Injuries in High School Rowing Athletes:
welcome! Thank you for visiting our Physio-pedia page. We are a group of graduate students in the Doctor of Physical Therapy program at Bellarmine University in Louisville, Kentucky. We’ve been following and conducting research related to rowing injuries. Literature shows Due to the mechanics of the rowing stroke and its repetitive motion, rowers often suffer from overuse injuries.  While there are several prevalence studies of elite adult rowers, few studies have assessed the prevalence of injuries among high school rowers.
We recently conducted a pilot study with high school teams at the Louisville Rowing Club (see below for details on this study), in which we investigated their injury rates and implemented a program emphasizing core strengthening Exercise plan for strength to prevent low back pain. While we gained some information from this study, we wanted to gather more information on the prevalence of injuries in the high school population to fill gaps in the literature.
In order to obtain this information, we respectfully ask that you take a survey. In the sections below, there are links to two different surveys. If you are a rowing instructor, please click on the instructor link and complete the survey. If you are an athlete, please click on the link below athlete and complete the survey. Please rest assured that no personal information will be disclosed by participating in this survey.
Coach Survey: ‘https://www.surveymonkey.com/s/3JCCV6S
Athlete Survey: https://www.surveymonkey.com/s/3DR2MZY
Prevention of low back pain in high school rowers: a pilot study
Due to the mechanics of the rowing action and its repetitive motion, rowers often suffer from overuse injuries. 1 The most common of these overuse injuries are the lower back of the forearm/wrist and knee. 23 Evidence shows that low back pain accounts for the majority of injuries experienced junior elite rowers, but few studies have evaluated prevention strategies for this injury in the high school population. 2-4 Less experienced rowers are more likely to acquire traumatic injuries. 4 During the capture phase of the stroke, the rotation and stretch are increased Stress on the lower back increases the risk of injury. 1 Fatigue of the erector spinae and increased lumbar flexion throughout rowing can also lead to injury. 2 Research suggests circuit training may be an effective exercise regimen for rowers because it simulates repetition Rowing is overloading, so train endurance to prevent lower back injuries. A 12-week study by 1 Chtara showed that a low-frequency resistance-based circuit training program significantly improved muscle strength, power, and power endurance. 5 Rowers rely heavily on the aerobic and anaerobic systems to develop strength and endurance, so circuit training is an appropriate method to meet these needs. Also, it is important for rowers to have a strong core and sufficient trunk stability to prevent injury. Research Retraining to support local muscle groups or core musculature is important for trunk stabilization and prevention of low back pain. 6 The purpose of this study was to design and implement a specific prevention program for low back pain among high school rowers. this preventive program Circuit training concepts will be utilized, including trunk stabilization targeting specific core muscles. Additionally, this proposed study may provide insights into the prevalence of low back pain and other chronic injuries in the high school rowing population. This information may help fill in the literature.
Participants Participants in this study were a convenience sample of 24 high school rowers (13 female and 11 male) who were members of the Louisville Rowing Club. Rower experience ranges from 2 months to 3 years. Ages range from 14 to 18 years old.
Survey Prior to the initiation of the prevention program, rowers completed a survey designed to collect demographic rowing experience and injury history data. A revised survey will be conducted at week 6 and at the end of the program to assess how the program has progressed. An example of a survey is included in this packet.
Protocol In general, rowing involves the use of the major muscle groups, starting with the legs, then the back, and finally the arms. Athletes are more prone to acute and chronic injuries when muscle imbalances or fatigue occur. Study shows correlation between backbones of core stability Endurance and relief of low back pain symptoms. 6 Low back injury management recommendations for rowers include stretching the hip extensors for core stability and strengthening for proper pelvic alignment Lumbar erector spinae and endurance training in neutral posture alignment.2 It is with these concepts in mind that we have designed a training program that includes dynamic exercises that not only address strengthening the major muscle groups used in rowing, but also include specific activities recommended for the prevention of low back pain. The training program will be implemented Once a week, 30 to 40 minutes each, in addition to the team practice program that takes place every weekday.
The program is divided into three phases in order to correlate with the physiological response to long-term training. These three phases are known as the anatomical adaptation phase, the strength phase, and the maintenance phase. 1 The anatomical adaptation phase will emphasize low and high resistance. Less training volume, more repetitions. The strength phase involves transitioning to more sets and fewer reps. This follows the idea that during this phase of strength training the weight is increased and therefore the number of repetitions decreased. However, in this protocol, instead of increasing the weight Exercises gradually increase in difficulty, requiring more strength and control. The Sustain phase will focus on the gains made during the Retain Strength phase.
The three-stage exercise can be divided into combination exercises for upper and lower extremities and flexibility exercises. Most of the exercises that make up these categories target the muscles that attach to the spine or contribute to posture and movement. Core stability. These interventions were compiled into an exercise bank that served as a reference for organizing the training circuit syllabus. Each circuit included an even distribution of exercises from each category, and each circuit was repeated three times during the training session. these stages are Consists of three circuits that rotate in weekly sessions. Phase 1 (Weeks 1-6) Investigator presence. The second and third phases of the plan are best assigned and implemented by the coaching staff.
Results/Outcomes Results of the pre-program survey (week 1): 18 of 24 rowers reported experiencing low back pain during their rowing careers. Nineteen rowers have been rowing for a year or less. Six people reported injuries other than low back pain related to boating. Of these, 4 reported knee pain, 1 reported elbow pain, and 1 reported a hip flexor injury. Of those reporting low back pain, more than 50% rowed on both the port and starboard sides. 22 of 23 people who reported low back pain said they had a pain scale of 5 On a visual analog scale or less. Approximately 80% of rowers participate in 5-8 hours of training/practice per week. A summary of the survey responses is attached at the end of this document.
Survey results after phase one or program (week 6): Only 14 of 24 people who completed the initial survey also completed the follow-up survey. Of the 14 people, 100% answered yes to the following questions: 1. Do you feel you have a better understanding of the importance of core stability? Are you preventing low back pain? 2. In the exercises used in this circuit training program, do you feel like you have gained a better understanding of the proper body mechanics you need? 3. Have you noticed any improvement since starting the exercise program?
Four of the 14 reported that they were currently experiencing low back pain. All reported pain was less than 3 out of 10 on a visual analog scale.
The main finding of this pilot study was that 75% of rowers reported low back pain from rowing. This finding supports our main hypothesis that low back pain is highly prevalent among high school rowers. Another interesting finding is that most rowers Reported low back pain has been rowing for less than a year. This may indicate that low back pain is common in both experienced and inexperienced rowers. These inexperienced rowers may develop lower back pain secondary to lack of body awareness and proper posture during exercise. researchers observed Poor body mechanics and lack of proper strength and endurance when doing circuit exercises. Specifically, the researchers noted increased difficulty in exercises such as dumbbell prone deadlifts and side plank squats, push-ups, V-shaped crunches, and superman. increase these difficulties Practice has shown that these rowers lack adequate core and lumbar stability. Based on our research, we know that core and lumbar stabilization are critical to preventing low back pain. We can infer that if these poor body mechanics are used in the circuit, they will also Used when boating. The combination of these poor mechanics and inadequate core and lumbar stability may explain the increased incidence of low back pain in high school rowers.
Despite the positive results seen from the exercise program, our results were not conclusive due to study limitations.
The coaching staff at the Louisville Rowing Club can only conduct one round per week. Better results may be seen if the program is implemented twice a week as planned. Additionally, researchers can only oversee one phase of the program. Since Phases 2 and 3 will not be supervised by investigators, there is no assurance that the program will continue according to protocol, which would reduce the validity of the study.
Another limitation of the study is the survey. Their surveys were too open-ended, leading to increased variability in responses and a lack of quantitative measurement. Nor were any objective measurements made, other than the surveys the researchers created. also There were 34 rowers who participated in the tour, but only 24 returned to the initial survey and 14 returned to the follow-up survey.
In future studies, it would be even more beneficial to implement the program twice a week to maximize results. Higher quality studies in this population are needed.
The researchers hope this community partnership will continue with the coaching staff in the coming months. The researchers also educated rowers on better body mechanics and awareness to help reduce the incidence of injuries. Ideally, this knowledge will benefit them their future rowing careers.
Our community partnerships have helped us become aware of the lack of research on rowing injuries in high school athletes. Capstone’s goal was to obtain information on the larger prevalence of injuries among high school rowers.
References (for pilot study)
1. Allen K Jones M. Specific sports conditioning for the prevention of boating injuries. Strength and Conditioning [Online Continuous]. 1998 Feb;20(1):35-39. Available from: SPORTDiscus with full text IpswichMA. Accessed 28 October 2013.
2. Rumball J Lebrun C Di Ciacca S Orlando K. Rowing Injured. Sports Medicine [online serial]. 2005 Apr;35(6):537-555. Available from: CINAHL Ipswich, MA. Accessed 28 October 2013.
3. Hosea TM Hannafin JA. Rowing was injured. Sports Health. 2012;4(3):236–45. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3435926&tool=pmcentrez&rendertype=abstract. Accessed 9 September 2013.
4. Smoljanovic T Bojanic I Hannafin J Hren D Delimar D Pecina M. Trauma and overuse injuries in international elite youth rowers. American Journal of Sports Medicine [online serial]. 2009 Jun;37(6):1193-1199. Available from: MEDLINE Ipswich, MA. Accessed 28 October 2013.
5. Chtara M Chaouachi A Levin G. Effects of simultaneous endurance and circuit resistance training sequences on the development of muscular strength and power. J. Power… 2008;22(4):1037–1045. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Effect+of+concurrent+endurance+and+circuit+resistance+training+sequence+on+muscular+strength+and+power+development# 0. Accessed 15 November 2013.
6. TSE M McManus A Masters R. Development and validation of a core endurance intervention program: effects on performance in collegiate-aged rowers. J. Power… 2005;19(3):547–552. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:DEVELOPMENT+AND+VALIDATION+OF+A+CORE+ENDURANCE+INTERVENTION+PROGRAM+:+IMPLICATIONS+for+performance+in+college-age + rower #0. Accessed 15 November 2013.
7. Gee T Olsen P Berger N. Strength and conditioning exercises for rowing. …intensity conditions. … 2011;(30):668–682. URL: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Strength+and+conditioning+practices+in+rowing#0. Accessed 15 November 2013.
8. Stutchfield B Coleman S. Hamstring flexibility in relation to lumbar flexion and low back pain in rowers. European Journal of Sports Science [online serial]. 2006 Dec;6(4):255-260. Source: SPORTDiscus with Full Text Ipswich MA. Accessed 28 October 2013
Circuit training program (from pilot study)
Circuit 1: File:Circuit 1 Exercises.pdf
Circuit 2: File:Circuit 2 Exercises.pdf
Circuit 3: Documentation: Circuit 3 Exercises.pdf
Circuit 4: File:Circuit 4 Exercises.pdf
Circuit 5: File:Circuit 5 Exercises.pdf
Circuit 6: File:Circuit 6 Exercises.pdf
- ↑ Allen K, Jones M. Sport-specific conditioning to prevent injuries in rowing. Strength & Conditioning [serial online]. February 1998;20(1):35-39. Available from: SPORTDiscus with Full Text, Ipswich, fckLRMA. Accessed October 28, 2013.