Rib Stress Fracture
Stress fractures of the ribs were quite rare in rowing prior to the introduction of a more efficient oar design, back in the early 90′s, which was rapidly and widely adopted. This new oar holds its position in the water with less slippage, and thus transmits greater forces to the muscles of the arm and chest wall. Since then, stress fractures of the ribs have been seen at all levels, and are regarded by the rowing community as common.
It is suggested that an over activation of a muscle called serratus anterior leads to bending forces at the ribs, leading to the stress fracture, this usually occurs toward the back and side of the 5th-9th ribs. With this over activation comes a fixing of the ribs where they attach on to the spine. By embarking upon a specialist mobility programme to release the spine and ribs, great gains can be made to reduce the incidence of this type of injury. Don’t leave this one until it is too late, as it will lead to a lot of time away from rowing.
Forearm Tendinitis
Maintaining the tight hand grip required to hold on to the oar(s) for extended periods of time puts the forearms at risk for overuse injuries. Each rowing stroke also involves twisting the oar parallel to the water when feathering the oar in the recovery phase. This motion is carried out by extension at the wrist, further stressing the forearm.
Rowers with forearm tendinitis typically experience pain, tenderness, and even crepitus of the top of the wrist. It is also common to have pain and swelling in the region of the top of the forearm. As with other overuse injuries, this problem is more common early in the outdoor rowing season when feathering the oar is still an unaccustomed activity.
Treatment of forearm tendinitis involves appropriate rest and technique modification. Looser grip on the oar(s) is also very important. Medical treatment involves ice, nonsteroidal anti-inflammatory drugs. We have had great results treating tendinitis with the use of K-Tape, a relatively modern form of proprioceptive taping. This usually resolves fairly quickly with appropriate management.
Minimise Risk
Most injuries that are caused from rowing can be minimised through specially designed mobility, flexibility and strength programmes. This type of programme, should be carried out to supplement general technical and performance sessions. Resistance training (various applications depending on the age) is vital to develop strength , but we must remember this:
Strength that is put on an unstable base will create a short term gain, but mid and long term issues.
Get your gremlins sorted early or you will suffer!