Pre-Hab Essentials

summarized by David DeWinter
YouTube player

 

Speakers

Dr. Mark Nowak – Director Athlete Health, USRowing

Supplementary Material

Slides

The 3-Sentence Summary

There are several muscles that end up weak, overused, or inhibited as a result of rowing, and they require exercises outside of the boat to care for them and avoid injury. Dr. Nowak demos 8 of these exercises that rowers can do daily to address potential dysfunction before it becomes an issue.

Timestamps

0:30 Introduction + Contact Info: My job is to evaluate, treat, and maintain rowing athletes from junior to collegiate to Olympic to masters. I’ve seen 20 years of patterns of dysfunction to cover today.

Hierarchy of Needs

2:36 Essential = absolutely necessary before training:

  • Tissue/joint mobility, muscle recruitment
  • Core stabilization in all three planes

4:17 Order of needs:

  1. Tissue/Joint Mobility
  2. Core Stability
  3. Strength
  4. Power

Without the first two, you start moving inefficiently, and then that leads to pain and injury, which leads to more instability, etc.

What we’re preventing

5:59 Common dysfunctions in rowing athletes:

  • Postural dysfunction: Upper and lower crossed syndrome
  • Pelvic torsion
  • Flexibility deficits/imbalances
  • Muscular activation/strength imbalances
  • Core activation/strength/endurance imbalances

8:56 Anterior pelvic obliquity: 90% rotated anteriorly on the right, posteriorly on the left. Lots of stress on the spine.

11:16 Muscle groups in which rowers have range of motion limitations

  • Pecs/internal shoulder rotation
  • Lats
  • Thoracolumbar fascia
  • Abdominals
  • Hip flexors
  • Hip adductors
  • Hamstrings
  • Gluteals
  • Calves

13:59 Core muscles are a cylinder that protects the spine.

15:05 List of muscles that get weak/tired, tight/overused, or inhibited (limited mobility) in rowing.

How we address issues

19:28 Athlete Wellness: When there is a problem, we all (athlete, coach, medical staff) have the same information, and we work together on addressing it.

  • Restore normal range of motion
  • Improve strength and stability
  • Include exercises that recruit the right muscles
  • Consider strength ratios

22:21 Exercise Quality

  • Intentional, focused
  • Belly breathing; inhaling on recovery, exhaling on exertion
  • Good form
  • Activating the right muscles, relaxing antagonist muscles
  • STOP if the athlete cannot maintain proper form – there may be an underlying pathology.

Exercises

25:01 Balloon-Assisted Breathing Exercise Demo:

  1. Belly breathing: relax the shoulders, engage the transverse abdominis and obliques
  2. Balloon breathing: Inhale through nose, exhale through straw. Don’t let air out in between exhales; keep abdominals engaged
  3. Can be done while squatting, bridging, etc.

28:22 Hip Abduction-Internal Rotation Exercise Demo

  • Gluteus medius and maximus activation

30:35 Prone Shoulder “Y” with Chin Tuck Exercise Demo

  • Lower trapezius, rotator cuff, deep neck flexors, posterior deltoid

33:03 Prone Shoulder “T” with Chin Tuck Exercise Demo

  • Middle trapezius

34:53 Overhead squat with bands Demo

  • Upper Body: Trunk extensors, deltoids, rotator cuffs, middle and lower trapezius, rhomboids, triceps
  • Lower Body: Core stability, gluteus medius and maximums, quads, calves
  • Watch for leaning too far forward – sign of underlying weakness

38:30 Swiss Ball Prone Demo

  • Lower Body: Core strength and stability, hip flexors, trunk extensors
  • Upper Body: Triceps, deltoids, rotator cuffs, serratus anterior, lats, middle and lower trapezius, rhomboids
  • Watch for too much hip flexor activation or sagging.

42:15 Reverse Lunge – Sliding Disc Demo

  • Calves, quads, glutes, hamstrings, core, trunk extensors, hip flexors
  • Start without weight. Progress to 5lbs, then 10lbs.

44:31 Deep Lateral Lunge Demo

  • Core, trunk extensors, quadratus lumborum (QL), calves, quads, hams, gluteus medius and maximus, hip stabilizers, hip adductors

46:24 Again, pay attention to form.

48:33 These activities are essential but not sufficient. The slides reference other webinars with more exercises you can integrate.

Questions

50:03 What should my quad:hamstring strength ratio be?

It’s about 2:1. BUT – focus on combined movements like squats and lunges so we build strength while stabilizing the knee. When you isolate these muscles, that’s when imbalances occur.

53:09 Are there good exercises to isolate lats and delts?

Y’s and T’s. Scapula needs to be secure and stable. An unstable scapula can lead to problems with the serratus anterior and posterior shoulder.

56:10  Should athletes be doing these exercises for injury prevention?

  • This is for strength; add some yoga for stretching (e.g. open the chest, sidebending…)
  • These should be daily – at least once or twice a week. Treat them as reminders of the musculature you need to activate while rowing.
  • Even elite athletes can forget that these muscles need to be retrained.

59:52 Beach Sprint Male Athlete of the Year goes to Brian O’Leary.

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