Back pain: rowing injuries treatment and prevention

Lower back injuries for rowers

A client of my London fitness clinic recently suffered a stiff and painful lower back after a rowing workout. He was examined by my osteopath colleague, Clive Lathey, who diagnosed that the left-hand side of the lumbar sacral joint was very stiff and probably inflamed. The stiffness was accompanied by a very tight left hip flexor and tight left gluteal muscles. Clive and I surmised that the stiffness in the left lumbar-sacral area post-rowing workout had most likely been caused by the fact that the left gluteal and hip flexors were already hypertonic, or tight. It is very important for all the joints and muscles on both sides of the spine to be fully mobile, otherwise tightness means that the stresses placed on the spine during rowing can be excessive and cause pain, as in this case.

We discussed the likely causes of this left-hand-side tightness, trying to work out if there were any activity or habit that occurred on a regular basis during the client's everyday life that could place excess stress on the left hip. From this discussion, we decided that the most likely cause of the problem was that the client spent at least 15 hours a week driving around London. As you may know, city-centre driving involves lots of clutch pumping and changing gears, especially between first and second!

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If we think about the biomechanics of using the clutch, we can see that our hypothesis makes a great deal of sense. Pressing and releasing the clutch involves hip and knee flexion/extension of the left leg. Because of the driving position, this flexion/extension occurs over a very limited range of movement with the hip flexed. This kind of repetitive small-range flexion/extension movement is exactly the sort of activity that will cause tightening and loss of flexibility in a muscle group. In addition, the fact that the left-leg movement occurs in a seated position is likely to mean that the rear of the left pelvis, lumbar-sacral and SI joint area will take some strain, thus causing the left gluteal to tighten.

As well as the osteopathy treatment, which successfully released the stiffness in the lumbar spine, we prescribed various stretches for the client. He had to perform regular hip flexor and gluteal static stretches to help with the treatment. However, we also decided that he should introduce a dynamic, full range-of-motion hip flexion/extension exercise into his daily routine to help counteract the tightening effects of his city-centre driving. This involved standing on the right leg and swinging the left leg forwards and backwards. The swings were small initially and gradually increased to full-range swings. Two sets of 30 swings each day helped maintain a full range of active motion in the hip area and also helped the clutch-pumping from tightening up the left side once more.

Raphael Brandon

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