Athletes are under constant pressure and stress, from performing at peak levels to staying well in the off season; maintaining health, balance and preventing injury are all priorities in the life of an athlete, whether a novice fitness enthusiast or an elite olympian, staying healthy and recovering quickly are of utmost importance. As I’ve started to venture into the world of open water rowing at the South End Rowing Club, I’m quickly learning many of the possible points of injury for rowers, myself included. While rowing is a low impact sport, posture and positioning are extremely important, as is training frequency and duration when it comes to preventing injury. Overtraining can quickly lead to injury, just as poor posture and stroke technique can set up a rower for injury down the line. As an Acupuncturist, I commonly treats patients for pain related to athletic endeavors and sports injuries, and I can say that taking care of an injury when it first appears is by far, one of the most crucial points to helping an athlete heal faster and without further injury. When issues are in the acute phase, they are generally easier and faster to respond to treatment, whether with acupuncture, physical therapy, chiropractic, massage or other modalities, treating a condition sooner than later can help an athlete get out on the water more safely, and sooner than attempting to ignore a minor injury which sets up re-injury later on.
Common Rowing Injuries
Injury from rowing is commonplace, one study of senior international rowers found that the prevalence of injury was 0.92 injuries per rower(1), which can make it seem like injury is essentially guaranteed at some point or another. Most injuries occur due to overuse and overtraining, in addition making changes to the type of boat one rows can open a rower up for injury, making significant changes to the routine like a sweep rower changing sides mid-season can be an entry-point for a new injury to develop. The good news is, most rowing injuries tend to be of minor nature, more severe injuries are significantly less common, but this all depends on how we deal with and treat injuries in their minor stages, preventing them from becoming larger problems later on.(2)
The most common injuries amongst rowers are low back injury and knee injury, and it is thought that a new rower with a history of these types of injuries will be more susceptible to re-injury due to rowing, in which case a slow training regimen with emphasis on proper technique will be crucial to the health of the athlete. In addition to the back and knees, other injuries include the wrist - mostly due to the repeated motion of feathering the oars, the rib cage, shoulder and arm injury, and occasionally neck and upper back strain. Being acutely aware of our bodies, while participating in any sport or exercise program is essential to helping us notice when something is ‘off’ and course correcting so that we heal the injury in its’ initial phases.(3)
Exercises to Prevent Injury
One great way to help prevent injury is to strengthen our weaknesses, and also to take it easy when we feel like an injury may be developing. Overtraining was the #1 cause of injury among rowers,(1,2) which makes it obviously important to listen to our bodies and work on our weaknesses. We don’t become Olympic athletes overnight, and our training schedules should reflect this fact - building muscle and skill takes time, and overdoing it will more likely do more harm than good for most.
Good Posture on the Erg (and while rowing!)
By far one of the most important ways you can spend your time training to row is making sure you’re getting good posture and a good, efficient stroke on the erg. A correct stroke can be all you might need to avoid injury. Not sure what that looks like? Ask an advanced rower! There are also plenty of videos on YouTube to help give you some ideas for tidying up your stroke, like this awesome stick figure video.
Patellar pain is one of the most common types of knee pain in rowers, if you’re feeling some knee pain after a row it’s important to take that as your body’s HUGE warning signal and address it right away. Some exercises and stretches to help with patellar knee pain are:
Straight Leg Raises - Wall Slide (or wall assisted squat) - External Hip Rotation - Iliotibial Band and Buttock Stretch - Hamstring and Calf Stretches
Lower Back Care
Those prone to low back pain might notice this pain spot lighting up after rowing, poor posture like hunching over, pulling with the arms instead of pushing with the legs and failing to keep those shoulder blades down are all habits that can lead to stressing the low back. Getting on the erg with someone who can critique your stroke will be very helpful if you’re experiencing some lower back pain. Caring for your back with these exercises and stretches will also be helpful:
Planks - strengthen the core! - Back Extensions - Swiss Ball Pikes (you might want to google this one!) - Reverse Hip Raises - Knee to Chest Stretch - Lying Knee Twist - Yoga Cat / Cow Position - Piriformis Stretch / Seated Twist
Acupuncture for Treatment and Prevention
Sometimes we miss our body’s signals to proverbially ‘jump ship’ and take a break from training, and we wind up with a more serious injury. If we’re wanting to avoid surgery and heal in the most complete and quick way, then we need to be pretty proactive about our healing, in addition to exercises and stretches to help heal the injured area and of course - taking a break from training, there are many options for alternative therapies and treatments to help speed recovery and acupuncture is a great option. Using additional therapies, like acupuncture, can help speed healing, but they are traditionally most effective to help us prevent injury in the first place, so even though we may not notice any particular injury (yet) we can still take care of ourselves proactively - because training is stressful on the body!
Acupuncture is an incredibly effective modality to not only prevent and heal injury, but help you become the best athlete you can be. Many professional sports teams, like the SF Giants and even the SF Ballet, employ Acupuncturists to take care of the athletes on an ongoing basis. So while some of us might not consider ourselves the caliber of SF Giants ‘athlete’ material, we are still participating in some incredibly extreme sports and should care for ourselves with the same diligence and enthusiasm as any Olympian would.
In my practice I employ a wide variety of Traditional Chinese Medicine and Japanese Acupuncture techniques. I find one of the most effective treatments for treating muscle pain from sports training and sports injuries is Japanese Trigger Point Acupuncture - this modality involves using specific trigger points affecting the fascia of the muscles and signaling the body to help those muscles disengage, release dopamine and in turn - relieve pain. A Japanese trigger point acupuncture session can relieve muscle pain by 50% in just one session, without the traditional painful treatment sensations as in traditional trigger point acupuncture or massage. In addition to Japanese trigger point acupuncture I also employ the use of electro-stimulation, moxibustion, cupping, gua sha, dietary and supplement regimens to help an athlete find their most efficient and effective path to healing. Acupuncture helps to reduce inflammation in the body in addition to triggering muscles to disengage and relax, which helps reduce pain and improve lymphatic drainage through the tissue. Utilizing regular acupuncture treatments in conjunction with your training regimen can not only mean faster recovery from injury, but more strength and resistance to injury in the first place. When we avoid injury entirely, that means stronger rows and faster times!
Dr. Kim Peirano, DACM, LAc is the Owner and Acupuncturist at Lion's Heart Wellness, the San Francisco Bay Area and Marin's #1 Cosmetic Acupuncturist and #1 Holistic Healer.