A pain in the back

“My parents weren’t sure if rowing was a good sport for girls. They told me, ‘you will get sore knees and back,’ and that’s true!” World Rowing Athlete of the Month for January, Jitka Antosova of the Czech Republic expresses the common belief about the impact of rowing on the body, especially amongst women.

But what are the hard facts?

A New Zealand study comprising of 363 lightweight schoolgirl-aged rowers has just been conducted to examine the issue of spinal back problems in young female rowers. Dr Gillian Johnson and Dr Margot Skinner from the School of Physiotherapy at the University of Otago collected data over three consecutive years from rowers attending the annual New Zealand secondary schools regatta, the Aon Maadi Cup.

Johnson and Skinner conducted the study as they were aware of reports mentioning high levels of lower back pain amongst rowers, especially females. “We were interested in the rowers as they are typically young, healthy, fit girls who undertake repetitive movements in the flexing and extension movements of the spine and whether rowing predisposed them to pain,’ says Johnson. Lightweight female rowers were specifically targeted because of their higher risk of back problems as they generally have lower body weight and muscle strength compared to their male counterparts.

The results of those who took part in the study were statistically significant. Nearly a quarter (22.5 per cent) of the participants who were interviewed reported currently suffering from back pain and were currently undergoing treatment for it. But despite rowing literature indicating sweep rowing is a key factor in back pain experienced by rowers, this was not supported by Johnson and Skinner’s results.

“In terms of sweep rowing style, in the literature it is well known that the position with rotation in a flexed position (at the catch), will compromise the spine,” says Johnson. “But in our modelling we didn’t get reports of higher levels of back pain (amongst the sweep rowers).”

Identifying specific factors that caused the back pain, however, was difficult. “It is very hard to get cause and effect in any back pain population,” says Johnson. “But it’s clear that back pain is a multi-factorial problem, not a single underlying cause. A small percentage (of the athletes) may already have underlying spinal pathology which would predispose them to back pain, while others have been exposed to poor training regimes and poor technique.”

Other aspects of the sport also came to light in terms of their impact on the back. “Fifty per cent said that when they got pain they were citing rowing-related activities such as lifting the boat or carrying the boat,” says Johnson. Others talked about specific exercises, such as weight training. “So they were getting pain with specific activities,” adds Johnson.

Skinner points out that no one factor stood out. Rather it was a variety of things. “When you study rowing forces, the requirements are extreme and the high loading is mainly happening in the lower part of the spine,” says Skinner.

Both Johnson and Skinner, however, do not want to discourage young women from rowing. In fact, they believe the opposite. They feel passionately about the need for adolescents, especially females, to be physically active for the building and strengthening of bone mass which can help prevent the chance of osteoporosis later in life.

They state in their study: “The long-term benefits of exposing young females to repetitive loading during rowing in this age group should theoretically promote bone health and be protective against spinal osteoporosis into old age and therefore rowing should be advocated in this positive light.”

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“Rowing is an attractive sport for girls because they are building bone mass up to their early 20s,” says Johnson. “Females have a limited window of opportunity to build up their peak bone mass and they need to expose their bones, including their spine, to loading in their teenage years. Peak bone mass is the result of two factors: a genetic component, which accounts for about 60 per cent, with the remaining 40 per cent influenced by factors such as mechanical loading of bones (including the spine) and good diet. “Physical activity that includes lots of weight-bearing activity is important to encourage from an early age and to continue through life,” adds Skinner. “Rowing is a good example of a sport that loads the spine.”

As the study focused solely on rowers that were currently competing, it did not take into account rowers who could no longer row due to back problems. “Anecdotally,” says Johnson, “we were contacted by several mothers whose daughters had back pain that was so severe that they couldn’t continue rowing, but we weren’t able to find out more about the nature of these problems in this study.”

Amongst other points, the study concluded that training often needed to be tailored towards the individual, as what suits one athlete does not always suit another in terms of spinal health.

Melissa S. Bray