Transcript Rowing and OMT - American College of Osteopathic Pediatricians

American College of Osteopathic
Pediatricians
Shannon Moore, DO
Robert Hostoffer, DO
The basic rowing action is a coordinated muscle
action that requires application of force in a
repetitive, maximal and smooth manner. Every
large muscle group will contribute to this action.
The rowing action has been divided into the
following sequence:
 The Catch
 The Drive

• Leg emphasis
• Body swing emphasis
• Arm pull through emphasis


The Finish
The Recovery
The erector spinae muscles of the back are relaxed
to allow for trunk flexion, which is provided by the
abdominals.
 The psoas major and minor and the iliacus flex the
pelvis and hips.
 The sartorius muscle rotates the thighs.
 The hamstrings and gastrocnemius are contracting
while the knees are in flexion.
 The quadriceps are elongated and stretched, yet the
rectus femoris is contributing to hip flexion.
 The ankles are dorsiflexed by the tibialis anterior.
 The elbows are extended by the triceps brachii.
 The grip on the handle is accomplished by the
flexor muscles of the fingers and thumb.

 Legs Emphasis
 The quadriceps extend the knee.
 The feet are plantar flexed by the
soleus
and gastrocnemius muscles.
 A number of stabilizing muscles aid in
supporting the lower back.
 All the muscles of the shoulder are
contracting. These include the supra and
infraspinatus, subscapularis, teres major
and minor, and the biceps brachii.
 The scapula is stabilized by the serratus
anterior and trapezius muscles.
 As
the knees are finishing their
extension, the hip is also extending by
the contraction of the gluteus and
hamstring muscles. Back extension is
occurring by contraction of the erector
spinae.
 In the upper body, elbow flexion is
occurring via the biceps, brachialis, and
the brachioradialis muscles.






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

The knees are maximally extended, and the ankles are
plantar flexed.
In addition, hip and back extension are being completed.
The upper body musculature is contracting with high force
to finish the drive.
The elbow flexors are dominant.
The flexor and extensor carpi ulnaris muscles of the forearm
contract to stabilize and adduct the wrist.
The shoulder is extended and adducted.
The upper arm is internally rotated by the latissimus dorsi
and pectoralis major.
The teres minor, posterior deltoid, and long head of the
biceps are acting on the shoulder joint.
The scapula is rotated downward by the pectoralis minor
and then drawn backward by the trapezius and rhomboid
muscles.
 The
knees and ankles remain constant as
the hips complete a full extension.
 The back extensors are continually
contracting, and the upper arms are
internally rotated by the contracting
latissimus dorsi.
 The triceps are extending the elbows
slightly.
 The
arms are pushed forward and away
from the body by the triceps until the
elbows reach full extension.
 The anterior deltoids contract along with
the coracobrachialis and biceps, and the
upper arms raise slightly as they pass over
the extended knees.
 The abdominals flex the torso, and once the
hands have cleared the extended knees, the
slide begins its forward motion through
ankle dorsiflexion and hip and knee flexion.


low back, mainly due to excessive hyperflexion and twisting, and
can include specific injuries such as spondylolysis, sacroiliac joint
dysfunction and disc herniation
Rib stress fractures account for the most time lost from on-water
training and competition.
• costochondritis,
• costovertebral joint subluxation
• and intercostal muscle strains

Shoulder pain is quite common in rowers and can be the result of
overuse, poor technique, or tension in the upper body.
Injuries concerning the forearm and wrist are also common, and
can include exertional compartment syndrome, lateral
epicondylitis, deQuervain's and intersection syndrome, and
tenosynovitis of the wrist extensors

Am J Sports Med. 2009 Jun;37(6):1193-9. Epub 2009 Mar 19.

 generalised
patellofemoral pain due to
abnormal patellar tracking
 iliotibial band friction syndrome
 Bilateral atraumatic medial meniscal
tears
 blisters and abrasions
 BMJ Case Rep. 2009;2009. pii:
bcr11.2008.1258. Epub 2009 May 17.
N Engl J Med. 2007 Mar 29;356(13):1353-60
 overuse,
 poor
technique,
 or tension in the upper body
 20
rowers
 Greatest numbers of injuries was to
lumber spine
• Half of the injuries
 Followed
by knees
 Followed by cervical spine
 Br J Sports Med. 2010 Feb;44(3):207-14.
Epub 2008 Aug 21.
A. Pump handle motion = upper ribs
B. Bucket handle motion= lower ribs
•Place
the fingertips of the anterior hand
against the costochondral junction, and
those of the posterior hand at the rib head of
the same rib.
Palpate along the region for tissue texture
changes and somatic dysfunction in the
individual ribs based on respiratory motion.
•
 Think “somatic
dysfunction does” and
name the dysfunction for what it likes to
do:
• Exhalation dysfunction: the ribs do not rise with
inhalation but move easily with exhalation
• Inhalation dysfunction: the ribs rise easily with
inhalation but do not lower with exhalation
 Exhalation dysfunction:
• Pump handle: ribs are stuck down in the front
and up in the back
• Bucket handle: ribs are stuck down and in
• Caliper: ribs are stuck pincing in
 Inhalation dysfunction:
• Pump handle: ribs are stuck up in the front
and down in the back
• Bucket handle: ribs are stuck up and out
• Caliper: ribs are stuck pincing out
 When Treating
Groups of Ribs:
• Exhalation dysfunction: treat the upper rib in
the group (frees up all ribs below it)
• Inhalation dysfunction: treat the lower rib of
the group (this rib is holding all ribs above it
in an inhaled position)
 Using
Functional Methods Diagnosis:
• This approach will lead to the key rib
because you are comparing each rib with the
one above and the one below. You are finding
the one that doesn’t move.

Techniques:
• Muscle Energy
• Rib raising
• Respiratory diaphragm facilitation/release
• Soft tissue techniques
• HVLA (consider patient’s age and history)

With all techniques used, one must determine the
patient’s condition/medical stability and to which
techniques their body will best respond
 Easy
to do for your hospitalized patient
on bed rest/limited activity
 Know which muscle groups you want to
activate depending on the dysfunctional
ribs involved
• Pectoralis minor muscle for upper ribs (3-5)
• Serratus anterior muscle for middle ribs (4-9)
• Latissimus dorsi muscle for lower ribs (7-12)
 Patient
is prone. Place thumb onto
paraspinal muscles adjacent to the
vertebral spinous process. In a bowing
like motion stretch the muscles away
from you and release. Perform slowly.
 Patient
is supine. Have the patient lace
fingers behind head. Standing to the side
of the patient grab the patient’s contra
lateral upper arm and pull toward you
and caudally.

The patient is in the lateral recumbent position. The side that the
dysfunctional vertebra is rotated towards is up (eg, for a left
rotated lumbar, the patient is lying on their RIGHT side). The
patients upper most leg is dropped over the side of the table. The
patients upper elbow is flexed. The lower elbow is also flexed and
the arm is tucked under the head. Stand to the side of the patient
with his/her face to you. Your one arm should be placed onto the
upper elbow and the other arm placed on the upper hip. A
twisting motion is performed by moving the patients elbow
backward and the patient’s upper hip forwards, carrying the
dysfunctional vertebra into correct position
Organ/System
EENT
Parasympathetic
Sympathetic
Ant.
Chapman's
Post.
Chapman's
T1-T4
T1-4, 2nd ICS
Suboccipital
Heart
Cr Nerves (III, VII, IX,
X)
Vagus (CN X)
T1-T4
T3 sp process
Respiratory
Vagus (CN X)
T2-T7
T1-4 on L,
T2-3
3rd & 4th ICS
Esophagus
Vagus (CN X)
T2-T8
---
T3-5 sp
process
---
Foregut
Vagus (CN X)
T5-T9 (Greater Splanchnic)
---
---
Stomach
Vagus (CN X)
T5-T9 (Greater Splanchnic)
Liver
Vagus (CN X)
Gallbladder
T6-7 on L
T5-T9 (Greater Splanchnic)
5th-6th ICS on
L
Rib 5 on R
Vagus (CN X)
T5-T9 (Greater Splanchnic)
Rib 6 on R
T6
Spleen
Vagus (CN X)
T5-T9 (Greater Splanchnic)
Rib 7 on L
T7
Pancreas
Vagus (CN X)
Rib 7 on R
T7
Midgut
Vagus (CN X)
T5-T9 (Greater Splanchnic), T9T12 (Lesser Splanchnic)
Thoracic Splanchnics (Lesser)
Small Intestine
Vagus (CN X)
T9-T11 (Lesser Splanchnic)
Ribs 9-11
T8-10
Tip of 12th Rib
T11-12 on R
Appendix
Hindgut
Ascending Colon
Transverse Colon
T12
Pelvic Splanchnics (S24)
Vagus (CN X)
Vagus (CN X)
Lumbar (Least) Splanchnics
T9-T11 (Lesser Splanchnic)
T5-6
---
---
---
--T10-11
T9-T11 (Lesser Splanchnic)
R Femur @
hip
Near Knees
L Femur @ hip
T12-L2
Descending Colon
Pelvic Splanchnic (S2-4)
Least Splanchnic
Colon & Rectum
Pelvic Splanchnics (S24)
T8-L2
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 1. The
most common injury that rowers
experience occurs to what structure:
• A. Knees
• B. Neck
• C. Lumbar spine
• D. Elbows
• E. Thoracic spine
 2. The
bucket handle motion occurs in
what rib set:
• A. rib 1-5
• B. rib 6-10
• C. rib 11-12
• D. floating ribs
• E. cervical ribs
 3. Shoulder
pain in a rower is usually from
all of the above except:
• A. poor technique
• B. overuse
• C. tension in the upper body
• D. idiot for a coxman