No one wants injuries. There are many things that rowers and coaches can do better to reduce risks, but we can never fully prevent injuries, so it’s important to have a plan in place for when one occurs. This article covers my general approach to rowing injuries, how rowers and coaches can work with rowing physical therapists for best results, and my go-to list of all-star rowing physical therapists for resources and appointments (virtual and in-person).
DISCLAIMER: While we are discussing injuries and the medical field very generally in this article, nothing ahead constitutes individual medical advice or specific information on injuries or other health problems. The whole point of this article is the value of consulting appropriate medical professionals when confronted with medical or health-related problems. I will discuss my approach to rowing injuries at a general level, and encourage you to apply the information as you personally choose to based on your knowledge, comfort level, and available medical resources, doing so in a way that does not render me personally responsible for your actions.
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Why Rowing Physical Therapists?
There are a few main types of physical therapists, also known as “physiotherapists” by readers outside the USA. General physical therapists have most of their experience and clinical practice in the non-athletic population, especially helping rehabilitation following surgery or another medical event. “Sports PTs” focus more on sports injuries and rehabilitation for athletes in general. Sports PTs are great for recreational athletes or people who are more physically active than the general population, but do not usually specialize in a specific sport, activity, or performance. Finally, there are specialty physical therapists who do a majority or entirety of their work within a specific population. Rowing physical therapists have all the physical therapy education, plus years of experience working with rowers. Many rowing physical therapists are also rowers or coaches themselves, do academic research on rowers, participate in rowing education programs, or are employed by a rowing team or organization medical staff. These are all great signs to look for when finding a specialist.
This specific knowledge of rowing allows rowing physical therapists to be more effective than general or sports physical therapists. Rowing is an unusual sport from a physical needs standpoint, and isn’t yet popular enough for knowledge about it to be truly mainstream. Rowing physical therapists can shortcut the whole introduction process that athletes often find frustrating when working with someone unfamiliar with the sport and training practices. Rowing physical therapists also know the specific performance needs of rowers, movements and common technical errors that can increase pain or risk of injury, and can communicate more effectively with other members of the training staff, such as strength coaches and rowing coaches. Rapid treatment for injuries to get athletes on a successful path quickly is a major point for effectiveness and minimizing athlete frustration during the recovery process.
Approach to Rowing Injuries
Before the injury, rowing physical therapists can help greatly with reducing risk of injuries through proactive movement screening and helping rowers and coaches address specific physical limitations. Many rowing physical therapists offer individual or team consultations to teach movement training to rowers and coaches.
My general practice for minor injuries is about five days of reduced loading, avoiding aggravating movements, and trying to find ways to reduce pain such as stretching, massage, foam rolling, etc. I consider it a minor tweak if it resolves fully in under a week and minimally interferes with training. If pain persists, worsens, or reoccurs while returning to train, it’s time to bring in a rowing physical therapist to get to the root of the problem and on track to a solution. Rowers should seek immediate medical advice and treatment for any abnormal sensation, injuries that are more severe than a clearly identifiable low-grade muscular tweak, pain persisting beyond a short initial period, or any other time they wish to. Skip ahead to the contacts list.
Once a rower has an injury, solving the injury starts with an understanding of which specialist has primary responsibility over which area of training. Here’s how I see this coming together. Strength coaches build general physical capacity. Our methods help improve muscularity, strength, power, fitness, and general athletic movement performance. Rowers and rowing coaches then take these improved physical skills and make better rowers, training the specific skills, techniques, and performance needs for athletes to be really good at moving boats over their intended race distance. If it were this simple, everyone would get strong, row fast, and stay healthy. However, sometimes it gets complicated and there’s an injury or something holding an athlete back from achieving full performance or specific technique. When this happens, there’s no one better to have available than a physical therapist who really knows rowing and can help troubleshoot from a more informed perspective.
For example, when an athlete struggles to hip hinge under load and a strength coach has already done all the instruction, cueing, and simplified exercises that we can do, a physical therapist may help identify and treat a specific weakness, restriction, or other problem preventing the athlete from achieving the movement. If rowers continue to make a consistent error when rowing on-water or using an erg and “just can’t fix it” despite recognizing the problem, maybe even correcting it at slower rates or under light pressure, and rowing coach and strength coach both doing all they can to help the athlete make the change, a rowing physical therapist can often identify a specific physical restriction preventing the rower from achieving the goal technique. General physical therapists can help here, but I’ve found it much more valuable to work with a specialist who has a deep knowledge of the rowing movement, performance needs, and specific dysfunctions, problems, and injury risks, on top of all the physical therapy education.
The rower then works with the physical therapist to improve the specific problem while the strength coach helps maintain training load, working around the problematic area so as to not interfere with the rehab. I’ve found that many general physical therapists will advise rowers to stop most other activity during therapy, even including pain-free strength and cross-training. This is often a mistake that prolongs recovery time. With good communication from a knowledgeable physical therapist to both athletes and coaches, we can often find ways to train around the injured area in strength training, cross-training, and perhaps even modified rowing training. Rowing physical therapists have this knowledge and can work with the rower and other coaches to maintain training load to reduce the amount of return-to-train time necessary for resuming rowing training.
All four parties–the rower, physical therapist, strength coach, and rowing coach–need to be on the same page as the rower returns to specific rowing training and performance. The rowing physical therapist can help inform the rower and strength coach on specific things to continue strengthening after concluding active rehab. The strength coach, rowing coach, and rower need to know how much training volume and intensity the rower can handle, any modifications that we need to make in training, and have a plan for gradual progression in volume, load, frequency, and specificity of strength and rowing training. Many athletes become re-injured due to an excessively rapid progression from a period of reduced training. The injury may have healed, but too much stress applied too quickly will re-injure it again or cause something else to be injured.
Read More: Rowing Return-to-Train Considerations
Some rowers may never return to exactly the kind of strength or rowing training that they did before the injury. For example, I will not use strength training exercises that put compressive load on the ribcage of rowers who have experienced a rib stress injury, such as chest-supported rows, barbell bench pressing, and of course, the dreaded bench pull. The risk of reinjury is too great, so we will find other exercises to strengthen these areas. In rowing training, I prefer that rowers with low back pain or rib stress injuries avoid prolonged erging (20+ minutes continuous), opt for dynamic ergs (or slides) instead of fixed ergs whenever possible, and do not use added-resistance rowing or erging training methods like high drag, cans or boatweights, and rowing eights by pairs. It’s important that the medical staff, coaching staff, and rower are all informed on injury mechanisms, specific risks, and training strategies to reduce risk of reinjury. The rower may also have some long-term maintenance exercises that will always be a part of their training to reduce risk of reinjury. A great rowing physical therapist is crucial to informing the training approach as an athlete returns from injury.
“All-Star” Rowing Physical Therapists
The below clinicians are people who I’ve personally worked with online and/or in-person. This is my personal “all-star” list of rowing physical therapists who I go to when I have questions or need to refer athletes for injuries, and who agreed to have their information listed here. I do not intend for this to be a comprehensive resource, nor do I plan to make this a global directory of everyone who is everyone in rowing physical therapy. Before you flame me for not including your favorite PT, please write and introduce me first. You can comment below or email me with any questions or suggestions. I’ve included some brief information about each individual with links to where you can find more details, make an appointment or find more resources, or follow them on social media.
Dr. Karen Calara
- In-person AND virtual appointments.
- Karen came to rowing during a physical therapy internship many years ago and has been an invaluable resource to rowers and coaches ever since. During normal times, she operates out of her clinic in Seattle, WA, travels to the Vesper Boat Club boathouse in Philadelphia, PA, as well as consulting with other teams and rowing programs.
- Find her on Facebook and Instagram
- Hear her on the Strength Coach Roundtable podcast talking about rib stress injuries and how rowing coaches, strength coaches, and physical therapists can work together better.
Dr. Deirdre McLoughlin
- In-person AND virtual appointments, including video review of rowing/erging technique.
- Deirdre has been all over the rowing world since joining as a college walk-on in the early 1990s, most recently coaching with Marin Rowing Association, UC Berkeley, Oakland Strokes, and serving on the medical staff for USRowing teams. She sees rowers and general clients at her clinic in Albany, CA.
- Find her on Twitter
Dr. Greg Spooner
- In-person AND virtual appointments, including a free 15-minute consultation.
- Greg started rowing in college and has gotten crazier with it each year since, including rowing across the Atlantic Ocean, the Mississippi River, and winning the 70-mile Seventy48 race in 2019, among other feats in his 20 years in the sport. He mostly works out of his clinic in San Diego, CA, but travels frequently between CA and WA and is also available for remote and mobile services.
- Find him on Facebook, Instagram, and Youtube
- Hear him on Rowing Chat with Rebecca Caroe.
Dr. Lisa Russell Lowe
- In-person AND virtual appointments at Champion PT and Performance.
- Lisa came to rowing in college, continued for a few years in a high-performance program, and still keeps it up with Community Rowing Inc. in Boston, MA. She has a specialty in para-rowing and is a member of the physical therapy support staff for the Para National Team rowers at CRI.
- Find her on Facebook, Instagram, and Twitter
- Lisa joined us on Volume 2, Issue 5 (May, 2021) of Science of Rowing, discussing hamstring flexibility and hip function in rowing.
Dr. Erin McConnell (McInerney)
- In-person appointments at Spaulding Brighton Outpatient Center and virtual visits with Massachusetts state residents.
- Erin rowed in high school and college and completed the Institute of Rowing Leadership program at Community Rowing Inc. in Boston, MA between college and physical therapy school. She brings the triple-whammy of experience as a rower, rowing coach, and physical therapist to the Rowing Performance Unit at the Brighton, MA location of the Spaulding Rehabilitation Network.
- Follow Upstream Physios on Instagram or Erin on Twitter
- Hear her on Joe DeLeo’s Leo Training podcast discussing injury rehab for masters rowers.
Dr. Fiona Wilson
- Limited in-person appointments only.
- Read about Fiona’s path from high-performance rower to clinician and low back pain specialist researcher in this Twitter thread. These days, she is focused on education and mentoring for other clinicians and rowing coaches, teaching at Trinity College in Dublin, Ireland. She is a member of the WorldRowing back pain pathway taskforce and a major leader in rowing injury research.
- ResearchGate Profile
- Find her on Twitter
- Hear her on the Strength Coach Roundtable podcast discussing core training for rowing.
- In-person appointments only at her private clinic BodySystem in Hobart, Tasmania.
- Kellie came to rowing after years of being a general sports PT and worked with the Australian Rowing Team from 2008 to 2016. Kellie is also a member of the WorldRowing back pain pathway taskforce and consults with rowers and coach-education through her “GRowing Bodies” company.
- Find her on Twitter and follow GRowing Bodies on Twitter or Instagram
- Kellie joined us on Volume 1, Issue 3 of Science of Rowing with Dr. Larissa Trease, talking about a 2020 injury study on Australian National Team rowers with takeaways for rowers and coaches to reduce risk of injury.