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4 common rowing injuries (and how to prevent them)

Rowing is an excellent way of improving your fitness and enjoying fantastic outdoor locations. The sport is rather unusual in that the rowers face the boat’s stern with their feet anchored to the foot stretcher. They perform a continuous cycle of rowing strokes with the legs alternately extended and flexed and the arms and body moving at the same time. You get great cardiovascular benefits from rowing, and your core, leg and arm strengths develop but unfortunately, overuse injuries and lower back injuries are relatively common.

Risk factors for rowing injuries

Overuse is the commonest cause of rowing injuries. These can occur when you increase your training level suddenly, change the frequency of training or change the type of boat you row. One of the causes of injury can be poor technique, so it is important that good technique is learnt from the start, and you should always seek to improve your technique.

Lack of fitness can also contribute to the likelihood of rowing injuries, so working on your core and back strength to build up muscular fitness will also help to prevent them. Flexibility training also helps to ensure that you acquire the necessary range of movement to row effectively.

Over training can also be a factor that can increase the risk of sustaining an injury as does excessive running as a component of your land training. The commonest sites where rowing injuries can occur are the wrist, hand and forearm, the ribs, knees and back.

Hand and wrist injuries

Rowers frequently suffer from hand blisters, but fortunately these are usually easily treated by covering with a dry sterile dressing.

Extensor tenosynovitis is very common, especially at the beginning of the season when rowers start training quite intensively but the weather is still quite cold. It is characterised by swelling, pain and crepitus (a creaky feeling) in the wrist. The rower experiences pain when rowing but also often with writing and similar activities.

Close up of a forearm showing red in the wrist to denote pain

Treatment for this condition is by using a wrist splint when the athlete is not rowing, ice to reduce swelling and anti-inflammatory medication. Sometimes local steroid injections are also prescribed. The most important aspect in preventing this condition is to keep the wrist and hand warm while rowing by wearing long sleeves and fleece covers over the hand and wrist when you are rowing in colder weather.

Rib injuries

Pain over the rib cage in rowers often indicates a stress fracture of the ribs. These injuries make up 10% of rowing injuries and usually occur during intense training in winter or early spring. They most commonly affect the area at the junction of the middle and back third of the rib. Stress fractures of the ribs are not always recognised immediately, but it is important to act on achiness in the chest wall that may occur before the condition develops into the pain of an acute fracture. This pain can become worse on deep breathing, coughing and movement.

Rib fractures are treated by stopping activities until the discomfort subsides. They can take some time to heal and it is important to avoid activities such as running at first. Ergometer training should be introduced at low resistance and a high stroke rate before progressing to rowing on water. Rib fractures are less likely to occur when rowers avoid long training sessions and upper back and core strengthening exercises are incorporated into your regular training programme.

Knee injuries

Pain in the knee cap (patellofemoral pain) usually becomes apparent when walking up or down stairs, and you can also experience a clicking sensation in the knee when rowing. The pain becomes more severe when you carry out training activities such as squat jumps and squats. Knee pain is usually treated by using anti-inflammatory medication and undertaking a stretching programme focusing on the hip, quadriceps and iliotibial band.

Close up of a knee joint being held to denote pain

Another fairly common condition experienced by rowers is iliotibial band friction syndrome. The iliotibial band (ITB) glides over the outside of the knee as it bends and in ITB friction syndrome it can be tight causing tight localised pain and some inflammation may result. This condition is treated by rest, ice, anti-inflammatory medications and stretching. Ultrasound can also be used.

Back injuries

Low back pain is commonly experienced by rowers, particularly those who undertake intensive training regimes. The pain may radiate to the buttocks when there is injury to the lower back discs. Pain may occur at the end of a rowing stroke when the legs are extended and also when sitting. Sometimes the back goes into spasm and the rower cannot bend forward far enough to touch their toes.

Image of a mans back showing red dots down the spine to denote pain

Following a disc injury, athletes should stop rowing. They can start cross training when this can be tolerated, and once they start rowing again, they should carry out a core stabilisation programme and flexibility exercises to ensure that their backs are fit for rowing. This should be continued throughout the period in which they are rowing. If strength training such as weightlifting is undertaken, it should be carefully monitored.

How to prevent rowing injuries

Staying healthy and training to develop good rowing techniques are the major elements that help to prevent rowing injuries, but there are other factors to take into consideration. In addition to avoiding injury in the first place, you need to work towards speeding up recovery time if an injury does occur. This also reduces the likelihood of being injured.

It is important to drink plenty of water. If you become dehydrated your body finds it more difficult to resist injury and disease and it can seriously impact on your strength. A properly hydrated athlete’s performance can improve by as much as 25%.

Nutrition is also crucial and the right diet can help you to stay healthy and to recover more quickly in the event of an injury. You should aim for slow to digest carbs, fat and protein for most meals, but eat protein and carbs that are easy to digest before and during rowing as well as immediately afterwards.

Sleep has been shown to be important and you should try to get 8 to 10 hours of sleep each day. Most athletes need 10 hours altogether, some of which can be in the form of daytime naps. According to Milewski et al. (2014), adolescent athletes who have less than 8 hours sleep per night are 1.7 times more likely to be injured.

Suddenly increasing the amount you train can make injury more likely, so avoid increasing it by over 10% in a week.

Before training you should warm up in a way that is specific to you and any weaknesses you may have. An assessment by a functional movement practitioner could help to identify your mobility restrictions and weak links and give you ways to correct these.

Strength training is important because you can develop muscular imbalances in rowing. Strength training will help the development of muscles that you do not use in rowing strokes. Learn how to lift by training with a qualified coach.

How to manage injuries

It is important to stop rowing or training immediately if an injury occurs in order to prevent the injury from becoming worse. Do not be tempted to row through the pain because this can aggravate the situation.

Soft tissue injuries such as muscle strains, ligament sprains, bruises and bumps should be treated immediately with RICE (rest, ice, compression and elevation) until you can see a health professional.

Swollen ankle showing bruising and the application of an ice pack

The more quickly you obtain treatment, the more quickly you will be able to return to rowing but you should not resume any activity until your injury is completely better and you have been given the all clear by your physio or doctor.

Finally, check that your technique is correct to avoid any further injuries.