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Insights with Ivan

QSMC would like to congratulate Larissa Trease, Kellie Wilkie, Greg Lovell, Michael Drew, Ivan Hooper on the publication of “Epidemiology of injury and illness in 153 Australian international-level rowers over eight international seasons” in the British Journal of Sports Medicine – a great achievement after years of hard work. 

In June, our very own APA Sports and Exercise Physiotherapist, Ivan Hooper, formed part of an original research team who were published in the prestigious British Journal of Sports Medicine (BJSM).

As one of the co-authors of the article, “Epidemiology of injury and illness in 153 Australian international-level rowers over eight international seasons”, Ivan and the team spent 8 years monitoring any instances of injury or illness to a total of 153 athletes selected into the Australian Rowing Team from 2009 to 2016.

The article has provided great insight into the frequency and seasonality of injury and illness of elite rowers. It is the largest study of its kind with most previous papers only investigating one season or major competitive event (i.e. Olympic Games).

We sat down with Ivan to discuss the paper and ask for his thoughts and insights into the findings of the paper and what it means for those in the rowing community.

1. How does it feel to have been published in the British Journal of Sports Medicine alongside the co-authors of this study?

It feels extremely rewarding as this is the culmination of 8 years of data collection and about 2 years of back and forth with the reviewers. At times, the process could be quite frustrating, but it was all worth it in the end. The BJSM is one of the more prestigious sports medicine journals, so to be published in there is also highly rewarding and hopefully a sign that the work is significant.

2. What was the benefit for the team and the research findings for this study to be conducted over two Olympic cycles instead of one?

No previous study has tracked rowing injuries for this length of time, in fact, very few exist in any sport. Quite often injuries can change year on year for many different reasons, particularly if the athlete cohort changes. This data has more power as you can see consistent and changing patterns. 

For example, you see more injuries when younger athletes make their first team. Looking across two Olympic cycles also allowed us to examine the effect of changing ergometer testing protocols. We were able to prove that testing on a dynamic ergometer reduced low back injury and testing on a stationary ergometer increased it again. This has implications for how coaches and rowing programs choose to train their athletes.

3. Of the cohort assessed, 92 individuals were selected into two or more teams. Did the research team uncover if these 92 individuals experienced more injuries and/or illnesses compared to the 61 individuals who were only selected into one team over the 8 year period?

We did not specifically examine for this, but in my opinion, I would say it is actually the complete opposite. Young athletes are at a higher risk of injury when they make their first team as they step up into higher training loads. If they do get injured, there is a chance that they are more likely to not make the next team. Often if they do not fully recover, or miss too much training, then it means potentially missing the next year’s selections. 

4. The paper identifies an association between ergometer testing and lumbar back pain but does not allow for causality to be inferred. Do you think that there is further testing that can be performed on dynamic vs fixed ergometers given the associations found?

There are several biomechanical studies that discuss the differences between the two types of ergometer training. There are noticeably clear differences, and it can be inferred that these would produce different loads on the lumbar spine. I think our paper adds a lot of weight to this. 

Lots of athletes do different types of training. Whilst the testing was set, I am sure that weekly ergometer training would have been variable across athletes. And so, these factors could not be controlled for. To investigate whether one ergometer type was causative of injury, you would need to control for training loads on the water, on the ergometer, plus weights, and monitor this across a large number of athletes. In elite sport, this is pretty much impossible.

5. What do you think are the main takeaways from this paper that would be helpful to those involved in the rowing community such as coaches of elite rowers?

  1. Low back pain is more common in males, and probably related to flexibility.
  2. Chest wall pain is more common in females, and probably related to upper body strength, hormonal factors, and relative energy deficiency.
  3. Cross training via cycling can cause injuries that result in significant time loss injuries.
  4. Illness is a significant component of time loss and strategies to specifically address this should be targeted.
  5. Wherever possible, especially for young developing athletes, ergometer testing should be done on a dynamic ergometer.

6. While the research time frame for this paper included both the London 2012 & Rio 2016 Olympics, during your career so far, you have attended five Olympic Games with the Australian Olympic Team. This in itself is an incredible achievement; can you elaborate on what it has been like to be involved professionally at an elite level for such a long time?

I never intended to be involved for that long. It’s funny how quickly things pass when you start working in 4 year “chunks”. After Athens 2004, I found myself in a role that involved more planning and preparation for the team, so that four year period felt like we were building towards something. On top of that, we had a World Championships to prepare for each year too. Over the years there was just always something to keep my mind on to stay busy with.

7. Furthermore, your experience with the Australian Rowing Team as the Physiotherapist for 16 years (1997- 2012) covered three consecutive Olympics where Australia took home 12 medals for Rowing. How does it feel to have been involved in helping prepare those athletes for their performances?

It was a bit of a roller coaster – some amazing performances that resulted in medals, and some disappointing performances when crews didn’t go so well. I can reflect now on what was good and bad about those campaigns, but I know there’s also a bit of luck involved for it to all come off. 

There have been some very satisfying experiences over the years I was involved, like the men’s pair winning Gold in 2008 despite Drew Ginn having a massive disc herniation that required surgery after the event; and the women’s pair winning Silver in 2012, just 33 days after Sarah Tait had surgery on her arm.

By the time I had finished with the team after London 2012, there were only maybe 2-3 coaches that had been in the team for longer than I had. I felt like I was a welcome and important member of the team, which in itself was very rewarding. Looking back, you can always think of things that could have been done better, but I’m happy with my time in the team.

We are extremely lucky to have Ivan on board as one of our dedicated practitioners. If you would like to book an appointment with him at our Woolloongabba Clinic, please get in touch with our Reception team on (07) 3891 2000 or book online.

Congratulations once again, Ivan!

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