This morning as I sat down for my regular coffee routine (more of a religion actually) I couldn’t help but overhear the words ‘back pain’ and ‘rowing’ being used together. After 2 minutes of eaves dropping I couldn’t help but turn around and join in. It turns out the table was a group of rowers from the Argonauts Rowing Club here in Melbourne and a number of them were experiencing both rowing and back pain at the same time. I let my double espresso go cold and we started to talk.

Rowing has the highest rate of back pain and back injury, across all age and skill levels (recreational to elite), of any sport in the world.

Literature states that 30-50 per cent of rowers will have an episode of low back pain each year. The 12-month incidence is reported at 3-18 per cent for the general non-rowing population, a high figure in itself but no where near the levels seen in our sport. Rowing also lacks many of the risk factors we see in the general population that are related to increased back pain rates, such as obesity, smoking and inactivity, so we can logically assume that the difference in back pain rates between fit individuals who regularly exercise but don’t row and rowers would be even higher.

Clearly this is a problem and it doesn’t seem to be improving even with the core craze and improved training methodologies.

What are the key risk factors?

• Increased training volume
• Ergometer sessions lasting longer then 30 min
• An increase in ergometer training
• Previous episodes of back pain (if you’ve had it you are at a higher risk of getting it again)
• Season phases – initial winter training (likely linked to the ergo stats above) and pre-regatta racing season (likely due to the volume and intensity of training) are the highest risk periods
• Lack of pelvic tilt through the drive to recovery
• Restricted movement of the mid-spine and restricted hip rang of motion
• Increased use of the low back for flexing forward or extending back (if the back is doing all of the work it has more load)
• Fatigue (of course) but this is less pronounced in-boat vs the ergometer again
• Poor technique with a lack of effective force transfer

What doesn’t reduce your risk?

• Static core training

Interestingly, despite the hype around planking and static holds to ‘activate’ muscles like the transverse abdominus and internal obliques etc this more static approach has shown poor clinical results and a poor correlation with prevention.

What should we be doing?

At BAT Logic we are very focused on the idea of prevention – it’s a lot easier and more effective to prevent an injury or reduce a risk factor than to rest and rehab an injured athlete. To prevent injuries we need to consider and respect the risk factors and how the athlete moves.

• Increase pelvic movement through the stroke; we need the pelvis to move through the catch and finish to recovery so that the lumbar spine in particular isn’t doing all of the work
• Recovery is as much a part of performance as training is – allow adequate and quality rest between sessions – this is where repair and growth occurs for the body
• Maintain good movement through your hips and mid spine – the lumbar spine sits between these and is influenced heavily by them so if they don’t move well the rest of your spine and body is affected
• Train in 3 dimensions as much as possible and get good at fundamental movements like squatting

Rowing is very much a flexion-extension sport (sagittal plane) when viewed simply but in reality there are many rotational and side bending movements and the fact that we row on a fluid means that the body must have good movement and control in all planes. Resistance and flexibility training should take this in to account to prepare the athlete for real life movements which always occur in multiple planes of motion i.e. including rotation, side bending and balance control.

Fundamental movements like the squat, when done properly, can help with pelvic control and motion and enhance hip range of motion.

The erg is not your enemy but treat it with respect.

• Don’t use the erg as your first warm up routine – be warm by the time you get on the erg. It is key with early morning training that you have moved your spine, pelvis and hips through a good range of motion before simply jumping on the erg and that you have already increased your body temperature and prepared for the sacred spinning of the flywheel
• Erg sessions should not be excessively long, especially for juniors or beginners with poor technique
• No long ergs before weight training – there is some research to say that the protective reflex activity of the spinal musculature may be dampened during long sessions, so lifting afterwards is a bad idea

Get set up properly for your needs.

• Do you feel comfortable in the boat or on the erg? Research shows that foot height and splay can have a significant effect on hip motion and pelvic movement. Get yourself set right for your needs before pushing off or starting an erg
• Do your shoes fit and is your technique supporting the way you produce force? We are huge advocates of using equipment that supports you properly – the ShoePlate Pro QuickRelease on the ErgAdaptor and in-boat is designed to improve your foot position in order to engage more of the muscles that support your body to produce and transfer force – like the glutes and hamstrings. The CustomPack is designed to rectify leg length issues that can produce asymmetrical forces on the foot stretcher, which are proven to affect the way the pelvis moves and the force that it and the lumbar spine experience during the stroke

Where to from now?

The fact that these injury rates are not reducing means that we are missing something. From the BAT perspective we see that back pain is often the end point in a chain of mechanical issues, many of which are often easy to rectify, including technical and equipment factors listed above.

New research needs to look more at the factors of force transfer on the erg and in-boat – we should be advancing our understanding of what the athlete goes through in training and racing and approaches should be more in line with the most up to date literature on whole body movement and effective recovery. Considerations of the simple factors above is a good start – get your pelvis moving more, use shoes and equipment that fits you properly, don’t smash the erg before you are warm and continue to work on your technique.

Most importantly don’t be scared – you are already doing the best thing you can to prevent back pain and in fact any disease; you are moving! If you add to this some simple yet smart approaches to the movement you choose to do then nothing can stop you.