“I see a sizable amount of patients who row,” says Mounif “Moe” Rifkah, MD, a primary care sports medicine physician with Burke and Bradley Orthopedics at UPMC. They don’t always identify themselves as serious rowers, he says. “Sometimes they just come in to see me for various aches and pains.”
But when he inquires about their exercise regimen, and they say “rowing,” he immediately understands some things. The rowing stroke is unique in its demands on the body.
Does rowing inevitably lead to injuries? What are the most common rowing injuries? And most importantly, how can you prevent a rowing injury?
Dr. Rifkah, who sees the entire range of athletes from weekend warriors to elite crew rowers, has answers. Plus, he also likes to row for exercise.
Is Rowing Hard on Your Body or Good for You? Both!
Overall, rowing is terrific exercise, Dr. Rifkah says. It’s not as hard on your body as high-impact sports. It usually results in fewer acute injuries than contact or ball sports.
Still, there are pitfalls. “Rowing is all about technique,” Dr. Rifkah explains. And if that technique isn’t correct, it can cause problems.
It’s called the rowing kinetic chain. You start with your legs completely flexed, your back leaning forward, and your arms extended. And you end up with your legs completely extended, your arms flexed, and your upper back behind your shoulders.
And then you repeat that movement hundreds and hundreds of times.
It’s perfect in its simplicity and its balance of upper and lower body strength. “But how you complete that motion over and over is where injuries come from,” Dr. Rifkah says. Also, when you start to fatigue, it’s easy to overuse the wrong muscles or stray from the proper technique.
It’s why one of the most common issues from rowing is the development of low back pain. However, Dr. Rifkah sees other common rowing injuries, as well.
Most Common Rowing Injuries
When we talk about rowing injuries, there’s one important factor – which is to delineate between the two types of rowing.
“There’s rowing you complete on water and rowing for exercise on an erg,” Dr. Rifkah says. An erg, or ergometer, is a rowing machine that you typically see at the gym, which does not involve being on a body of water.
But one key thing separates the two. Rowing on the water, for example, as part of a crew team, is all about forward propulsion. “With an erg, you’re only rowing for exercise, which means the goals are ultimately different.”
It also means the injuries are slightly different, depending on whether you’re on a crew team or using the erg at the gym. Here are the most common problems Dr. Rifkah sees in patients and athletes who row.
Low back pain from rowing
When you’re rowing, lower back pain is one of the most common complaints. “The back is the most commonly injured region in rowing,” he says. This is because of how much forward and backward movement is required in the rowing stroke.
Rowers can get sprains, strains, bulging disks, and stress fractures in the lower back. “A nonspecific low back strain is one of the most common injuries I see in rowers,” Dr. Rifkah says.
Rib stress fractures from rowing
“This injury gets a lot of press because it’s surprising,” Dr. Rifkah says. Rowers can have rib injuries from overuse combined with weak core strength.
Why the ribs? Muscles and tendons surround your ribs. Ideally, the force applied to all those muscles and tendons dissipates as you move through the rowing kinetic chain.
But with bad technique, that force can settle in and around your ribs. “Plus, you’re using your ribs to contract and expand with each breath,” he says.
All of it stresses the rib cage, which can lead to stress fractures in the ribs. “These types of injuries can certainly be painful for rowers,” says Dr. Rifkah.
Forearm pain from rowing
Dr. Rifkah often sees people with forearm pain from rowing. Intersection syndrome is one of these types of forearm and wrist tendonitis. As with most rowing injuries, this happens because of overuse.
“It’s typically more common with the erg,” Dr. Rifkah says. This is because of the different style and tighter, firmer grip on the handle. By contrast, forward propulsion is the most important aspect of rowing when on water.
Shoulder injuries from rowing
“Shoulder injuries aren’t as common as you would think with rowing,” Dr. Rifkah says. They do happen, though, usually because of scapular weakness. Shoulder injuries from rowing can include shoulder impingement and rotator cuff tendonitis.
“Rowing puts your upper body and shoulders in different postures,” he says. If the muscles around your shoulder girdle are weak, they don’t keep your shoulder in its proper place. If you already have shoulder impingement or rotator cuff pain, rowing can worsen it.
Knee pain from rowing
“Sometimes, rowers can have pain around the kneecap,” Dr. Rifkah says. This is usually the result of poor mechanics and not properly pushing off from a bent knee to an extended knee.
But Dr. Rifkah believes that rowing can actually be beneficial for your knees. It’s a low-impact sport and can help you strengthen the muscles around your knee. Plus, it helps you improve aerobic capacity (which some may find harder to do with a low-impact sport).
Treating and Preventing Rowing Injuries
Proper technique throughout the rowing kinetic chain is the best injury prevention. Think about your form the entire time, Dr. Rifkah says.
On the erg specifically, don’t get too attached to your stats, especially if it makes you sacrifice form. That’s a common pitfall, but pushing too hard, grabbing too tightly, and straining too much can lead to injury.
Getting adequate rest between rowing sessions is also very important. Rest in between sessions is important, especially with such a repetitive sport. And if something hurts, see the doctor; don’t wait for it to get worse.
Many of these repetitive rowing injuries can heal with time. For wrist pain, you might need a brace. For knee pain, you could benefit from a physical therapy session. For shoulder pain, you may benefit from an injection. Therefore, it is always prudent to consider an evaluation by a physician.