We see a lot of rowers come to the clinic in Cambridge with knee pain. Some of them have been experiencing what’s commonly known as ‘rower’s knee.’ With the amalgamation of strength, endurance, and technique in rowing, it is not surprising that athletes may experience knee pain. In this comprehensive guide, we will delve deep into the causes, available treatment options, and preventive measures for rower’s knee. Drawing upon the most current scientific research, expert guidance, and practical wisdom gleaned from seasoned rowers, our primary objective is to furnish rowers with valuable information to aid their understanding and management of this issue.
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Understanding Rower’s Knee: More Than Just Pain
Rower’s knee serves as a broad classification that covers a range of knee issues that can arise from participating in rowing activities. These issues may encompass conditions such as patellofemoral pain syndrome (PFPS), iliotibial band syndrome (ITBS), and meniscus tears. The repetitive movements and substantial strain placed on the knees during rowing can contribute to the manifestation of these conditions, particularly when proper technique is disregarded.
Unravelling the Causes of Rower’s Knee
The primary culprit behind rower’s knee is the repetitive strain and pressure placed on the knee joint during rowing. This strain can lead to inflammation and damage to various parts of the knee, including the cartilage, ligaments, and tendons. Other contributing factors to rower’s knee include:
- Poor rowing technique: Incorrect form can place additional stress on the knees, leading to injuries.
- Overtraining: Rowing too frequently or for too long without adequate rest can lead to overuse injuries.
- Lack of flexibility: Tight muscles can pull on the knee joint, causing pain and inflammation.
- Muscle imbalances: Weak or imbalanced muscles can lead to improper knee alignment, which can cause pain and injury.
Navigating Treatment Options for Rower’s Knee
The treatment for rower’s knee will depend on the specific injury and its severity. However, most treatments will involve a combination of the following:
- Rest and Ice: Rest is crucial for healing any sports injury, including rower’s knee. It’s important to take a break from rowing and any other activities that cause knee pain. Applying ice to the knee can also help reduce inflammation and pain.
- Physical Therapy: Physical therapy can be very beneficial for treating rower’s knee. A physical therapist can provide exercises to strengthen the muscles around the knee and improve flexibility. They can also advise on proper rowing technique to avoid future injuries.
- Medication: Pain relievers and anti-inflammatory drugs sold over the counter can help control pain and reduce inflammation. A doctor may recommend harsher drugs or corticosteroid injections in some circumstances.
- Surgery: In severe cases, may be necessary to repair damage to the knee. This is usually a last resort when other treatments have not been effective.
Preventing Rower’s Knee: An Ounce of Prevention is Worth a Pound of Cure
Prevention is always better than cure. Here are some strategies to prevent rower’s knee:
- Warm up and cool down: Prioritise the incorporation of warm-up exercises before commencing rowing and cooling-down exercises after completing your rowing session. This deliberate approach aids in effectively preparing your muscles and joints for the activity, ultimately decreasing the chances of injury.
- Polish your technique: Paying attention to precise rowing technique plays a vital role in mitigating knee strain. Consider enlisting the expertise of a coach or trainer to polish your form and make necessary refinements.
- Strengthen your muscles: Strong muscles can help support your knees and reduce the risk of injury. Focus on strengthening your quadriceps, hamstrings, and hip muscles.
- Stay flexible: Regular stretching can help maintain flexibility and reduce the risk of injury.
- Don’t overdo it: Avoid overtraining and give your body plenty of time to rest and recover between workouts.
Additional Insights: Avoiding Rowing Machine Knee Pain
Improper usage of rowing machines can result in knee pain, despite their popularity as a training and fitness tool. To help you steer clear of knee discomfort when utilising a rowing machine, here are some additional pointers:
- Proper Setup: Ensure the rowing machine is set up correctly for your body size and strength. The footrests should be adjusted so that your knees are slightly lower than your hips when you’re seated. The resistance should be set at a level that challenges you but doesn’t strain your knees.
- Correct Technique: Use the correct rowing technique to avoid unnecessary strain on your knees. The power in rowing should come from your legs and hips, not your upper body. Your knees should be straight when you pull the handle towards your body and bent when you extend your arms and slide forward.
- Gradual Progression: Increase the intensity and duration of your workouts gradually. Sudden increases can lead to overuse injuries.
- Strength Training: Strengthening the muscles around your knees can help protect them from injury. Incorporate exercises like squats, lunges, and leg presses into your workout routine.
- Stretching: Regular stretching can help maintain flexibility and prevent injuries. Focus on stretching your hamstrings, quadriceps, and hip flexors.
Specific Exercises for Rowers Knee
1. Activation Exercises
Activation exercises are designed to stimulate specific muscles and improve their neuromuscular activation. Here are some exercises targeting key areas:
- Glute Medius: Side-lying leg lifts and clamshell exercises can help activate and strengthen the glute medius, which plays a crucial role in stabilising the pelvis during movement.
- Glute Maximus: The hip thrust is an excellent exercise for activating the gluteus maximus, the largest muscle in the glutes, responsible for hip extension and external rotation.
- Vastus Medialis Obliquus (VMO): Terminal Knee Extension (TKE), Short Arc Quad, Isometric Wall Sit, and Leg Press with Toes Turned Inward are effective exercises for activating the VMO, a muscle crucial for knee stabilisation.
- Lumbar Spine Extensors: Bird Dog, Superman, Bridging, and Prone Press Up are beneficial exercises for activating the lumbar spine extensors, a group of muscles that help extend and stabilise the lower back.
- Rotator Cuff: External rotation with a resistance band and prone horizontal abduction are excellent exercises for activating and strengthening the muscles in the rotator cuff, located in the shoulder joint.
2. Flexibility Exercises
Improving flexibility can help prevent injuries. Here are some exercises that can enhance hip mobility and flexibility:
- Butterfly Stretch: This exercise stretches the inner thighs, improving flexibility.
- Hip Flexor Stretch: This stretch targets the hip flexors, which can often be tight in rowers.
- Pigeon Pose, Lizard Pose, and Frog Pose: Can significantly improve hip flexibility and mobility.
3. Strength Exercises
Strength exercises can help protect the knees from injury by strengthening the muscles that support them. Here are some exercises beneficial for rowers:
- Deadlifts and squats: By incorporating these compound exercises into your routine, you can effectively engage major muscle groups, such as the glutes, hamstrings, and lower back. This comprehensive approach enhances overall strength and power in the legs and lower back, facilitating greater performance capabilities.
- Pull-ups: Aids in the development and reinforcement of essential muscle groups crucial for executing the rowing stroke, specifically the back, shoulders, and arms.
- Bench Press: Targets the chest, shoulders, and triceps, improving pushing power, which is important during the drive phase of the rowing stroke.
- Rows: Targets the back muscles, including the lats, rhomboids, and traps, improving posture and pulling power during the rowing stroke.
- Planks: This core strengthening exercise improves overall stability and balance, crucial for maintaining proper rowing form and technique.
Conclusion
Among rowers, experiencing rower’s knee is a common injury, but by adopting the right treatment and prevention strategies, it can be effectively managed. The first crucial step in preventing and treating rower’s knee is to comprehend its underlying causes and recognize its symptoms.
By integrating correct rowing technique, adequate rest periods, strength training, and flexibility exercises into your routine, you can substantially decrease the likelihood of developing rower’s knee. If you encounter knee pain, it is crucial to seek early medical guidance. Timely intervention can impede the condition from deteriorating and promote a more expedient recovery.
When dealing with a more serious injury, medical intervention, such as pain-relieving drugs, injections, or, in extreme cases, surgery, may be required. Nonetheless, with proper treatment and rehabilitation, the majority of rowers can return to their sport and retain peak performance.
Keep in mind that each rower is distinct, and what may be effective for one individual may not yield the same results for another. Pay close attention to your body’s signals and consult with professionals when necessary. By adopting the appropriate approach, you can relish the numerous advantages of rowing while minimising the discomfort of knee pain.
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This article was written by our team of specialist therapists at Perfect Balance Clinic. If you would like more specific advice about how our team can help you with this condition or symptoms you may be having, please complete the contact form below and one of the team will get back to you shortly.
