Rowing is widely regarded as a low-impact, full-body sport that builds strength, endurance, and coordination. However, despite its many benefits, rowing places repetitive and sometimes high loads on specific areas of the body. Over time, this can lead to a range of injuries—particularly when technique, training volume, or recovery are not well managed.

This article explores common rowing-related injuries, key risk factors, and why seeking a physiotherapy assessment is an important step in maintaining performance and long-term health.

Rowing involves cyclical, repetitive motion—often performed thousands of times per session.

Rowing involves cyclical, repetitive motion—often performed thousands of times per session. Each stroke requires coordinated force generation through the legs, trunk, and upper body. Small inefficiencies or imbalances can become magnified over time, placing stress on joints, muscles, and connective tissues.

Additionally, training programs often include high volumes, ergometer (indoor rowing machine) sessions, and strength work, all of which can contribute to cumulative load.

Common Rowing-Related Injuries

1. Lower Back Pain

Lower back pain is one of the most frequently reported issues among rowers. The lumbar spine is subjected to repeated flexion and extension under load, especially during the drive phase of the stroke.

Contributing factors may include:

  • Poor technique (e.g., excessive spinal rounding)
  • Weakness or poor coordination in trunk stabilising muscles
  • Fatigue leading to loss of form
  • Sudden increases in training intensity or volume

2. Rib Stress Injuries

Rib stress injuries, including stress reactions or fractures, are relatively common in competitive rowers.

Risk factors include:

  • High training loads, particularly on the ergometer
  • Muscle imbalances around the trunk and shoulders
  • Inadequate recovery
  • Repetitive strain from powerful upper body drive

3. Knee Pain

The knee joint experiences repetitive compression and extension forces during rowing.

Common contributing factors:

  • Poor alignment during the drive phase
  • Muscle imbalances (e.g., quadriceps dominance)
  • Limited ankle or hip mobility affecting movement patterns
  • High stroke rates over prolonged sessions

4. Hip Pain and Femoroacetabular Impingement (FAI)

Hip pain in rowers is increasingly recognised, particularly in relation to femoroacetabular impingement (FAI)—a condition where the shape of the hip joint can lead to abnormal contact between the ball and socket during movement.

Rowing places the hip into repeated deep flexion, especially at the catch position, which may aggravate this condition.

Associated risk factors include:

  • Repetitive end-range hip flexion under load
  • Reduced hip mobility or structural variations in hip anatomy
  • High training volumes, particularly on the ergometer
  • Compensation from other areas (e.g., lumbar spine or pelvis)

5. Wrist and Forearm Injuries

Grip and handle control are essential in rowing, placing strain on the forearms and wrists.

Potential issues include:

  • Tendinopathy from overuse
  • Poor handle technique or excessive gripping force
  • Equipment setup that does not suit the athlete

6. Trigger Finger

Trigger finger is a condition affecting the tendons of the fingers, where a finger may catch, lock, or click during movement. In rowing, repetitive gripping of the handle—especially under high load or fatigue—can contribute to irritation of these tendons.

Contributing factors include:

  • Prolonged or forceful gripping of the oar or erg handle
  • High training frequency with limited recovery for hand tissues
  • Technique that relies excessively on grip rather than hook-like hand positioning
  • Equipment handle size or texture

7. Shoulder Pain

The shoulder complex plays a stabilising role during rowing, particularly during the finish and recovery phases.

Associated risk factors:

  • Poor scapular control
  • Muscle fatigue
  • Overtraining or insufficient recovery
  • Weakness in supporting musculature

Key Risk Factors Across All Injuries

While each injury has specific contributors, several overarching risk factors are consistently seen in rowing populations:

  • Training Load Errors: Sudden increases in intensity, duration, or frequency
  • Technique Inefficiencies: Suboptimal biomechanics repeated over time
  • Muscle Imbalances: Strength or flexibility discrepancies affecting movement patterns
  • Fatigue: Reduced neuromuscular control under prolonged exertion
  • Inadequate Recovery: Insufficient rest between sessions
  • Equipment Setup: Poorly adjusted ergometers or boats
  • Previous Injury: A history of injury increases susceptibility to recurrence

Why a Physiotherapy Assessment Is Advisable

Even minor discomfort in rowing should not be ignored. Because of the repetitive nature of the sport, small issues can escalate quickly if underlying causes are not addressed.

A physiotherapy assessment provides a structured and detailed evaluation of multiple factors that may be contributing to pain or reduced performance:

1. Movement and Technique Analysis

Physiotherapists can assess rowing-specific movement patterns, identifying inefficiencies or compensations that may not be obvious during training.

2. Load and Training Review

Understanding how training volume, intensity, and recovery are managed is crucial in identifying overload-related issues.

3. Strength and Mobility Screening

Targeted assessment can reveal deficits or asymmetries that increase injury risk.

4. Early Identification of Injury

Subtle signs of overuse injuries—such as early stress reactions—can often be detected before they become more serious.

5. Individualised Risk Profiling

Each rower has unique biomechanics, training demands, and history. Physiotherapy helps identify personal risk factors rather than relying on general assumptions.

The Importance of Early Assessment

Rowers often continue training through mild discomfort, assuming it is a normal part of the sport. However, persistent or recurring symptoms are often indicators of underlying issues.

Early physiotherapy assessment can:

  • Clarify the cause of symptoms
  • Prevent progression to more significant injury
  • Support long-term participation in the sport
  • Help maintain consistent training and performance

Final Thoughts

Rowing is a demanding and highly repetitive sport that requires careful attention to technique, training load, and physical conditioning. While injuries are common, they are often linked to identifiable and modifiable risk factors.

A physiotherapy assessment plays a key role in identifying these factors early, providing valuable insight into movement, load management, and overall physical readiness. Whether you are experiencing discomfort or aiming to optimise performance, a proactive approach to assessment can make a meaningful difference in both injury prevention and long-term athletic development.