Yudu - sportEX dynamics - 1999-2010

ROWING INJURIES

causes of low back pain are numerous and the best advice I can offer is to suggest that if an athlete has low back pain for 48 hrs without resolution, medical advice should be sort. Back pain should be treated with respect, it is a sign that something is wrong - be it a pulled muscle, a ligament strain or an interverte- bral disc injury.

Disc injury By far the most common low back problem in rowers today is an intervertebral disc injury. Unfortunately this type of injury may have long term sequelae, so early treatment is essential. Disc injury in rowers is an overuse injury resulting in degenerative change in the substance of the disc which causes a bulge to develop particularly with sustained loading of the lower back in forward bending. Once a bulge exists, pressure on the surrounding structures causes pain. There is no typical presentation, the symp- toms being determined by the actual position of the bulge. Prevention: It is generally accepted that the way to minimise the risk of disc injury is to reduce the loading of the lumbar spine in flexion during training. This can be achieved by: 1. Not doing a land based training session immediately after a long water session when the body is fatigued

2. Not incorporating lifts that require accurate technique into competitive circuits

3. Eliminating power cleans and dead lifts from weights pro- grammes. More injury occurs with these lifts than any others.

4. Doing appropriate exercises to: ■ train the antagonist muscles ■ improve coordination ■ improve flexibility ■ maintain hamstring length

5. Not working for longer than 30 minutes continuously on an ergometer without stopping to perform extension exercises

6. Avoiding consecutive outings of long low rate steady state 7. Using functional bracing: this is difficult to portray in print but in essence means following a core stabilising programme to increase the body’s natural corset so that at the point of load- ing ie. the catch, the disc can be held in good posture. If pos- ture control is lost during an outing the training session should be terminated.

Core stability should be taught to all rowers whether or not they complain of low back pain. Medical advice: With this condition the help and advice of a good sports physician/physiotherapist/osteopath is essential. Training should be stopped until the condi- tion is stabilised and then a gradual loading programme should be followed until normal training is possible with no signs of the under- lying condition.

Psoas muscle

Hip Groin pain In rowing is this usually caused by tightness of the hip flexor muscles. It is often seen as a consequence of another injury eg. lumbar disc herniation. Prevention: Psoas (hip flexor) stretches should be included in the

rower’s flexibility programme. If the hip flexors will not give with stretching, it is important to look for an underlying reason. With groin pain it is important to consider more unusual causes eg. labral tear of the acetabulum (hip bone socket) as the forces that pass through the hip joint are considerable during the rowing stroke. Knee

Anterior knee pain (chondromalacia patella) This condition is believed to be caused by an imbalance of the quadriceps action in the thigh. It is common to find that at backstops when the legs are at their straight- est, they are still flexed. In this position there is no medial quadriceps action. Repetitive straightening of the bent knee during the rowing stroke strengthens the other three parts of the quadriceps. The combination of the increasing lateral

Vastus medialis muscle

Patella

quadriceps strength, in the presence of diminishing medial quadri- ceps strength, produces an imbalance of pull on the knee cap, pulling it laterally over the buttress of the groove on the femur. The end result is erosion of the cartilage on the back of the kneecap which causes pain. Prevention: Correction of the quadriceps imbalance will alleviate the pain behind the knee cap. Medical advice: The pain in the knee may be quietened with elec- trotherapy.

Calves Scarring The construction of the rowing boat is such that, for the majori- ty, when the feet are set in the correct position in the boat, sit- ting at backstops will cause the slide-beds to apply pressure to the back of the calves. Initially this doesn’t cause a problem, however chronic irritation thickens the skin and forms a scar. Sometimes the chronic irritation abrades the skin and causes acute inflammation. Prevention: Adjust the slide-beds so that they do not make con- tact with the calf muscle. If this is not possible apply tape to the back of the calf to prevent the irritation.

SUMMARY Injury in rowing can affect virtually any part of the body. Prompt attention to an injury will ensure that it settles quickly with least interruption to training, however with a good understanding of the biomechanics of the sport it is possible to prevent injury occurring. Prevention is better than treatment.

This article is written from personal experience as such there are no references made through the text to specific papers.

THE AUTHOR ■ Dr Ann Redgrave is a physician in musculoskeletal medicine and sports medicine at the Redgrave Clinic in Bourne End, Bucks. She has been interested in rowing since the early 1980s, competing at the Los Angeles Olympics in 1984 W8+. She was Chief Medical Officer to the national rowing team from 1992 through to 2002.

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