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Adaptive Rowing: Setting Up for Success

August 01, 2010

Each athlete has a specific set of conditions, deficits, and postures that need to be addressed.

Each athlete has a specific set of conditions, deficits, and postures that need to be addressed. While it is possible to start everyone from the same basic adaptive platform, to maximize performance, each rower should be fit individually to the rigging and seat. The effect of a proper "fit" on an adaptive athlete who is correctly connected to the seat and boat, can be substantial. In this article, we will talk about the "fit" of the seat/boat to the rower, and a future article will discuss rigging. Remember though, they are interrelated.

Position in the Boat
While we stated we are not discussing rigging in this article, it is important to note that the athlete should be positioned so that they can row through the pins. Since the athlete does not use a slide; using a standard oar, spread and pin position prevents the athlete from achieving an efficient catch angle. Spread, oar length, and pin location all must be changed substantially. The result of correct fixed seat rigging means that the athlete will have an effective catch angle, consequently they will need to be strategically secured in the seat in order to handle the load on the oar and maximize their effort.

Adaptive rowers who use a fixed seat can be divided into two groups: those who row using torso and arms (TA), and those who row using the arms and shoulder girdle (AS). These are the recognized Athlete Sport Class for rowing and we will refer to them here. Each of these groups have some basic similarities, but there are significant differences too.

The single most important principle in fitting an adaptive athlete is to "fill the gaps."

To fill the gap means that if posture, prosthesis/orthosis, or some other effect from a disability creates a gap somewhere, that space needs to be filled. For example, an AS athlete with scoliosis (curvature of the spine) will have asymmetry in their back, creating gaps where the body meets the seat. By filling these gaps with foam, we make a positive and stabilizing connection. We want to eliminate all movement that is not contributing to effective movement of the boat. And we want to direct the effective movement in the most efficient way possible. 

The flip side of filling the gaps is to "shim" the athlete. Shimming pushes the athletes body towards a "normal" neutral position. This is not something that should be done without proper consideration and follow-up. Pushing an athletes body into a position that is not natural for them can create imbalance, disrupt the kinesthetic chain, and possibly even cause injury. Think very carefully before making any radical adjustments. Still, it is part of the "bag of tricks" that is sometimes employed.

The second most important principle is to take a functional sport approach. Trying to fit someone to a seat by their labeled disability and not how they move as an individual can lead to under-performance. While we "get in the ballpark" using the labeled disability approach, we may miss the individualized adjustments that are necessary for an athlete to row.

The best approach is to look at how a person moves when rowing, what is the effective range of their movement and how can we direct that movement efficiently. Just because an athlete has a disability, does not mean the mechanics and principles of rowing are fundamentally changed. Take what you know about rowing, look at what your athlete can do, and work with and sometimes around what they do. This is the essence of good coaching for any athlete, isn't it? 
So now we have some guiding concepts to approach fitting an athlete to the boat. Let's talk about equipment. But before we discuss gear, we need to briefly discuss the rowers’ physical capacity. We will use the Athlete Sport Class (ASC) designations  to help us begin our fitting approach.

How do I know if my athlete is AS or TA?
Assuming your athlete has not undergone Classification, there is a simple test you can use roughly gauge the ASC. (Note: This does not mean that this is the class your athlete will be when competing. It's only a way to help you in the beginning with set-up). Have the athlete, from a sitting position, bend forward. If they can bend more than 45 degrees and then sit upright, with no assistance from the arms, try them set up as a TA rower.

The Seat
Seating is critical, and probably is not addressed with enough attention. The standard adaptive seat, such as the one made by Wintech, is a metal frame with a carbon fiber rigid seat pan. The back is canvas, and it can be tilted back as the athlete requires. It can be moved fore and aft in the boat. Individual adjustments to the seat are possible and beneficial, as you will see below.

Seat Pan
The seat pan is the part of the seat that you sit on. Typically an athlete will use a cushion on the seat pan. For an athlete using a wheelchair, this is often a wheelchair cushion. A large percentage of TA and AS rowers have spinal cord injuries or other conditions that impair sensation. A wheelchair cushion is filled with gel and helps prevent things like skin sheering and blisters that can result for those without sensation. It is important if a rower with a SCI is using something other than their own seat cushion, to check to make sure that this cushion adequately protects them from pressure points that could cause pressure sores. 

Some seat cushions are thick and will raise the rower up significantly in the boat. Raising an athletes' center of gravity, especially an athlete with impaired trunk and hip control, is not desirable. Striking the right balance between preventing injury and good rower height is the goal. Recently, we have had good success using a white water kayak "vacuum" seat that is basically a fabric cover filled with small beads. The rower sits on it, moves a bit to settle on it, then extracts the air; the beads form to the rowers shape. The cost about $70.00; this is a good example of "filling the gaps," our fundamental principle to fitting. Other rowers have removed the carbon fiber seat pan and place their cushion on a custom insert made of wood or foam to drop a little further down in the boat.

Seat Back Angle
How much the seat back tilts depends on the athletes trunk stability and control. Those athletes that fall into the TA class use little or no seat back for support. They need to get sufficient layback, and the standard seat back can be in the way as well as create a lot of wind resistance.

For rowers in the AS class a seat back is required. Seat back angles are typically upright (90 degrees). The AS rower will be strapped at the chest and this forward reaching position will help them maximize their length and power. The seat height can be raised so that the chest strap can remain high for taller rowers. 

Strapping
Straps are the main way to connect the rower to the seat and to provide them the bracing in which they can generate force on the oar. Each boat class has required strap locations for racing but for a recreational rower you can brace as needed. (Whatever strap is used, Velcro is the preferred closure. Mechanical fasteners such as buckles and clasps can be difficult to remove in an emergency situation such as capsizing). Remember, we are after a very solid connection with no extraneous movement or "slop." 

Strapping for TA Rowers 
The key strap is on the legs. This is best achieved by placing a strap as high up on the legs as possible. The type of strap is critical. A good choice is a weightlifting belt. Nike, Schiek and Vario make them. They are about 6" wide, rigid, and have a roller buckle and Velcro attachment. Note: Velcro enclosures are required for competition; no mechanical buckles should be used for straps that hold the athlete to the boat. The belt is slipped under the seat frame, and around the athletes’ legs, and pulled securely.

For rowers with a leg discrepancy, i.e. one leg atrophied, cutting foam to fit under the strap to fill the gap will be beneficial to holding the athlete in, and keeping the strap secure.

TA rowers usually need no other strapping, though some may benefit from a strap that goes around the hips if they do not have the ability to brace their hips with their legs.  A low seat back (lumbar region) might benefit some athletes who need support.

Fitting the AS Rower
AS rowers have less core stability than TA rowers. Impaired abs, restricted ROM, and other deficits put them in this class.

Strapping for AS Rowers The main difference between the TA rower and the AS rower’s strapping is the chest strap. AS rowers use one, while TA rowers do not. It should be high and tight across the chest. Make sure the connection point of the chest strap to the seat frame is high enough to prevent the strap from falling down while rowing. It also helps to have a leg strap to brace high near the hips to keep the hips back and keep the rower from sliding forward on the seat.

The rower should take a deep breath, hold it, and put the chest strap on tightly. This strap is critical for stability and performance for the AS Rower. A rough analogy is to think of it as a foot stretcher. At the catch, the athlete will push off the strap to begin the stroke.

The Foot Stretcher
You may be thinking, "Why use a foot stretcher if the rower does not use their legs? Even though an athlete may not be using their legs for propulsion, the connection for the feet can help with boat and rower stability. The skeleton helps with stability when the feet can be secured. The TA athlete in particular may be able to press to brace against the footplate to propel the boat. 

An exception to attaching to a stretcher or foam block would be someone missing legs or someone with an orthopedic condition that prevents enough leg extension to reach the stretcher. But in the case of an amputee, the use of prosthesis can allow for the rower to be connected to the stretcher.  This does not mean all athletes with an amputation should wear their prosthesis. It will have to be evaluated on an individual basis with feedback from the athlete. If an athlete is missing legs and NOT wearing prosthetics, or cannot attach to the stretcher, then the leg strapping becomes even more critical, because it provides all the stability. In this case, anchoring the hips to the seat/boat would be important. 

Some AS rowers will find that they fare better without a foot stretcher as it will allow their feet to be lower in the boat and the knees will be out of the way. They can lock in against a foam block instead.

Grips
Hand impairment can be present, more typically in AS rowers. If this is the case, there are a number of solutions. Hand grips used for weightlifting can be used, or simply using Coban to connect the hand. Fixing the hand to an oar must be considered very carefully. This is a safety issue. I have recently come across hand grips designed for kayaking, and hope to try them out soon; they are much safer and have potential. Rowers should be able to release any hand aid with their mouth.

Pontoons
AS rowers use pontoons in competition, and should at other times as well when rowing in a 1x. Pontoon height is important. They should be set to just touch the water for experienced rowers, and a bit lower for a new rower or someone with more involved stability problems.

If pontoons are set high without touching the water, the momentum from them causes the boat to tip side to side, an undesirable condition. If you set the pontoons too far down and, hey will be lifting the shell out of the water.

Fitting an adaptive athlete into the boat requires attention to detail, regular adjustments and patience. Small incremental changes are best. The effect of the efforts can pay off big on the water.

Set-up in a nutshell
•Determine ROM (TA or AS)
•Approach adjustments and problems from a functional sport approach rather than a medical model.
•Fill any gaps
•Movements only where it matters, secure the rest. Strap rower to seat appropriately
•Connect the athlete to the foot stretcher whenever possible.
Test, listen to rower feedback and adjust until you have it right.

Typical problems and solutions

Can't clear hands in recovery
•Look at the seat height, can this be lowered safely?
•Raise the oarlock height.
•Remove the heel cups and let the feet rest in bottom of boat.
•Use low profile shoes or take shoes off (use padding to protect feet).
•Remove foot stretcher, or push out of the way (Using a large foam block wedge to brace feet against).

Leg strap falls down
•Poor anatomical fit. Use shaped foam between the strap and the body.
•Check the attachment point, will moving it help?
•Use some clamping to keep straps from moving.

Chest strap falls down
•Attachment point on frame is too low.
•Strap is put on too loosely.
•Wrong strap type. Use a rigid weightlifting belt.
•Use some clamping or mechanical fastener to keep straps from moving.

Athlete slides towards the stern while rowing
•Fix feet to stretcher.
•Make sure straps are tight.
•Add additional strapping, pelvic strap or low waist strap.

Athlete slides towards the bow while rowing
•Fix feet to stretcher.
•Make sure straps are tight.
•Place support across seat back down very low.

Poor Set
•Make sure the athlete is firmly connected and there are no gaps in the connection to seat and stretcher.
•Check the oarlock height, they should be level.
•Add weight to high side (last resort, sometimes used for single leg amputees).
•If using pontoons, are they level (count the holes)? Do they rest on water? (they should).
•Foam wedge under residual or atrophied limb (for single above knee amputee, severely atrophied leg, or someone with hemiplegia).
•Time in boat! Mileage can help a lot.

Stuff I use…these are the things I cannot do without when fitting a rower.
•Foam: Soft and Hard. Hard foam is Minicell foam often used in kayaking. You can buy this in huge blocks down to precut shapes. It’s easy to shape and doesn't degrade, Shape with sure-form tools, a bread knife, and a band saw if you are lucky enough to have one.
•Soft foam: whatever you can find, upholstery foam can be a good choice.
•3M 77 spray adhesive. For bonding foam together.
•Coban: Looks like an ace wrap, but with adhesive properties (only sticks to itself, not a persons skin)

Tools
•Sureform: long plane, and a short curved one
•Sandpaper
•Saw or bread knife for cutting foam
•Utility knife
•Marker (permanent)
•Long Straightedge
•Level
•Ratchet wrenches
•Calculator
•Brain

Other stuff
•Goop (for gluing foam together)
•Silicone
•West Epoxy System (for big repairs, or major modifications)
•Duct Tape: Not a permanent solution, but in a pinch. Buy it in a color, easier to ID your gear, and it looks more "sporty" and no so DIY.
•Electrical tape; much kinder to boats, but less sticky than DT. Also, use a color.
•Zip ties. For emergency use only. They WILL fail eventually, and often at the worst time.

Jeff McGuiness, Philadelphia Adaptive Rowing

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