Case Study of an International Rower With Recurrent Low Back Pain

After ankle ligament reconstruction, the rower developed right-sided back pain during longer sessions and repeatedly rowed until he had to stop for days or months. Imaging showed an L5-S1 disc protrusion, but with no serious pathology he was managed as non-specific low back pain with a nociceptive, mechanical pattern. Thomas identifies his endurance coping style as the main barrier, plus reduced right hip flexion and ankle dorsiflexion, a hypertrophied right erector spinae and a Biering-Sorensen time of about 150 seconds, against roughly 180 seconds linked to protection in the general population. Management began with education to change how he trained and handled flare-ups, then band-assisted hip and ankle mobility, deadlifts for extensor endurance, global strength work such as inverted pull-ups, and interval training on a bike or cross trainer. After 12 weeks he rowed 60 minutes at RPE 6 without pain. Bilateral thoracolumbar pain at higher intensity resolved once he drove through his legs rather than his upper trunk, and rehab was blended into his normal team training.