Thoracic outlet syndrome

[sbolling]

Hello everyone, looking to see if anyone has experienced TOS (or something similar) from rowing, or has some advice for me.

I've had the C2 rower for a little over 3 years and use it as my primary cardio workout. I'm 48 years old, in pretty good shape, lift weights in addition to rowing. I usually row 4-5 times a week.

Recently I increased from 5k rows to 10k. Did those for about 2 months and had to stop due to bad nerve pain in forearms (sometimes right side, sometimes left, or both) at night. I'd wake up with needle like pain, and numb hands. Often had to get out of bed and stretch in order to go back to sleep. Sometimes this would happen multiple times a night. When rowing I would get slight numbing in hands, but no nerve pain. Keeping a light grip on the handle, and moving fingers on the down stroke would minimize this.

I stopped rowing 3 weeks ago and the nerve pain was gone after about a week. Never had this happen before. Looking onine it seems like Thoracic outlet syndrome, but I'm not sure. Anyone else experienced this? Have any tips to stop it from happening again?

[p_b82]

Hi and Welcome!

Are you keeping your wrists flat through the whole stroke - or is there any flexation/extension?

You got the older flat bar handle or the newer slightly angled one?

Have any carpel tunnel or RSI issues outside of rowing - bad wrist position at a desk being aggravated by additional rowing meters maybe?

I've not had any issues myself, so don't have any real advice to offer I'm afraid.

Our resident troll will probably be out shortly to tell you that it's the terrible design of the C2 handle though...

[JaapvanE]

I usually row 4-5 times a week.

Recently I increased from 5k rows to 10k.

Do I understand you correctly that you went from 25k a week to 50k a week? That is quite a change overnight and might overload your muscles.

[Sakly]

I would say the same - 5k to 10k is no gradual increase. Take it easier.
If you go back on the rower for 5k rows - working well or also getting the symptoms now?

Our resident troll will probably be out shortly to tell you that it's the terrible design of the C2 handle though...

lol
Probably you are right.
3 years of rowing were fine and then suddenly the handle design caused this problem.
Doubling the amount of meters as step function cannot be the reason.

[jamesg]

The key to rowing is style, and a good part of this is sequences, relaxation and posture, so suggest you check all your action:
https://www.concept2.com/indoor-rowers/ ... que-videos

Never tense a muscle if you can avoid it; this includes the hands, arms and shoulders. If you pull the handle high, and hold it high on return, some muscle somewhere is tensed for no good reason. 10k is at least a thousand strokes; far too many to do anything even slightly wrong, especially if pulled at high force.

Fingers are hooks only, the thumbs hang free, shoulders are loose: using a slow recovery, chain tension is enough to control the handle.

Make sure drag is low so that you can move fast with low impact; keep the straps over your toes so that the foot is free to move; keep the slide well away from your heels, so that the knee angle is open and the catch can be quick.

[Dangerscouse]

Not much to add to the above, but your comment about lightening the grip helping with the pain is interesting. I only hook my hands, and my thumbs are redundant, so there's no tension in the wrists.

Where does your stroke end? Above the sternum, and with a 'flicked' wrist style? I row to just below my sternum with minimal wrist movement, and I've only ever had some vague and temporary nerve pain during ultra distances, which is to be expected.

[Slidewinder]

Our resident troll will probably be out shortly to tell you that it's the terrible design of the C2 handle though...

...but let's all pretend that 'technique' can overcome this equipment design deficiency.

On the RowErg there are three points of contact between the user and the unit - three human/machine interfaces. These are the handle, the footrests, and the seat. At any such interface the machine should adapt to the user, not the user to the machine. Users for many years, in many threads, report similar pain as the OP, but whether that pain is mild or debilitating the only approved response here is that the user, not the machine, is to blame. Coincidentally, three current threads under this 'Health & Fitness' category highlight the design deficiencies at these three points of contact - "Sore Bottom" (the seat); "Continued Troubles with Tendonitis - Biomechanical Solutions for the Erg" (the footrests); and this thread, "Thoracic outlet Syndrome" (the handle).

[JaapvanE]

Our resident troll will probably be out shortly to tell you that it's the terrible design of the C2 handle though...

Congratulations on winning this bet within 24 hours....

[Sakly]

Our resident troll will probably be out shortly to tell you that it's the terrible design of the C2 handle though...

Congratulations on winning this bet within 24 hours....

[Slidewinder]

Our resident troll will probably be out shortly to tell you that it's the terrible design of the C2 handle though...

Congratulations on winning this bet within 24 hours....

Quoting you from the referenced thread on the subject of footrests and an injured user: "Perhaps fitting a rotating footplate from a boat might help you."

Very good, JaapvanE. We agree. A pivoting footplate would ensure the user's feet and ankles remain aligned with the direction of applied force throughout the stroke. Now apply the same rationale to the handle - include pivoting elements to ensure the user's hands, wrists, and forearms remain aligned with the direction of applied force throughout the stroke. This is what needs to be done. Since we agree, possibly we could collaborate in some manner.

[JaapvanE]

Keeping a light grip on the handle, and moving fingers on the down stroke would minimize this.

As several indicated: the handle doesn't have to be "deathgripped", but only hooked by your fingers lightly. If you didn't do that before, that is an important place to start. It is an important improvement of your rowing technique if this is the case, but regardless of that I would urge you to look at your cumulative training load.

5 trainings per week allows for little recovery time, so watching your body is quite crucial and you might have passed beyond a threshold. In essence, you can row a 10K, but at this moment in time it might be too much for your body to do 5 10K's in a week. The new distance isn't too much in itself, but your body hasn't repaired itself enough before you start your next training and the cumulative effect of too much training with too little recovery time manifests itself somewhere. This in itself isn't odd as 50K a week is a very serious distance. And as a former semi-pro athlete I can tell you: when training intensity goes beyond a certain point, the less you talk about the sport and the more you talk about recovery times (this is why Garmin, Polar and the like add that specific functionality to their high end sport watches).

If this is the case, and if I were you, I would go back to 5 x 5K, and slowly move to a 5 x 10K training by extending the rows one by one. So for several weeks, you do 4 x 5K and one 10K. Once you feel confident, you do 3 x 5K and 2 x 10K. This allows your body to adopt slowly to the bigger stress of a training. This is not only vital for preventing potential overloading underarms, but also for several other recovery processes. Above all, it allows issues that pop up due to potential overtraining (or like some like to call it: underrecovery) to stay small. Be aware of typical signs of cumulative overload of your body, like having tired arms or legs. Another (important!) sign is how you feel before or after the row: if you hate the distance, you might also be wearing out without any physical symptoms showing.

[Slidewinder]

For comfort and reduced risk of injury the hands and wrists must be kept in an ergonomically correct angular relationship throughout the stroke. But what is that correct relationship? Look at the design of a pistol for the answer. Note that the handgrip is never perpendicular to the barrel, but angled back slightly. This ensures that when pointed at a target the gripped hand and wrist are in the correct angular relationship. Now apply this observation and teaching to rowing ergometer handle design.

Visualize two pistols hinged together at their muzzles such that when you take them in your hands the two pistol handgrips are in the position of the handgrips of the C2 handle. Visualize this assembly connected to the C2 RowErg pull chain at the muzzle hinge point. Simple. That is a vastly improved rowing handle. In the progression from catch to finish the angle between the pistol barrels, hinged at their muzzles, will increase, thereby ensuring that the user's hands, wrists, and forearms will always remain in bio-mechanically correct alignment. There will be no need for any of the grip-the-handle-lightly-in-your-fingertips stuff. All that is just an attempt to accommodate, as best as one can, the non-compliant rigid stock handle. The handgrips of the two pistol hinged assembly just described will follow the natural angular progression of the user's hands, maintaining the correct angular relationship between the hands, wrists, and forearms throughout the stroke. This is not complicated.

[JaapvanE]

Fingers are hooks only, the thumbs hang free, shoulders are loose: using a slow recovery, chain tension is enough to control the handle.

Shane Farmer (Dark Horse Rowing) has quite a good video about how to hold the handle, and what goes wrong in your training if you do it differently: https://youtu.be/cRUj7Eok8CM

He does suggest a slightly stronger grip (but certainly no death grip!) and holding the thumbs under the handle against the fingers. So he gives a slightly different advice, although they are subtle nuances.

[jamesg]

let's all pretend that 'technique' can overcome this equipment design deficiency.

Overcome is too late. We are told that TOS can originate from:

Tumors or large lymph nodes in the upper chest or underarm area
Stress or depression
Participating in sports that involve repetitive arm or shoulder movement, such as baseball, swimming, golfing, volleyball and others
Repetitive injuries from carrying heavy shoulder loads
Injury to the neck or back (whiplash injury)
Poor posture
Weightlifting

Maybe just plain old age too. Now that we know TOS exists, maybe we'll see it everywhere.

As of today, my first guess would be that keeping fit, anyhow, helps avoid such problems; but seeing the above list, that maybe some types of exercise are better than others. Any suggestions?

So not a monopoly of C2 machines. In any case, how many of us who erg and row do suffer from TOS? Is the incidence any different from that of swimmers, weight lifters, golfers? Must say I'd never heard of TOS anywhere, and certainly not on this forum. Up to yesterday I'd have said on messages seen that the incidence here is zero.

Putting TOS in the search box topright here I got plenty of how-tos, just one TOS, yesterday's.

I never had anything like this. I also had good coaches, started 70 years ago. As ever, when all else fails, read the instructions.

[p_b82]

For comfort and reduced risk of injury the hands and wrists must be kept in an ergonomically correct angular relationship throughout the stroke. But what is that correct relationship? <snip>

I really don't want to feed you - and derail the actual advice being offered to the OP (even if I personally failed to comprehend what TOS was by being initially lazy in my response and thinking it was something else without fact checking myself)- as imo your points are not really related to TOS at all, one could have perfect alignment and still demonstrate this behaviour, as the wrist position during the rowing stroke probably has no impact on the thoracic area - if the OP's issue is due to that.

I'll be perfectly honest Slidewinder, I do not know why the moderators still allow you to post on here; very little of your advice is constructive, it is repetitive, it is often off topic and it is toxic imo - just look at how many threads get locked when you chip in with your comments that, also imo, should tell you something about the nature of what you are posting.