Rowing (Care of the Young Athlete)

Low back pain

Low back pain is very common in rowers. It
can occur suddenly (from twisting when reaching at the catch or pulling back
during the drive) or over time (from repetitive movements or when the back
is bent forward). Power used to accelerate the drive portion of the stroke
should come from the legs, but if the legs are weak or not used, or the back
is in a rounded and slumped position, the back takes the brunt of the
stress. Athletes who do not “sit up” enough at the finish of
the stroke can also stress the low back. Rowing on an ergometer can increase
back strain if there is too much machine resistance or poor technique.
Weight training, specifically Olympic lifts (squats, power cleans, and dead
lifts), if done incorrectly, and/or lifting the shell (boat) improperly in
and out of the water can also lead to back pain.

Common back injuries include muscle
strains/spasm, facet pain, lumbar disc disease, and stress fractures.
Treatment of these injuries includes rest, ice, and/or heat, and
nonsteroidal anti-inflammatory drugs (NSAIDs). Pain that lasts for more than
5 to 7 days should be evaluated by a doctor. Warning signs of a more serious
injury include severe pain, numbness or tingling down the legs, bowel or
bladder problems, or leg weakness. Athletes can help prevent back injuries
by

• Strengthening the abdominal,
  gluteal, hip, and buttock muscles

• Using proper technique: proper
  positioning at the catch and finish, pushing with the legs and not
  the back, not opening up too quickly during the drive, and proper
  adjustment of the boat rigging

Wrist injuries

Wrist tendonitis (also known as
intersection syndrome) is the most common wrist injury
seen in rowers. The feathering hand (the inside hand that twists the oar) is
more frequently injured due to repetitive extension of the wrist to get the
blade in and out of the water. Common symptoms include pain, weakness,
swelling, and creaking of the wrist. Icing the wrist after activity and use
of NSAIDs can help with pain and swelling. Strengthening the shoulder blade
muscles and proper technique/feathering can decrease the risk of injury.

Taping the wrist to avoid excessive wrist
extension during feathering may also help. Use of a wrist brace when not
rowing can give rest to the arm. Sometimes complete rest is needed to allow
the area to heal.

Knee injuries

Knee injuries may occur when the knees are
flexed and loaded at the catch. Knee pain can also occur with improper
technique during weight training, particularly squats. Patellofemoral stress
syndrome (kneecap pain) and iliotibial band syndrome (pain at the outside
knee) can occur with increased loading and too much knee bend at the catch.
Immediate treatment consists of the use of ice and NSAIDs. Core body
strengthening, especially of the hip rotators, should be part of treatment.
Modifying the shoes or foot stretcher position and decreasing knee bend at
the catch can decrease symptoms.

Rib pain

Rib pain can occur in the muscles, in
between the ribs, or on the bone. Muscle strains can occur with repetitive
use and pull on the same chest muscle. Athletes with weak back muscles but
strong chest muscles may place uneven loads on the muscles or bone, causing
pain. Repetitive motions can load the bone and cause a stress reaction or
stress fracture. Rowing with hatchet blades may increase the forces on the
chest wall.

Bone pain associated with rib stress
fractures can occur when rowing, when at rest, or with deep breathing.
X-rays are usually normal if symptoms have been present less than 3 to 4
weeks, so a bone scan or magnetic resonance imaging (MRI) may be needed to
diagnose a rib stress fracture. Ice and pain medicine may help with initial
pain.

Treatment includes rest, strengthening of
the surrounding muscles, and evaluation of rowing technique. Not sitting up
enough at the finish, pulling into the rib cage too much at the finish, or
reaching too far at the catch may predispose rowers to rib stress fractures.
Boat rigging should be evaluated and changed if necessary. Sometimes rowers
will switch sides of the boat (starboard or port) to decrease stress on a
certain side of the chest.

Blisters

Blisters are a common problem in the novice
rower. They usually occur along the heel of the palm or just below the
fingers at the junction of the palm. Blisters are often caused by friction
from pulling and feathering the oar. In more experienced rowers, calluses
form where blisters once were.

Blisters can become infected, especially
after exposure to dirt or river water, so proper care of them is necessary.
Signs of infection include swelling and redness around the area, pus
drainage, and increasing pain. Blisters should be kept clean and dry. Hand
washing and use of antibacterial ointment are helpful. Fluid-filled blisters
should be drained but the overlying skin kept intact to protect the surface
from further damage.

Tape can be used to cover blisters and
prevent new ones, but care should be taken as the tape itself may cause a
new blister to form. Tape should never have wrinkles, should wrap around the
entire hand, and should be larger than the blister being covered. Gloves are
not practical while rowing.

Track bites

Track bites are irritations that occur on
the back of the calves when the legs hit the slide at the finish. Scrapes,
blisters, and bleeding can occur. Taping the area, readjusting the foot
stretchers and slide, and not jamming the legs down at the finish can
prevent this injury. Care should be taken to prevent infection.