Welcome back to the second installation of Injuries in Masters Rowers, see the previous article here: https://juniorrowingnews.com/injuries-in-masters-rowers-part-1/
Limitations:
There are two key limitations to this study. The first is there are injured masters rowers unaccounted for. A limitation of the retrospective survey system is that masters rowers who were too injured to participate in the regatta are excluded from the study population. The injury numbers may be underreported due to the selection bias.
The second major limitation of this study is that it is retrospective. In a retrospective study, researchers collect information after an event or time frame. In a prospective study, researchers collect data as the event is ongoing. Retrospective studies have limitations of the memory and accurate recording practices of the study participants. Additionally, the researchers do not note the exact dates of study.
They state that the regatta took place in 2007, but do not identify when they collected the survey and interview data. It would be helpful to know if this data was collected 1-2 years after the athletes participation at this event or if they were not contacted until 2017, a year before publication date. If the participants of this study were asked to go back and complete a survey for an athletic event that took place a decade earlier we would be relying on some very detailed training journals, medical records and memory. As of the time of this publication I did contact lead author Tomislav Smoljanovic to clarify when the survey was given.
Takeaways: Based on the results of the study, the researchers conclude that masters rowers get injured less frequently than other age groups in the sport. This is true in total number of injuries. However, to understand full context of injuries as they relate to the masters rower we must consider the following numbers and variables.
Masters rowers are training at a significantly reduced volume and intensity in comparison to other age groups. For every 1000 training sessions masters rowers averaged an injury every 2.25 sessions which actually led all rowing age groups.
Most of the injuries are chronic in nature; 224 total chronic injuries vs. 135 total acute injuries. Chronic injuries tend to be overuse injuries so in this case we have to objectively review our training program and ask some hard questions. Are we transitioning from the water to indoors in a safe manner? Are we increasing volume/intensity in a progressive manner? A good rule of thumb is no more than a 10% increase in volume per week.
160 rowers experienced multiple injuries. If multiple injuries are occurring has the athlete fully rehabbed their initial injury before they returned to training? The interesting thing is the researchers note there is not a loss in training time for most injuries. We know most injuries are chronic – this leads me to believe that many masters rowers may be training through pain/injury.
The increase in upper body injuries in the F+ age group may be happening for two main reasons: continued loss of strength and lean muscle mass and a potential shift in rowing stroke technique. The researchers propose this age group may emphasize a more upper body focused drive in comparison to the other master’s age groups.
Cross training is important from both a mental and physical development standpoint. When cross training it is critical that you ease into them slowly and give your joints and tissues time to acclimate to these new stresses on the body. Rowing provides us with great cardiovascular fitness and the ability to easily transition to other sports and activities. However, rowing and cycling are weight supported sports and soccer, running and skiing are weight bearing sports. The impact on the joints and tissues in all of these field and court sports is very different in comparison to rowing. Do not underestimate how this factors into training stress as well as recovery.
Rowers with elite level experience had less injuries. We are left to wonder whether this may be due to higher technical proficiency, exposure to higher level training and greater resilience, or better understanding of training principles.
Another key takeaway from this study has to do with the length of the training session. The AB group experienced fewer acute low back injuries. However, this same group experienced significantly more chronic knee injuries on the ergometer. This suggests that the erg places greater stress on the knees as we age in comparison to the rowing shell. Interestingly, the opposite occurred for the F+ age group. These athletes experienced more low back injuries in sessions less than thirty minutes. Perhaps, these athletes may be increasing the intensity of these shorter training sessions and this is why they experience more injuries at this age group.
Implementation: This was the first study on masters rowers. Hopefully, more research is in the pipeline. After reading this study here are some practical training recommendations that the masters rower can implement into their training.
This study reaffirms other rowing studies that the lumbar spine (low back) is the number one injury site in rowing across all age groups. In general, as we age there is a gradual loss of mobility. A loss of mobility at the ankles and hips will migrate stress to the low back. If a joint segment is deficient in mobility another area will take up the slack. By maintaining adequate hip and ankle mobility this will take stress off the low back as well as provide positive benefits for health and performance. In addition, they must learn to prioritize stability at the lumbar spine, i.e. learn to control and limit motion at this joint segment. The principle of proximal stability for distal athleticism must be adhered to! We need to have control and stiffness at the core/trunk of the body which will allow greater mobility and power at the hips and shoulders. The prying goblet squat and half kneeling ankle rock are solid recommendations. For stability, I recommend the McGill Big 3.
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A significant number of injuries occurred with multiple cross training activities. My recommendation is that outside of rowing and strength training pick only one other cross training activity. That could be cycling, running, cross country skiing or swimming. All of the cross training sports mentioned in this study are weight bearing and require a greater level of balance than rowing. Remember, fall risk increases with age. All of the aforementioned activities place a significant amount of stress on the joints of the body and in a different way than rowing. This is critical to take into consideration because you have to be able to recover from this stress.
Masters rowers who had experience at the elite level had less injuries than their age level counterparts. Athletes in a high performance environment understand how to train and plan. They know when to push it in their training and they know when to back off and prioritize rest and recovery. The amount of training volume you will be able to do will decrease as you age. Recovery from sessions will take longer thus quality over quantity becomes even more important.
Finally, there is a noted shift in injury site with the F+ age group. One could hypothesize that with loss of lower extremity strength, older masters rowers might change their rowing technique, and that increased or more pronounced use of upper extremities might result in a higher frequency of overuse injuries. From a strength training perspective, I would program the lunge pattern to address this unilateral deficit. This will get the individual to not only develop strength but also eccentric control as their ankles, knees, and hips descend toward the ground. A win-win for strength gains and health benefits.
As masters rowers age they will want to prioritize power and strength development. These two qualities will decline over the course of our lifetime. To mitigate stress on the low back masters rowers will want to practice daily ankle and hip mobility. This will allow them to get into a strong catch position as well as help with function in daily life activities. Emphasis on lower body strength should also be emphasized to mitigate a shift in rowing technique to an upper body dominant drive.
Citations:
[1] Smoljanovic, T., Bohacek, I., Hannafin, J. A., Terborg, O., Hren, D., Pecina, M., & Bojanic, I. (2015). Acute and chronic injuries among senior international rowers: a cross-sectional study. International Orthopaedics, 39(8), 1623-1630.
[2] Smoljanovic, T., Bojanic, I., Hannafin, J. A., Hren, D., Delimar, D., & Pecina, M. (2009). Traumatic and overuse injuries among international elite junior rowers. American Journal of Sports Medicine, 37(6), 1193-1199.
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