One of the lesser-known injuries in rowing, but arguably amongst the most debilitating, is forearm pain. Imagine how difficult it would be to row if you can’t even hold an oar! The pressure through your legs, body and arms is useless if you cannot translate it into the blade.
Common Presentations of Forearm Pain in Rowers:
Lateral Epicondylalgia AKA Tennis Elbow: How on earth can a rower get tennis elbow? Well, even across my general practice as a physiotherapist, the vast majority of people I see for this injury are not tennis players! Even amongst broader society, this injury is common because it affects the muscles that extend your wrist (the muscles that feather your oar).
Indicated most commonly in athletes that have experienced a sharp increase in the loading of extensor muscles, most often including the extensor carpi radialis brevis (ECRB), but less frequently the extensor digitorum, extensor carpi radialis longus (ECRL), and extensor carpi ulnaris.
If you experience pain outside your elbow and forearm when standing with your palms up, you may well be experiencing Tennis Elbow. There can sometimes be associated with pain down the side of the forearm or up the arm. (This should be assessed by a professional to rule out nerve-related pain).
Intersection Syndrome: Named after two muscles – the extensor pollicis brevis and the abductor pollicis longus – that rub over each other, causing inflammation and pain, intersection syndrome usually affects the outer lower forearm. Common symptoms include localised swelling, along with a grinding sound when you move your wrist.
A challenging condition to treat, and with little rehabilitation available, the most effective treatment forms are those that allow the injury to settle. Usually, this involves time off the water, ice, special wrist splints, medication, injections and in some cases, surgery.
Compartment Syndrome of the Forearms: Far less common, this will feel like an increase in pressure during rowing, amplifying as the session’s intensity builds. This is caused by an accumulation of fluid in the forearms from muscle activity; the pressure leads to reduced circulation to the muscles, leading to pain and muscle dysfunction.
Prevention of Forearm Pain in Rowers:
- A lighter grip will reduce muscle activity through some of the tendons outlined above.
- A technical assessment – particularly looking at the body opening late and the elbows bending or “breaking” early in the drive phase. Also, assessing your feathering and squaring positioning and technique can help.
- Strengthening the muscles at the back of the shoulder to help translate the force from the legs into the blade more efficiently.
- Taping the forearm or wrist in tennis elbow – sometimes braces can be helpful too.
- Icing after activity for 20 minutes and throughout the day where possible.
- Avoiding prolonged sessions with wash or wind may be beneficial where possible (for those suffering from pain).
- Cortisone injections may be an option for intersection syndrome, whilst PRP (Platelet-Rich Plasma) injections may also be an option for tennis elbow, on a case by case basis.
- Surgery is often an option in compartment syndrome and intersection syndrome cases that do not respond to other treatment methods.
If you have any questions concerning wrist and forearm pain, do not hesitate to contact me on Instagram @therowingphysio.
*Note: This article does not substitute the need for medical advice from a competent practitioner. Seek an assessment from a professional for your injury needs.
Matt
This article was written by Matt Anthis. To find out more about his work and story, head over to our content partners page, or read more of his work here.
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Photos by Roesie Percy
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