Hip pain on the rowing machine: a pinch at the catch, the hip flexors, the seat and what helps

What nobody has countedEmerging evidence

No study counts hip pain in people who use a rowing machine for fitness. Every survey is of competitive rowers, most of whom also row on water: in 743 masters rowers, the pelvis, groin, buttock, hip and thigh made up 37 of 359 injuries (10.3%), against 32.6% for the lower back, and only 5 of the 359 were sudden injuries on the rowing machine, though most used one. In 207 young rowers, the hip or buttock was 2 of 89 pain reports (2.2%), against 48.3% for the lower back; in elite juniors, the low back, knee and forearm led, and a review names the knee, lower back and ribs as most often affected. At the 2023 world indoor rowing championships, 44% of 180 competitors who replied had an injury in the 4 weeks before, mostly overuse, but the body regions weren't reported.

So the map on this page is built from lab studies of rowers on the machine, studies of the hip conditions, and NHS, NHS inform, NICE and rowing body pages, and it says so. There are no data on gym users, and no study has measured the load inside the hip joint on a rowing machine.

Sources 1, 2, 19, 3, 18

What the catch asks of the hipEmerging evidence

At the catch, the hip is bent as far as it goes in the stroke, with the legs compressed and the arms long. An expert estimate puts the bend needed at about 130 degrees, a figure that traces back to a practitioner article rather than a measurement. In 10 high-level rowers on the machine, the lowest part of the lower back was close to the end of its bending range at the catch and early drive, so the hips have to supply the rest of the reach. The hip drives the stroke: in 20 elite women, hip movement explained 48% of the force through the feet.

In people with sensor hip implants on an exercise bike, a lower saddle, so a deeper hip bend, raised hip load by about 15%. That is cycling, and only an analogy for the rower.

Sources 3, 2, 4, 5, 20, 21

Tiredness, the rate and the slideEmerging evidence

A review of 22 studies of 429 rowers found that tiredness bends the lower back more at the catch, more on the machine than on the water, and that rowers with back pain rolled the pelvis back more there. In 19 elite men, lower back bending rose 4.4 degrees on the machine during a step test against 1.3 in a boat; at higher stroke rates the pelvis tipped forward less at the catch in 10 club rowers; and in 20 teenage rowers the pelvis drifted backwards over just 20 minutes. Experienced rowers at a low rate held their shape for an hour. In 11 men, more knee bend at the catch went with more backward pelvic rotation and less hip bend.

Our reading: when the slide goes past vertical shins, the rate climbs or you tire, the pelvis rolls back and the deep bend shifts between the hip and the lower back, which is one reason a sore hip or back shows up late in a piece.

Sources 6, 7, 8, 9, 22, 23, 24, 10

The foot stretcher, the seat and the machineEmerging evidence

In 11 college rowers, raising or lowering the foot stretcher 20 to 40 mm, or tilting it, changed mainly the ankle and slightly the hip, much less than the stroke rate did; the authors' idea that a lower foot stretcher could ease the hips and lower back is a hypothesis they didn't test. In 10 male rowers, higher foot stretchers shortened the stroke and reduced how far the pelvis moved. British Rowing's set-up rule is that the knees should be above the ankles at the catch, so the shins are vertical: raise the feet if the knees go past, and lower them if they don't reach.

The left and right hips move differently on the machine, and different and free-floating machines change the pattern a little, but a review found too little evidence to recommend one machine type. No study has measured the seat.

Sources 11, 25, 12, 26, 27, 28, 29, 6

How the causes are told apartEmerging evidence

A deep pinch in the groin or hip crease at the catch, worse sitting low or putting on socks, is the hip running out of bend, and sometimes impingement or a labral tear: in 18 young rowers with labral tears, 71% had pain only in the groin and 81% had positive impingement tests, and the authors believe repeated deep hip bending is the cause, though they didn't test it. Impingement syndrome needs symptoms, examination signs and a scan together to diagnose. A pulling ache at the front of the hip that hurts more lifting the knee against resistance or stretching the hip flexors points to the hip flexors. A stiff groin ache from mid-life with short morning stiffness is often hip arthritis, which the National Institute for Health and Care Excellence (NICE) diagnoses without imaging from 45.

The bony point on the outside, sore to lie on, is usually the gluteal tendons, commonest in women aged 40 to 60, with a sudden increase in load among the triggers. The sitting bone, sore on the seat and with long sits, is usually the hamstring tendon. The buttock with back pain or tingling down the leg is usually the back; the sacroiliac joint is often blamed, but the only study in rowers used examination tests that don't show pain. A lump in the groin or top of the thigh can be a hernia; femoral hernias mainly happen in women over 50 and can become strangulated, so see the warning signs.

Sources 13, 30, 31, 3, 32, 33, 34, 35, 36, 37

Who gets itEmerging evidence

Hip pain on the rowing machine is most likely in a new rower who slides too far or rows at a high rate, with long pieces or a jump in sessions, in younger active people with impingement-shaped hips, from mid-life with arthritis or outer hip tendon pain, and with sitting-bone pain in people who sit a lot. That list is our reading: training load on the rowing machine was the training factor most linked with injury in 20 elite rowers, and training volume in 160 club rowers, but no study has looked at gym users.

Sources 38, 39, 13, 33

When a scan helps, and how it usually goesStrong evidence

Not usually at first. Hip shape and labral changes are common in hips that don't hurt: a cam shape in 37% of 2,114 pain-free hips and labral damage in 68% of those scanned; labral tears in 54% of people without pain against 62% with pain; and in 20 elite rowers, 85% had a cam shape and 95% labral tears on MRI, yet only half had ever had groin pain. Pain-free elite rowers showed cartilage changes on special MRI too, which can't show cause. A scan matters for catching or locking that hasn't settled with exercise, before considering surgery, and with the warning signs.

No study follows hip pain from the rowing machine. The NHS says see a GP if hip pain hasn't improved after 2 weeks of looking after it at home, and NHS inform asks you to see a professional if it hasn't improved within 6 weeks. Hip-related pain in active adults needs exercise-based care for at least 3 months; outer hip pain can take 6 to 12 months of rehabilitation to settle. Of 18 young rowers operated on for labral tears, 10 returned to rowing, at a mean of 8 months. No one can promise a date.

Sources 40, 41, 14, 42, 32, 43, 44, 15, 33, 17, 13

Changing the rowing machine: guidance and lab readings, untested against hip painEmerging evidence

No trial has tested slide length, foot height, the seat, the rate or the damper against hip pain on a rowing machine. The steps below are our reading of: the slide (the maker's catch, with shins vertical or as close as is comfortable and never past it, and a review's note that stops on the slide can limit the reach); foot height (British Rowing's shins-vertical rule, with small effects on the hip in lab studies); the hinge (World Rowing's summary that rowers should bend through the hips, rocking forward over the sit bones, and that tiredness moves the bend into the lower back); the rate (the pelvis tips forward less at higher rates); and the seat (a lower saddle raised hip load in cycling, and the NHS says avoid low chairs with hip pain). A seat pad, letting the knees drift a little wider and the rest of the set-up tips are our suggestion, untested.

Sources 45, 3, 12, 11, 25, 46, 8, 6, 21, 43

Hip joint pain in active adults: at least 3 months of exerciseEmerging evidence

A consensus of 38 researchers and clinicians recommends exercise-based treatment for hip-related pain, for at least 3 months, and recommends physical activity, including sport. In the UK FASHIoN trial of 348 people with impingement syndrome, keyhole surgery beat physiotherapist-led hip therapy by 6.8 points on a 100-point scale at 12 months, just above the 6.1 points that matters, and both groups improved. None of this evidence is from rowers.

Sources 15, 16

Outer hip pain: education and exercise firstStrong evidence

In the LEAP trial of 204 people aged 35 to 70, education plus exercise was a success at 8 weeks for 51 of 66 people, against 38 of 65 after a steroid injection and 20 of 68 with wait and see; the education included avoiding positions that squeeze the tendons. NHS inform says slow progressive loading through strengthening exercise is the key.

Sources 17, 33

Sitting-bone (high hamstring) painEmerging evidence

A review of 13 small studies supports progressive tendon loading with exercises for the lower back and pelvis, with or without shockwave therapy, at a moderate grade. Early on, avoid long sits and deep hip bend under load (our reading of a clinical review).

Sources 35, 34

Hip arthritis, and the bike as a swapStrong evidence

NICE says offer therapeutic exercise, such as local muscle strengthening and general aerobic fitness, to everyone with osteoarthritis, and warns that joint pain may rise when you start. Indoor rowing is one aerobic option; no trial has tested it for hip arthritis, though a survey's authors call rowing suitable after a hip replacement. In people with sensor hip implants, cycling at a moderate effort with a normal saddle height gave relatively low hip loads, and a lower saddle raised them by about 15%.

Sources 32, 1, 21

What to change on the rowing machine today (written steps)

Our 3D figure can't show the slide, the foot stretcher, the seat or the machine's settings. These steps come from British Rowing, World Rowing, the maker, lab studies of rowers and our rowing machine and hip guides; where a step is our suggestion or our reading, it says so. None has been tested against hip pain.

• 1. Stop the slide before the pinch: find the point at the catch just before your hip pinches and row to there, adding slide back as the pain rule allows (our suggestion). Never past vertical shins, as the maker says; a review notes stops on the slide can limit the reach.
• 2. Set the feet so the shins are vertical at the catch: raise the feet if your knees go past your ankles, and lower them if they don't reach, as British Rowing advises. Don't expect foot height alone to fix it: small changes barely moved the hip in lab studies. Keep the strap across the ball of the foot (our rowing machine knee guide).
• 3. Sit tall on your sit bones and hinge forward from the hips, shoulders in front of the hips, rather than rounding the lower back, as the maker and World Rowing describe.
• 4. Knees in line with your feet, about hip-width; letting them drift a little wider at the catch may ease a groin pinch (our suggestion, untested).
• 5. An easy rate while it's sore, about 18 to 22 strokes a minute: at higher rates the pelvis tips forward less at the catch (our suggestion for the number).
• 6. Damper 3 to 5, and set the effort by how hard you push, as our rowing machine back guide says.
• 7. Shorter pieces with breaks; end a piece when your back starts to round or the pinch appears, because tiredness moves the reach into the lower back.
• 8. The seat: a seat pad lifts your hips a little relative to your feet, which may ease a pinch, and with sitting-bone pain a cushioned pad and shorter sits help (our suggestion, untested; a lower saddle raised hip load in cycling, and the NHS says avoid low chairs with hip pain). If you add a pad, check the foot height again (our rowing machine knee guide).
• 9. A different machine for now: the recumbent or upright bike with the seat not too low, walking or swimming, whichever passes the pain rule (editorial).
• 10. One change at a time: slide, then time, then rate, then damper or intervals (editorial). Training load on the machine was the training factor most linked with injury in elite rowers.
• 11. Warm up first, and stop if you feel unwell, as British Rowing's safety alert says.

Sources 45, 3, 12, 11, 46, 8, 6, 21, 43, 38, 47

How the rowing machine comes back (written steps)

No study has tested this order; it follows our rowing machine back and knee guides (editorial).

• 1. A shorter slide, an easy rate, damper 3 or lower, short rounds.
• 2. The full slide to vertical shins, still easy.
• 3. Longer steady pieces, up to your usual time.
• 4. A higher rate, a little at a time.
• 5. Intervals and a higher damper last, if you want them.
• 6. A 2,000 m test or a race comes last, after two weeks of normal training.