Lower back pain is, and likely will remain the hot topic of rowing-based injuries for some time, it would seem, as they are overwhelmingly the most common injury in rowers.
That’s not to say there aren’t any other injuries – shoulders, knees, forearms, and the occasional rib stress pain are other injuries I see, but in my experience, 70% of the rowers I see complain of lower back pain.
I have been looking forward to and anticipating this lower back pain consensus statement (Wilson et al., 2021) from a team of all-star rowing medical practitioners for some time which arrived in March 2021. You can visit the guide here:
https://bjsm.bmj.com/content/early/2021/03/11/bjsports-2020-103385.abstract
Breaking down the paper, one of the most informative pieces for the rowing athlete is Figure 2, which outlines a tidy progression program for lower back pain. This program is logical and makes sense from the point of view of a progressive increase in intensity. So, for example, we wouldn’t return to racing or full pressure training before trialling at least one lighter session on water (and completing it successfully).
For the first session back, I usually send my injured athletes out in a single scull (ideally with a coach or supervision to work on technical changes) with pressure around 50-60% of maximum, rating 18-20, covering 6-8km depending on their level of ability and how long they have been off the water (less distance and/or pressure if they have been injured for longer).
Whilst there are guidelines for these injuries, you will see at the bottom of that figure that there is a 3-12 week variation in lower back pain return to rowing times in moderate and more severe cases!
That is a huge variance but highlights that all recoveries from lower back pain need to be individualised. They are also multifactorial (i.e. have a variety of different causes).
This highlights the importance of working with an experienced rowing practitioner when experiencing lower back pain to identify where things may have gone wrong and what to address to mitigate your chance of lower back pain in the future.
Unfortunately, it is challenging to prevent lower back pain. This is acknowledged in the paper – monitoring training load and avoiding spikes in intensity (particularly after other injuries/breaks/illness) is the most effective strategy.
As mentioned in previous blogs, technique, posture, hip flexibility, trunk strength, and increased training load are cited as potential causes of lower back pain.
If you have any questions or need clarification on anything discussed in the paper, don’t hesitate to reach out to @therowingphysio on Instagram.
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