2021 consensus statement for preventing and managing low back pain in elite and subelite adult rowers

Purpose To synthesise evidence on low back pain (LBP) in adult rowers and to create a consensus statement to inform clinical practice. Methods There were four synthesis steps that informed the consensus statement. In step one, seven expert clinicians and researchers established the scope of the consensus statement and conducted a survey of experienced and expert clinicians to explore current practice. In step two, working groups examined current evidence relating to key scope questions and summarised key issues. In step three, we synthesised evidence for each group and used a modified Delphi process to aid in the creation of the overall consensus statements. Finally, in step four, we combined information from step three with the findings of the clinician survey (and with athlete and coach input) to produce recommendations for clinical practice. Results The scope of the consensus statement included epidemiology; biomechanics; management; the athlete's voice and clinical expertise. Prevention and management of LBP in rowers should include education on risk factors, rowing biomechanics and training load. If treatment is needed, non-invasive management, including early unloading from aggravating activities, effective pain control and exercise therapy should be considered. Fitness should be maintained with load management and progression to full training and competition. The role of surgery is unclear. Management should be athlete focused and a culture of openness within the team encouraged. Conclusion Recommendations are based on current evidence and consensus and aligned with international LBP guidelines in non-athletic populations, but with advice aimed specifically at rowers. We recommend that research in relation to all aspects of prevention and management of LBP in rowers be intensified.

Automated summary

The consensus statement on low back pain in adult rowers was created through a process involving expert clinicians, researchers, and input from experienced and expert clinicians, athletes, and coaches. Recommendations for prevention and management of LBP in rowers are based on current evidence and aligned with international guidelines, with specific advice tailored to rowers. Further research on all aspects of LBP in rowers is recommended for future improvement.