17 Common Rowing injuries (Prevention & Treatment)

All 17 common rowing injuries, starting with lower back damage, then rib stress fractures, shoulder impingement, wrist strain and hand blisters.

The stroke repeats thousands of times, so overuse injuries, knee and elbow tendonitis and neck strain follow, with dehydration, sunburn, hypothermia and falls from the boat covered too.

From lower back troubles to tendonitis, and even the perils of sunburn and hypothermia.

Knowledge is power, after all, and awareness is your first line of defense.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
Elite Australian rowers recorded 270 injuries over eight international seasons, an incidence of 4.1 to 6.4 injuries per 1,000 athlete days.	153 Australian international-level rowers (48,611 athlete days), 2009 to 2016 (eight international seasons); published 2020	British Journal of Sports Medicine (Trease et al., 2020)
Rowing injuries are overwhelmingly overuse problems: 83 percent of injuries in elite Australian rowers were overuse, compared with 15 percent acute injuries.	153 Australian international-level rowers, 2009 to 2016; published 2020	British Journal of Sports Medicine (Trease et al., 2020)
The lower back is the single most frequently injured region in elite rowing, accounting for 84 of the 270 injuries recorded over eight seasons.	153 Australian international-level rowers, 2009 to 2016; published 2020	British Journal of Sports Medicine (Trease et al., 2020)
Low back pain in international rowers occurred at a rate of 1.67 episodes per 1,000 exposure hours, with point prevalence moving between 6 and 25 percent across the year.	76 New Zealand international-level rowers (46 men, 30 women), 12-month prospective follow-up; published 2015	British Journal of Sports Medicine (Wilson et al., 2015)
Among elite junior rowers, 73.8 percent of reported injuries were overuse injuries, and female rowers reported more injuries than males, 110.2 versus 90.5 per 100 rowers.	398 rowers at the 2007 Junior World Rowing Championships (42% female, 58% male), 2007 championships; published 2009	American Journal of Sports Medicine (Smoljanovic et al., 2009)

Overview

Injury	Body area	Typical time out
Lower back injuries (herniated disc, muscle strain)	Lower back	1 to 3 weeks, 4 to 12 with a disc
lder injuries (rotator cuff, impingement)	Shoulder	2 to 6 weeks, months if torn
Rib stress fractures	Ribs and chest wall	3 to 8 weeks, plus graded return
Wrist injuries (sprains, strains)	Hand and wrist	1 to 3 weeks, up to 8 if advanced
Hand injuries (blisters, calluses)	Hand	0 to 14 days depending on tearing
Overuse injuries (from repetitive motion)	Whole body	2 to 6 weeks, months if ignored
Knee injuries (tendonitis)	Knee	6 to 12 weeks of graded loading
Tendonitis (from repetitive motion)	Tendons, several sites	2 to 6 weeks, months if chronic
Neck injuries (muscle strain)	Neck	A few days to 2 weeks
Dehydration	Whole body	Hours to a day, longer if severe
Hip injuries (hip impingement)	Hip	4 to 12 weeks, months after surgery
Sunburn	Skin	Usually none, 3 to 7 days to heal
Elbow injuries (tennis elbow)	Elbow	6 to 12 weeks, up to 6 months
Ankle sprains	Ankle	1 to 3 weeks, up to 12 if grade 3
Hypothermia (in cold weather conditions)	Whole body	About a day, longer if severe
Heat exhaustion/heat stroke	Whole body	1 to 3 days, weeks after heat stroke
Injuries from falling off the boat	Whole body	Days for bruises, weeks if fractured
Acromioclavicular Joint Sprain	Shoulder	2 to 6 weeks, up to 12 for type III
Hamstring Strain	Thigh	2 to 4 weeks, longer if grade 2 or 3
Anterior Cruciate Ligament Tear	Knee	3 to 6 months to row, 9 to 12 to pivot
Finger Sprain (PIP Joint)	Hand	1 to 3 weeks, swelling months
De Quervain’s Tenosynovitis	Thumb and wrist	2 to 6 weeks, up to 12 if chronic
Concussion	Head	2 to 4 weeks, graded return
Foot Numbness and Metatarsalgia from the Foot Stretcher	Foot	Usually none, 2 to 6 weeks if nerve
Temporomandibular Joint Pain	Jaw	Usually none, 2 to 6 weeks to settle

Lower back injuries (herniated disc, muscle strain)

Rowing loads the lumbar spine at the catch, when the hips are fully flexed, the pelvis rotates backward and the discs and the small facet joints take the force of the leg drive. The tissue that gives way is usually the erector spinae or quadratus lumborum muscle, the disc anulus of L4/L5 or L5/S1, or the facet joint capsule. Long ergometer pieces are harder on the spine than water work because the position stays identical stroke after stroke.

Symptoms

• A deep ache across the belt line that builds during a piece and eases within hours after it
• Stiffness when you get out of the boat or off the erg, especially bending forward
• Pain that sharpens at the catch, at full compression, and when you cough or sneeze
• Shooting pain, pins and needles or numbness running into the buttock, thigh or calf
• A sense that one side of the back locks up and you cannot reach full compression

How serious it is: A grade 1 muscular strain is sore but lets you walk, sit and train in a reduced form, while a grade 2 strain limits almost every movement of the trunk. Disc involvement is the more serious end: leg pain below the knee, numbness or weakness in the foot points at nerve root irritation and needs a medical assessment rather than more training.

Typical time out: One to three weeks off full-pressure rowing for a simple muscular strain, four to twelve weeks when a disc is involved, and longer still if leg symptoms persist, because nerve tissue settles more slowly than muscle. The range is wide because most rowers keep training in a modified form and the return date depends on how quickly the spine tolerates full compression again.

See a doctor if: Get medical help the same day for numbness in the groin or saddle area, loss of bladder or bowel control, or clear weakness in a leg or foot.

What helps

• Keep moving with pain-adapted loading: walking, easy cycling and short low-rate pieces beat lying still
• Cut stroke rate and drive pressure first, and shorten the piece before you drop rowing altogether
• Reduce compression at the catch, either by raising the foot stretcher or by shortening the slide, until the spine tolerates the position again
• Build trunk endurance rather than trunk power: side bridges, bird dogs and loaded carries several times a week
• See a physiotherapist if pain lasts beyond two or three weeks, and reserve imaging for cases with leg symptoms or a suspected fracture

lder injuries (rotator cuff, impingement)

The supraspinatus and infraspinatus tendons run through a narrow space under the acromion, and the subacromial bursa sits with them. Every stroke asks the shoulder to hold the arms long at the catch and then to draw the handle in at the finish, which is thousands of repetitions of the same arc in a session. When the scapula does not rotate freely, usually because the upper trapezius overworks and the lower trapezius and serratus anterior do not, the tendons and the bursa are pinched.

Symptoms

• Pain on the front or outer shoulder when reaching away at the catch
• An ache deep in the joint that shows up at night and when you lie on that side
• Weakness or a dead feeling when you draw the handle to the ribs
• A catching or clicking sensation as the arm passes shoulder height
• Fatigue between the shoulder blades that lingers for a day after a session

How serious it is: Irritation of the tendon and bursa without a tear is the common form and responds to loading and technique work. A partial or full thickness cuff tear is the severe end and is suspected when you cannot hold the arm out to the side against light resistance or when weakness persists after the pain has settled.

Typical time out: Two to six weeks of modified training for straightforward subacromial pain, three to six months when a cuff tendon is torn and the shoulder is rehabilitated without surgery, and longer after a repair. The spread is large because most rowers keep training legs and trunk throughout and only the handle work is restricted.

See a doctor if: See a doctor if the arm cannot be lifted at all after a fall or a sudden pull, or if weakness rather than pain is the main problem.

What helps

• Load the cuff rather than resting it: external rotation and abduction work, heavy enough to feel, tolerating mild pain that settles within a day
• Train scapular control, especially lower trapezius and serratus anterior, since the shoulder blade sets the space the tendon runs through
• Check the finish position: drawing the handle too high or letting the shoulders shrug narrows the subacromial space every stroke
• Replace part of the erg volume with cycling or running while the shoulder settles, so fitness does not have to be rebuilt later
• Corticosteroid injection can calm a very painful bursa short term, but it does not fix the tendon and repeated injections make tendon tissue worse, so treat it as an exception

Rib stress fractures

A rib stress fracture is a crack in the bone of a rib, usually the fourth to the eighth on the side, caused by repeated bending forces rather than a single blow. The serratus anterior pulls the rib outward while the external oblique and the internal oblique pull it inward, and the rib bends between them at every stroke. Big blade loading, long low rate pieces and a sudden jump in ergometer volume are the classic triggers.

Symptoms

• A sharp, well localized pain you can point to with one fingertip
• Pain on a deep breath, a cough, a sneeze or a laugh
• Pain when rolling over in bed or pushing yourself up from lying
• Pain at the catch and at the finish, when the trunk twists over the rib
• Early on, a vague ache after training that later starts during training

How serious it is: It runs from a bone stress reaction, where the bone is irritated but not cracked and the pain only follows training, to a complete stress fracture that hurts with every breath. The earlier it is caught, the shorter the layoff, which is why persistent one-sided rib pain in a rower should be assumed to be bone until proven otherwise.

Typical time out: Three to eight weeks away from rowing for most, with a further two to four weeks of graded return to full pressure. It takes longer if training continues through the early warning phase, and slower healing is common in athletes with low energy availability or low bone density.

See a doctor if: Seek care for shortness of breath, chest pain that spreads, or rib pain after a heavy blow, since these point at the lung rather than the bone.

What helps

• Stop rowing and ergometer work early: bone needs unloading, and continuing turns a two week problem into a two month one
• Keep fitness with cycling, running or a stationary bike, anything that does not bend the chest wall
• Get a medical assessment, since plain X-rays often miss early rib stress and MRI or bone scan is the reliable test
• Look at the cause: a jump in erg volume, a heavier rigging, a new blade, or a training block with poor fueling
• Return by rate and pressure in steps, not by distance alone, and stop if the pinpoint pain reappears

Wrist injuries (sprains, strains)

The tendons that extend the wrist and thumb run in sheaths across the back of the forearm, and feathering the blade rotates the wrist under load at every stroke. The two typical rowing problems are tenosynovitis, where the sheath itself becomes inflamed, and intersection syndrome, where the thumb tendons cross over the wrist extensors a few centimeters above the wrist and the two groups rub. Sprains of the wrist ligaments happen less often and usually come from a fall or a caught blade.

Symptoms

• Pain and swelling on the back of the wrist or a hand’s width above it
• A creaking or squeaking feeling under the skin when you move the wrist
• Pain when feathering, gripping hard or wringing out a towel
• Weak grip and a tendency to drop things after training
• Morning stiffness that eases and then returns during the session

How serious it is: Tendon sheath irritation is graded by how early it appears: pain only after training is mild, pain during every stroke is advanced. Ligament sprains follow the usual grade 1 to 3 scale, from stretched fibers with a stable wrist to a complete tear with instability and a need for imaging.

Typical time out: One to three weeks for early tenosynovitis handled promptly, four to eight weeks once it is established, and six weeks or more for a significant ligament sprain. Cold, wet weather and a sudden increase in outdoor kilometers both push the recovery toward the long end.

See a doctor if: Get it checked if the wrist is visibly deformed after a fall, if you cannot bear weight through the hand, or if numbness spreads into the fingers.

What helps

• Loosen the grip: the fingers hook the handle, the thumb sits underneath, and the wrist stays flat instead of curling
• Reduce or drop feathering for a while and row square blades in easy sessions
• Wear a wrist splint at night in the acute phase, and short periods of cooling for pain relief in the first day or two
• Rebuild with isometric then eccentric wrist extensor work before returning to full water volume
• See a physiotherapist or doctor if creaking and swelling persist beyond two weeks, since a short period of proper immobilization then saves months later

Hand injuries (blisters, calluses)

The oar handle shears the skin of the palm and the base of the fingers with every stroke, and the layers of the epidermis separate so fluid collects between them. Fixed seat rowing and sweep rowing are harder on the hands than sculling, because the inside hand rolls across the handle. Once a callus forms, the thickened skin can tear at its edge, which hurts more and heals more slowly than the original blister.

Symptoms

• A hot spot or burning patch on the palm during a session
• A raised fluid filled bubble at the base of the fingers
• Torn skin that stings on contact with water and sweat
• Thick yellow calluses that catch and split at the edges
• Pain that forces you to change grip and lose control of the blade

How serious it is: An intact blister is a minor problem and can usually be trained through with cover. A torn blister with an open wound is a wound with an infection risk, and any hand that becomes red, hot, swollen or streaked needs medical attention rather than tape.

Typical time out: None to a few days for a covered blister, one to two weeks for a deep torn blister that needs to close before you grip hard again, and longer if it becomes infected. Most rowers keep training and simply protect the skin.

See a doctor if: See a doctor for spreading redness, pus, a red line running up the arm or fever, all of which suggest infection.

What helps

• Cover intact blisters with a hydrocolloid dressing and leave them unpopped, since the roof is the best sterile cover there is
• Clean torn skin with soap and water, cover it, and keep it dry between sessions
• File thick calluses down flat with a pumice stone so the edges cannot catch and tear
• Adjust the grip rather than squeezing: a loose hook of the fingers slides less than a tight fist
• Tape the hands or use thin gloves for long pieces and in the early weeks of a season, when the skin is unconditioned

Overuse injuries (from repetitive motion)

Rowing repeats one movement pattern with almost no variation, roughly twenty to forty times a minute for the whole session, so tissue never gets the varied loading that keeps it robust. Tendons, bone and muscle all adapt to load, but only if the load rises slowly enough for repair to keep up. Overuse injury is what happens when the training load rises faster than the tissue rebuilds, which is why they cluster after a training camp, a rig change or a move onto the ergometer in winter.

Symptoms

• Pain that starts after training, then during training, then all the time
• Soreness that no longer clears with a normal night of sleep
• One area that is stiff at the start of every session and warms up briefly
• Falling power at the same perceived effort
• A niggle that keeps moving around the body as you compensate for it

How serious it is: The useful scale is functional: pain after activity only, pain during activity that does not affect performance, pain that does affect performance, and pain at rest. The first two are manageable with load adjustment, the last two mean the tissue is failing and need a proper assessment.

Typical time out: Two to six weeks of adjusted training for the early stages, and two to four months when training carries on through pain, because the tissue then has structural damage rather than irritation. In elite rowing, overuse rather than acute injury is the dominant problem, so this pattern is the norm rather than the exception.

See a doctor if: Get it assessed if pain wakes you at night, if it is a pinpoint bone pain, or if it does not improve at all after two weeks of reduced load.

What helps

• Change the load before you change the athlete: cut volume by a fifth to a third and hold intensity, rather than stopping altogether
• Increase weekly kilometers in small steps, and never add distance, rate and rigging load in the same week
• Cross train so the same tissue is not loaded in the same arc every day
• Feed the training: overuse injuries multiply when energy intake is below what the training costs, especially in bone
• Track a simple pain score session by session, since a rising trend is the earliest signal you get

Knee injuries (tendonitis)

The patellar tendon runs from the kneecap to the shin bone and takes the load of the leg drive, and the knee closes to a very sharp angle at the catch before extending explosively. Under repeated load the tendon changes structure, which is why the condition is now called tendinopathy rather than tendonitis: it is not primarily inflammation. Pain sits at the lower pole of the kneecap, and irritation of the fat pad or the underside of the kneecap can feel similar.

Symptoms

• Pain just below the kneecap that you can press on and reproduce
• Pain at the catch, at full compression, and when going down stairs
• Stiffness in the knee when you stand up after sitting
• Warming up during the session and hurting more afterward
• A feeling that the knee gives slightly under load

How serious it is: Mild tendinopathy hurts only at the start of a session and settles once warm. The severe form hurts throughout and afterward and limits daily stairs, and if pain is accompanied by swelling inside the joint or locking, the problem is inside the knee rather than in the tendon.

Typical time out: Six to twelve weeks of structured loading for most tendinopathy, sometimes longer, because tendon adapts slowly and there is no way to shorten it. Rowers usually keep training at reduced compression throughout rather than stopping.

See a doctor if: See a doctor for a swollen knee that locks, gives way completely, or cannot be straightened.

What helps

• Start with heavy isometric holds for pain relief, then move to slow heavy resistance work such as leg press and squats
• Limit compression at the catch for a few weeks: move the foot stretcher, shorten the slide slightly, or drop the heels
• Keep training but keep the daily pain score below a level that has settled by the next morning
• Build quadriceps and gluteal strength off the water, since a weak leg drive puts more of the work on the tendon
• Avoid corticosteroid injection into or around the tendon: it eases pain for weeks and leaves the tendon worse over the following year

Tendonitis (from repetitive motion)

The tendons most affected in rowing are the wrist and thumb extensors in the forearm, the patellar tendon at the knee, the rotator cuff at the shoulder and the common extensor origin at the elbow. In each case the tendon is loaded at the same angle thousands of times per session and the collagen begins to disorganize faster than it is repaired. Only the early phase is genuinely inflammatory, which is why anti inflammatory treatment alone rarely resolves it.

Symptoms

• Localized pain over a tendon that you can find with one finger
• Stiffness for the first minutes of activity that then eases
• Pain that returns worse a few hours after training ends
• Swelling or thickening you can feel along the tendon
• Reduced strength in that movement without any true injury event

How serious it is: Reactive tendinopathy is short lived, painful and fully reversible with load management. Degenerative tendinopathy has been present for months, the tendon is thickened, and it takes a structured loading program of several months. A tendon that ruptures gives a sudden loss of function and is a different, surgical problem.

Typical time out: Two to six weeks for a reactive tendon caught early, three to six months for a long standing one. The spread depends almost entirely on how long the tendon was loaded through pain before anything changed.

See a doctor if: Seek care after a sudden pop with immediate loss of strength, which suggests a tear rather than tendinopathy.

What helps

• Progressive loading is the treatment: isometrics for pain, then slow heavy resistance, then speed
• Manage the training load in parallel, since loading the tendon in the gym and on the water at full volume is too much
• Accept mild pain during the exercise if it settles within twenty four hours, and reduce the load if it does not
• Check equipment and technique for the site involved, because a rig or grip that causes it will cause it again
• Reserve imaging for cases that do not improve after six to eight weeks or where a tear is suspected

Neck injuries (muscle strain)

The upper trapezius, levator scapulae and the small suboccipital muscles hold the head steady while the trunk swings back and forth, and they work isometrically for the whole session. Strain builds when the shoulders shrug at the finish or when a rower looks over the shoulder repeatedly to steer a single scull. On the ergometer, a screen mounted too high or too low forces the neck into the same held position for an hour.

Symptoms

• A tight band of ache along the top of the shoulders and up into the neck
• Pain when turning the head to one side
• Headache that starts at the base of the skull after long sessions
• Knots that are tender to press over the shoulder blade
• Stiffness the morning after a hard piece

How serious it is: Most cases are muscular and settle within days to a couple of weeks. It is more serious if pain radiates down the arm with numbness or weakness, which suggests a nerve root in the neck rather than muscle, or if it follows a fall or collision.

Typical time out: A few days to two weeks for a simple strain, four weeks or more when a nerve root is irritated. Most rowers can keep training at reduced intensity while the neck settles.

See a doctor if: See a doctor for neck pain with numbness, weakness or clumsiness in the hands, or after any impact to the head or neck.

What helps

• Let the shoulders sit down at the finish rather than lifting them toward the ears
• Set the ergometer screen at eye level and steer with short glances rather than a held turn
• Move the neck through its full range several times a day: gentle rotations and chin tucks
• Strengthen the deep neck flexors and the lower trapezius rather than stretching the sore spot alone
• Use heat for muscle tightness once the first day has passed, and see a physiotherapist if it recurs every training block

Dehydration

Rowing uses almost all the large muscle groups at once, so heat production is high and sweat losses in a hard session can be substantial, especially indoors where there is no airflow over the boat. Fluid loss reduces plasma volume, so the heart has to work harder for the same output and core temperature climbs faster. This is not a tissue injury but a state that makes cramp, heat illness and poor judgment more likely.

Symptoms

• Thirst, a dry mouth and dark yellow urine
• Rapidly rising heart rate at a pace that normally feels easy
• Headache and light headedness when you stand up after a piece
• Muscle cramps in the calves, thighs or hands
• Unusual fatigue and difficulty holding rate or focus

How serious it is: Mild dehydration shows as thirst and a slight drop in performance and is corrected by drinking over the following hours. It is severe when there is confusion, no urine output, a racing pulse or fainting, which requires medical treatment and often intravenous fluid.

Typical time out: Hours to a day for mild fluid loss, several days after a severe episode, since heat tolerance and appetite take time to return. Repeated heavy fluid loss across a training camp needs a rest day rather than a single drink.

See a doctor if: Get medical help if someone is confused, stops sweating, faints or cannot keep fluid down.

What helps

• Drink to a plan on long sessions rather than waiting for thirst, and include sodium when sessions run beyond an hour
• Weigh yourself before and after hard sessions and replace what the scale shows over the next few hours
• Use a fan and open air for indoor rowing, since still air is the main reason ergometer sessions dehydrate so heavily
• Check urine color first thing in the morning as a simple daily marker
• Treat cramps as a signal to reduce intensity and take fluid and salt, not as something to push through

Hip injuries (hip impingement)

At the catch the hip is flexed close to its anatomical limit, and if the femoral neck or the socket rim has extra bone, the two make contact and pinch the labrum, the cartilage ring around the socket. This is femoroacetabular impingement, and rowing exposes it because the position is repeated at the deepest point of every stroke. Hip flexor tendon irritation at the front of the hip feels similar and often coexists.

Symptoms

• Pinching pain deep in the front of the groin at full compression
• Pain after sitting for a long time, in the car or at a desk
• Clicking or catching in the hip when you move it through flexion
• A feeling that you cannot reach the same compression on one side
• Ache in the groin or the side of the hip for hours after training

How serious it is: Irritation without a labral tear settles with load management and hip strength work. A labral tear gives mechanical symptoms such as catching, locking or giving way, needs imaging, and is the form that sometimes ends in surgery.

Typical time out: Four to twelve weeks with conservative management, four to six months after arthroscopic surgery on a labrum. The spread is wide because the same anatomy causes anything from a mild niggle to a mechanical block.

See a doctor if: See a doctor for hip pain with locking, giving way or an inability to bear weight.

What helps

• Reduce the depth of the catch: raise the foot stretcher, adjust the slide, or accept a slightly shorter length for a period
• Strengthen the gluteals and deep hip rotators, since a well controlled hip sits better in the socket at end range
• Avoid forcing more compression by rounding the lower back, which trades a hip problem for a spine problem
• See a physiotherapist for a hip specific program, and ask for imaging only if mechanical symptoms are present
• Return by increasing stroke rate and pressure step by step, watching the groin pinch as the guide

Sunburn

Ultraviolet radiation damages the DNA of the skin cells in the epidermis and the body responds with inflammation and redness. Rowers get a double dose because the water reflects the light upward, so the underside of the chin, the nose and the backs of the legs burn even when the sun feels low. Long morning and evening outings in spring catch people out because the air is cool while the ultraviolet index is not.

Symptoms

• Skin that is red, hot and tender several hours after the outing
• Tightness and pain when clothing or a seat touches the area
• Peeling a few days later
• Blisters in the more severe cases
• Chills, headache or nausea when a large area is burned

How serious it is: Superficial burns are red and painful and heal without scarring. A burn that blisters over a large area is a second degree burn and, combined with fever, chills or feeling unwell, needs medical care.

Typical time out: Usually none, though three to seven days of covering the area and avoiding further exposure while it heals. Extensive blistering can keep someone off the water for a week or more.

See a doctor if: See a doctor for widespread blistering, fever, chills or confusion after sun exposure.

What helps

• Apply a broad spectrum sunscreen of SPF 30 or higher before launching and again after two hours or a swim
• Cover up with a long sleeved technical top, a cap with a brim and sunglasses, which work better than sunscreen alone
• Cool the skin with cool compresses and drink extra fluid for the first day
• Use a simple moisturizer or aloe gel for comfort and leave blisters intact
• Remember the reflected light: the chin, the nose and the underside of the arms need sunscreen too

Elbow injuries (tennis elbow)

Lateral epicondylalgia, commonly called tennis elbow, is a degenerative change in the common extensor tendon where the wrist extensors attach to the outer knob of the elbow. In rowing it comes from gripping the handle too tightly and from feathering with a cocked wrist, which loads that tendon origin at every stroke. Pain on the inner side of the elbow instead points at the flexor tendon origin and follows the same pattern.

Symptoms

• Pain on the bony point on the outside of the elbow, tender to press
• Pain when gripping the handle, a kettle or a door handle
• Weak grip that fails before the arm feels tired
• Pain that runs down into the forearm muscles
• Stiffness in the elbow first thing in the morning

How serious it is: Mild cases hurt only with a firm grip and settle within weeks. The severe form makes everyday gripping painful, has usually been present for months, and takes a structured loading program rather than rest.

Typical time out: Six to twelve weeks for most cases, and up to six months when it has been present a long time. Rowers rarely stop training completely, they change the grip and reduce the pulling volume.

See a doctor if: See a doctor if the elbow locks, swells inside the joint, or if numbness spreads into the ring and little fingers.

What helps

• Loosen the grip on the handle and keep the wrist flat: a light hook of the fingers is enough to move a boat
• Do progressive wrist extensor loading, isometric holds first, then slow eccentric lowering with a light weight
• Use a counterforce brace on the forearm for symptom relief during sessions, not as a substitute for strengthening
• Reduce feathering volume or row square blades for a period while the tendon settles
• Treat corticosteroid injection as an exception: it eases pain for a few weeks and gives worse outcomes at one year than loading

Ankle sprains

The lateral ankle ligaments, particularly the anterior talofibular ligament, tear when the foot rolls inward under body weight. In rowing this almost never happens in the boat, it happens on the pontoon, on wet steps, while carrying a shell, and during land training such as running and circuits. Carrying a heavy boat on the shoulder makes it worse, because you cannot see your feet and you cannot put a hand out.

Symptoms

• Immediate pain on the outside of the ankle after the foot rolls
• Swelling within the first hour, often with bruising a day later
• Difficulty putting full weight through the foot
• A feeling of instability when walking on uneven ground
• Stiffness that is worst in the morning for the first week

How serious it is: Grade 1 is a stretched ligament with mild swelling and a stable ankle, grade 2 a partial tear with marked swelling and difficulty walking, grade 3 a complete tear with obvious instability. Bony tenderness at the tip of either ankle bone, or an inability to take four steps, is the standard reason to X-ray for a fracture.

Typical time out: One to three weeks for grade 1, three to six weeks for grade 2, and eight to twelve weeks or more for grade 3. Rowing itself can often resume early, since the ankle is loaded far less in the boat than in running.

See a doctor if: Get it X-rayed if you cannot take four steps on it or if pressing on the bone at the back of either ankle bone is sharply painful.

What helps

• Start walking as soon as pain allows, with crutches for a few days if needed, because early movement recovers faster than immobilization
• Short periods of cooling in the first day or two for pain relief
• Use a lace up brace or taping for the first weeks back on uneven ground and pontoons
• Do balance and proprioception work, single leg standing then unstable surfaces, since this is what prevents the next sprain
• Return to running last, after full weight bearing, full range and pain free hopping

Hypothermia (in cold weather conditions)

Hypothermia is a fall in core body temperature below about 35 degrees Celsius, and cold water strips heat around twenty five times faster than air of the same temperature. A rower who capsizes in early spring is in the highest risk situation the sport has, because the water is still near winter temperature while the air feels mild. Wet clothing and wind also cause it slowly during a long outing without any capsize.

Symptoms

• Shivering that you cannot stop, and later shivering that stops while you still feel cold
• Clumsy hands that cannot manage a gate or a zip
• Slurred speech and slow, confused thinking
• Pale, cold skin and stiff movement
• Drowsiness and a lack of concern about the situation

How serious it is: Mild hypothermia means shivering and clumsiness with clear thinking, and is reversed by warmth and dry clothes. Moderate and severe hypothermia, where shivering stops and consciousness clouds, is a medical emergency: handle the person gently, since a cold heart is prone to dangerous rhythms.

Typical time out: A day for a mild episode once fully rewarmed, several days to weeks after a moderate or severe one, with a medical clearance before returning. Cold sensitivity often persists for a while afterward.

See a doctor if: Call emergency services when shivering stops, speech is slurred or the person is confused or drowsy.

What helps

• Get out of the wind and water, remove wet clothing and replace it with dry layers including a hat
• Insulate from the ground as well as the air, and use warm sweet drinks only if the person is fully alert
• Move to active rewarming with warm blankets and body contact rather than hot showers, which can drop blood pressure
• Prevent it: check water temperature, not air temperature, and stay near the bank when the water is cold
• Follow the launch rules of the club, carry a phone in a waterproof pouch, and have a launch present in cold conditions

Heat exhaustion/heat stroke

Heat exhaustion is the state where the circulation can no longer meet the demands of both working muscle and heat loss through the skin, and core temperature rises. Heat stroke is the next step, when core temperature exceeds roughly 40 degrees Celsius and the brain is affected, which damages organs and can kill. Rowing regattas are a classic setting: repeated racing, no shade on the water and heavy warm ups on the bank.

Symptoms

• Heavy sweating with pale, clammy skin, then in heat stroke skin that may be hot and dry
• Dizziness, nausea and a pounding headache
• Muscle cramp and heavy legs at a normal pace
• Confusion, aggression or odd behavior, which is the warning sign for heat stroke
• Collapse at the end of a piece

How serious it is: Heat exhaustion means the person is uncomfortable but mentally clear and improves quickly with cooling and fluid. Any change in behavior or consciousness in the heat is treated as heat stroke, which is an emergency, and the first minutes of cooling matter more than the transport.

Typical time out: One to three days after heat exhaustion, and several weeks with medical clearance after heat stroke, because heat tolerance is reduced for a period afterward. A second episode in the same week is far more dangerous than the first.

See a doctor if: Call emergency services for confusion, collapse or seizure in the heat, and start cooling immediately while waiting.

What helps

• Cool first and fastest: cold water immersion is the most effective method, otherwise ice packs to the neck, armpits and groin plus wetting and fanning the skin
• Move to shade, lie down and elevate the legs, and take fluid with electrolytes if fully alert
• Acclimatize before hot regattas over one to two weeks of gradually increased training in the heat
• Plan the race day around shade, ice and fluid rather than around the warm up alone
• Return to full training in graded steps and do not race again in the heat until a doctor agrees after heat stroke

Injuries from falling off the boat

A capsize or a crab throws the rower against the rigger, the gunwale or the handle, and the injuries are blunt trauma: bruising to the ribs and thigh, a cut from a rigger bolt, a shoulder driven backward by the handle, or a head strike. The water then adds cold and the risk of getting trapped under the shell or the foot stretcher. In doubles and eights, a collision adds the force of the whole crew.

Symptoms

• Immediate pain at the point of impact, with bruising and swelling within hours
• Cuts and grazes from riggers, bolts and the hull
• Pain on breathing after a blow to the chest
• Headache, dizziness or confusion after any strike to the head
• Coughing after inhaling water

How serious it is: Most falls give bruises and grazes only. It becomes serious with head impact, chest pain and breathlessness, a limb that cannot be moved or looks deformed, or any period of unconsciousness, and any water inhalation needs observation even if the person feels well.

Typical time out: A few days for bruising and cuts, two to six weeks for a soft tissue injury, and six weeks or more for a fracture. Head injury has its own graded return protocol and is not governed by how the athlete feels alone.

See a doctor if: Seek emergency care for any loss of consciousness, breathlessness, visible deformity, or coughing and breathlessness in the hours after inhaling water.

What helps

• Get the rower out of the water and into dry warmth first, since cold complicates every other injury
• Check the head, the chest and the ability to move all four limbs before worrying about the boat
• Clean and cover cuts promptly, and check tetanus cover for wounds from metal fittings
• Practice capsize drill so the automatic response is to stay with the shell rather than swim for shore
• Fix the cause: quick release foot stretchers, bow balls, buoyancy and a launch on the water in poor conditions

Acromioclavicular Joint Sprain

The acromioclavicular joint sits at the top of the shoulder where the collarbone meets the shoulder blade, and it is held by small ligaments that tear when you land on the point of the shoulder. In rowing this happens in a capsize, a collision or a fall on the pontoon, and it is also irritated slowly by carrying a shell on that shoulder. The joint takes the load whenever the arm reaches across the body, which is exactly the sweep rowing catch position.

Symptoms

• Pain right on top of the shoulder that you can point to precisely
• A visible bump where the collarbone ends
• Pain when reaching the arm across the chest
• Pain when carrying a boat or a bag on that shoulder
• Difficulty sleeping on that side

How serious it is: Type I is a sprain without displacement, type II a partial tear with slight step in the outline, and type III a complete tear with an obvious bump. Types I and II are managed without surgery, and even many type III injuries do well without it.

Typical time out: Two to three weeks for type I, four to six weeks for type II, and six to twelve weeks for type III, with sweep rowing on the affected side returning last because it loads the joint most. Sculling and ergometer work usually return earlier than boat carrying.

See a doctor if: See a doctor for an obvious step or bump at the top of the shoulder after a fall, or if the arm cannot be lifted at all.

What helps

• Use a sling only for the first days for comfort, then start moving the shoulder within pain limits
• Short cooling periods for pain in the first day or two
• Rebuild scapular and rotator cuff strength before returning to full pressure
• Carry the boat on the other shoulder, or share the load differently, for the whole recovery period
• Get an X-ray after a significant fall to check for a collarbone fracture, which looks similar from the outside

Hamstring Strain

The hamstring group runs from the sitting bone to below the knee, and the fibers tear where muscle meets tendon when the muscle is lengthening under load. Rowers rarely tear it in the boat, they tear it sprinting, playing football in a warm up game or jumping in circuit training, all common cross training. A separate rowing specific problem is proximal hamstring tendinopathy, a deep pain at the sitting bone that comes from the compression of sitting on a hard seat with the hip flexed.

Symptoms

• A sudden sharp pain at the back of the thigh during a sprint or jump
• Bruising down the back of the thigh over the following days
• Pain when stretching the leg out straight or bending the knee against resistance
• In the tendinopathy form, a deep ache under the sitting bone that is worst when sitting
• Pain at the catch, when the hamstring is at its longest

How serious it is: Grade 1 is a minor tear with local soreness and near normal strength, grade 2 a partial tear with clear weakness and bruising, grade 3 a complete tear or an avulsion off the sitting bone, which usually needs surgical assessment. Pain right at the sitting bone after a violent stretch deserves imaging.

Typical time out: Two to four weeks for a grade 1 strain, six to twelve weeks for grade 2, and three to six months after a proximal avulsion and its repair. Tendinopathy at the sitting bone commonly takes three months or more, because the tendon is compressed every time you sit down.

See a doctor if: Get medical assessment after a pop at the sitting bone with heavy bruising or an inability to walk normally.

What helps

• Begin gentle loading within the first days, since early controlled work returns athletes faster than rest
• Progress to eccentric strength work such as Nordic curls and Romanian deadlifts, which is what prevents recurrence
• Avoid aggressive stretching in the first weeks, especially with a sitting bone tendon problem, because compression makes it worse
• Use a padded seat cover and limit long car journeys while a proximal tendon settles
• Return to sprinting last, in graded speed steps, since the reinjury rate is highest in the first weeks back

Anterior Cruciate Ligament Tear

The anterior cruciate ligament runs diagonally inside the knee and stops the shin bone sliding forward and rotating under the thigh bone. It tears in a twist on a planted foot, in a landing, or in a fall, so in rowing it comes almost entirely from land training, ergometer circuits and getting in and out of boats on slippery surfaces rather than from the rowing stroke. The tear often takes the meniscus or the medial ligament with it.

Symptoms

• A pop or a tearing sensation at the moment of injury
• The knee swells markedly within a few hours
• A feeling that the knee gives way when you turn on it
• Inability to continue playing or training immediately
• Difficulty straightening the knee fully

How serious it is: A partial tear may leave the knee stable and can sometimes be managed without surgery, while a complete tear leaves it unstable in twisting and cutting movements. Rowing itself is a straight line sport, so some rowers manage a torn cruciate without reconstruction, but any other sport with pivoting usually pushes toward surgery.

Typical time out: Nine to twelve months back to full pivoting sport after reconstruction, and three to six months back to rowing specific training, because the boat asks far less of the knee than a court sport does. Without surgery the timeline depends on how quickly strength and control return.

See a doctor if: Get a knee that pops, swells within hours or gives way assessed promptly rather than waiting to see if it settles.

What helps

• Get the swelling down and full extension back first, since a knee that will not straighten does badly whatever the plan
• Follow a supervised rehabilitation program: quadriceps and hamstring strength are the biggest determinants of outcome
• Decide about surgery on the basis of what sport you want to return to, not on the scan alone
• Use the ergometer early in rehabilitation, once the knee tolerates the range, as a way to keep aerobic fitness
• Continue neuromuscular and landing training for a year after return, since second injuries are common

Finger Sprain (PIP Joint)

The collateral ligaments and the volar plate of the middle knuckle of a finger tear when the finger is bent sideways or backward, typically when a handle catches the hand in a crab, when a rigger traps a finger, or when handles clash in a sweep boat at the finish. The little finger is the one most exposed on the outside of the handle. The joint is small, so swelling limits movement quickly and stiffness is the main long term problem.

Symptoms

• Immediate pain and swelling around the middle knuckle
• The finger cannot be fully straightened or fully bent
• Pain when the finger is pushed sideways
• A thickened knuckle that stays swollen for months
• Weak grip on the handle because it hurts to close the hand

How serious it is: A sprain with a stable joint is grade 1 or 2 and does well with early movement and buddy taping. A dislocation, a joint that is unstable sideways, or a finger that cannot be straightened at all suggests a tendon or bone injury and needs an X-ray and a hand specialist.

Typical time out: One to three weeks before you can grip a handle firmly, three to six weeks to full comfort, and stiffness and swelling that can last three to six months even when the joint is fine. Rowing often continues with the finger taped to its neighbor.

See a doctor if: See a doctor for a finger that looks crooked, cannot be straightened, or is numb and pale.

What helps

• Tape the injured finger to the neighboring one for support and start moving it within days
• Move the joint through its full range several times a day, since stiffness is a bigger problem than laxity
• Get an X-ray after any dislocation or if the joint is tender over the bone
• Ease back into full gripping, and use a slightly larger handle grip in the first weeks if it helps
• See a hand therapist if the finger has not regained full straightening after three weeks

De Quervain’s Tenosynovitis

Two thumb tendons, the abductor pollicis longus and the extensor pollicis brevis, run together through a tight tunnel on the thumb side of the wrist. Gripping the oar handle with the thumb wrapped tightly and rotating the wrist to feather thickens the sheath, and the tendons no longer glide. It is one of the classic reasons a rower’s thumb hurts, and it appears within a few weeks of moving onto the water after a winter indoors.

Symptoms

• Pain on the thumb side of the wrist, worse when you feather or lift a kettle
• Swelling and sometimes a squeaking feeling over the tunnel
• Pain that runs up the forearm from the wrist
• Sharp pain when you tuck the thumb into the fist and tilt the hand toward the little finger
• A weak or unreliable pinch grip

How serious it is: Early cases hurt only during rowing and settle overnight, which is the point at which small changes fix it. Established cases hurt with everyday tasks such as pouring or lifting a bag and can take months, and the same symptoms after a fall on the thumb should be X-rayed for a scaphoid fracture.

Typical time out: Two to six weeks with early technique and load changes, six to twelve weeks once it is established, and occasionally longer if the sheath needs a release. Rowers usually keep training with the thumb splinted and the feathering reduced.

See a doctor if: See a doctor for thumb side wrist pain after a fall on the outstretched hand, since a scaphoid fracture is easy to miss.

What helps

• Change the grip: fingers hook the handle, thumb rests underneath rather than clamping around it
• Wear a thumb spica splint at night and during non rowing tasks in the acute phase
• Reduce feathering volume, or row square blades in steady sessions, until the sheath calms
• Load the thumb and wrist gradually with isometric then eccentric work as pain allows
• A single corticosteroid injection into the sheath works well here and can be considered when a splint and load change have failed, unlike in tendinopathy generally

Concussion

A concussion is a disturbance of brain function after a blow to the head or a force transmitted to it, without structural damage that shows on a normal scan. In rowing it comes from an oar handle striking the head of the rower in front during a crab, from a collision between shells, from a fall on the pontoon, or from being hit by a rigger. It is not a bruise on the brain and it does not require being knocked out.

Symptoms

• Headache and a feeling of pressure in the head
• Dizziness, nausea and blurred or double vision
• Feeling slowed down, in a fog, or unable to concentrate
• Sensitivity to light and noise
• Sleep problems and unusual irritability in the days afterward

How serious it is: Concussion is no longer graded on the day, because the old grading did not predict recovery. What matters is whether symptoms resolve within the usual two to four weeks, and whether there are red flags such as worsening headache, repeated vomiting or increasing drowsiness, which suggest a bleed and require emergency imaging.

Typical time out: Most adults recover within two to four weeks, with a graded return to rowing that starts after the first day or two of relative rest and adds intensity only while symptom free. A second concussion before the first has resolved means a much longer layoff and needs specialist input.

See a doctor if: Go to emergency care for a worsening headache, repeated vomiting, seizure, weakness on one side, or increasing drowsiness after a head injury.

What helps

• Remove the athlete from the water immediately and do not let them return the same day, whatever they say
• Take one to two days of relative rest, then start light aerobic activity below the level that provokes symptoms
• Progress through the standard graded steps, one step per day at least, and drop back a step if symptoms return
• Get a medical clearance before returning to full crew rowing, where a collision is possible
• Reduce the risk: bow balls, functioning steering, coxswain awareness and controlled traffic patterns on the water

Foot Numbness and Metatarsalgia from the Foot Stretcher

The forefoot is strapped hard against the footplate and the whole leg drive is pushed through the ball of the foot, which compresses the metatarsal heads and the small nerves that run between them. Numbness usually comes from pressure on the plantar nerves under the strap, while a burning pain between the toes points at irritation of the nerve itself. A separate problem is plantar fascia pain, which comes from land training rather than the boat.

Symptoms

• Numbness or pins and needles in the toes that starts partway through a piece
• Burning pain under the ball of the foot
• A feeling of a pebble under the forefoot
• Relief within minutes of loosening the straps
• Aching arches after long steady sessions

How serious it is: Numbness that clears within minutes of loosening the strap is a pressure problem and not tissue damage. Numbness that persists for hours or days after the session, or a burning pain that continues when walking, suggests genuine nerve irritation and needs assessment.

Typical time out: Usually none, since the fix is the rigging rather than rest, but two to six weeks of reduced load if a nerve is genuinely irritated or if a metatarsal stress reaction is suspected. Persistent forefoot pain in a high volume block deserves a bone check.

See a doctor if: Get it assessed if numbness lasts beyond the session, if the foot is weak, or if there is pinpoint bone pain over a metatarsal.

What helps

• Loosen the straps and set them across the widest part of the foot rather than over the toes
• Check the foot stretcher height and angle, since a stretcher set too flat pushes the pressure into the forefoot
• Use proper rowing shoes that fit, and add a thin metatarsal pad if the ball of the foot is the pressure point
• Break long ergometer pieces into blocks so the foot is unloaded periodically
• See a doctor for imaging if a specific bone stays tender after a jump in training volume

Temporomandibular Joint Pain

The temporomandibular joint connects the jaw to the skull just in front of the ear, and it carries a small disc between the two bones. Rowers clench the jaw hard through maximal pieces and races, which loads the joint and the chewing muscles for minutes at a time, and the result is joint and muscle pain rather than a tear. Direct trauma from a handle or a fall is the other route, and that one can involve the bone.

Symptoms

• Ache in front of the ear that is worse after hard sessions and races
• Clicking or popping when opening the mouth wide
• Tightness in the cheek and temple muscles
• Headache around the temples
• Difficulty opening the mouth fully in the morning

How serious it is: Muscular jaw pain from clenching is the mild and common form and settles with awareness and load management. It is more serious if the jaw locks open or closed, if the bite feels changed, or if the pain followed a direct blow, all of which need dental or medical assessment.

Typical time out: None from rowing in most cases, with symptoms settling over two to six weeks once the clenching is addressed. A jaw injured by direct impact needs assessment first and can mean weeks on a soft diet.

See a doctor if: See a dentist or doctor if the jaw locks, if the bite feels different, or if the pain followed a blow to the face.

What helps

• Notice the clenching during hard pieces and consciously let the jaw hang, with the teeth apart and the tongue on the palate
• Try a mouthguard or a night splint if you also grind at night
• Use gentle jaw range of motion exercises and heat over the chewing muscles
• Keep to soft food and avoid wide yawning and chewing gum while it is sore
• Get a dental assessment if it recurs each training block, since the bite may be part of the picture

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Rowing

• Raise weekly kilometers gradually and change only one thing at a time: distance, stroke rate or rigging load, never all three in the same week. Overuse rather than accident accounts for the large majority of rowing injuries, so training progression is the single biggest lever you have.
• Watch the catch position rather than the finish. If you can only reach full compression by rounding the lower back, shorten the slide or raise the foot stretcher, because that one position is where the lumbar spine, the hips and the knees take the most load.
• Cap the length of continuous ergometer pieces and break long sessions into blocks. The erg gives the spine and ribs the identical loading pattern with no variation from waves, steering or blade work, which is why rib stress and back pain cluster in winter.
• Build trunk and hip endurance off the water two to three times a week: side bridges, bird dogs, loaded carries, single leg work. Endurance rather than maximal strength is what keeps posture intact in the last 500 meters, which is where technique fails and injuries begin.
• Grip the handle with the fingers only, thumb underneath, wrists flat. Tight gripping and a cocked wrist are the direct cause of forearm tenosynovitis, thumb pain and elbow tendinopathy, and it is a free fix.
• Fuel and sleep for the training you are actually doing. Bone injuries such as rib stress fractures happen far more often when intake is below the training cost, and a training camp is the classic setting for both at once.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• Sudden pain with an audible pop and immediate loss of strength or a joint that gives way
• Any blow to the head with headache, confusion, dizziness or memory gaps, whether or not the rower was knocked out
• Numbness, pins and needles or weakness in an arm or leg that does not clear within minutes
• Chest or rib pain with breathlessness, or breathlessness and coughing in the hours after inhaling water
• A limb that looks deformed, cannot be moved, or cannot take any weight
• Confusion, slurred speech or a stop in shivering in the cold, and confusion or collapse in the heat

Sources

• British Journal of Sports Medicine (Trease et al., 2020)
• British Journal of Sports Medicine (Wilson et al., 2015)
• American Journal of Sports Medicine (Smoljanovic et al., 2009)

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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