Yesterday was day two of the Olympic finals at Dorney Lake in Eton where we witnessed the US Women’s Eight win their second consecutive Olympic medal with power, control and grace. This is a phenomenal group of athletes and coaches who have dominated this event and been undefeated for six years on the world rowing stage. They define the concept of teamwork as does the sport of rowing where each athlete is critical to the success of the boat.
Racing continues today at Dorney Lake where I have the privilege of working as the FISA (International Federation of Rowing Associations) Medical Officer. The London Organising Committee of the Olympic & Paralympic Games medical staff at the venue are highly professional and well trained from a sports medicine perspective. Life has been calm. The unspoken goal for all of the medical staff is to be prepared for all contingencies but not to be needed! We all wish for healthy athletes who do not require medical services at this pinnacle of their careers.
I have been a member of the FISA Medical Commission for over a decade, a team physician for US Rowing since 1994 and have treated rowers and their injuries over many years. The majority of rowing injuries are associated with training at high intensity, acceleration of training protocols without an adequate strength base (particularly in novice and junior rowers), and winter training with over reliance on the rowing ergometer, which is an exercise machine that measures the amount of work done by a muscle or group of muscles.
The most common injury seen in rowers of all ages, levels of expertise and training is to the lower back. Rowing requires the coordinated use of the arms, back and legs as power is exerted on the oar. The low back can be viewed as a connection point between the forces applied to the oar via the arms and the power generated by the legs during the drive phase of the stroke. A strong core is critical to stabilize the lower back and permit application and transfer of power. Rowing with poor posture and rowing into fatigue where good technique is lost put the non-elite rower at risk of injury. The intensity of training required for the elite or Olympic-level athlete can place the lower back at risk despite excellent form, excellent core strength and ultimate preparedness. There are athletes around the world who are not participating in these Olympic Games due to back injury during training over the last four years.
The second most common overuse injury seen in this sport is stress fracture of a rib. This injury is much less common in the high school, club or masters rower but is seen in top collegiate and national team rowers. Rib injury is most common in the 6th-9th ribs and occurs at the site where abdominal wall and scapula (shoulder blade) muscles attach to the ribs. These injuries can occur during high intensity winter ergometer or distance on-water training at high resistance and low stroke rates but can also occur in the spring with the transition from winter training to racing. A rib stress fracture can limit rowing competition for 4-6 weeks if the diagnosis is made early.
Rowing is a fantastic sport for active people of all ages, provides an excellent source of cardiovascular conditioning and strengthens musculature throughout the body. If watching Olympic Rowing has inspired you, look for a local club or training facility at US Rowing!
Dr. Jo Hannafin is an orthopedic surgeon in the Women’s Sports Medicine Center at Hospital for Special Surgery. She serves as the medical officer for FISA, Federation Internationale des Societes d’Aviron in French, or the English equivalent, International Federation of Rowing Associations.