GOTS – Pressenewsletter 29.10.2010
Sehr geehrte Damen und Herren,
auf dem Lake Karapiro im fernen Neuseeland beginnt morgen die Ruder-Weltmeisterschaft 2010. Über die häufigsten Verletzungen in dieser Sportart und deren Vorbeugung lesen Sie in diesem Newsletter.
Mit freundlichen Grüßen,
Frank Wechsel und Dr. Wolfgang Schillings, GOTS-Pressesprecher
Verletzungen beim Rudern
Vom 30. Oktober bis 7. November 2010 findet die Ruder-Weltmeisterschaft am Lake Karapiro in Neuseeland statt. Der deutsche Ruderverband hofft, dort ähnlich gut abzuschneiden wie im Vorjahr, als unter anderem der Deutschland-Achter Weltmeister wurde. Voraussetzung dafür ist, dass die Top-Athleten verletzungsfrei und optimal vorbereitet an den Start gehen.
Seit Beginn der Spiele der Neuzeit 1896 ist Rudern olympisch und seit 2008 auch bei den Paralympics vertreten. Die klassische Renndistanz beträgt 2000 Meter. Es gibt die offenen und die Leichtgewichtsruder-Klassen. Das Wettkampfrudern hat 14 olympische Bootsklassen, das WM-Programm 22. Man unterscheidet zwischen Riemenrudern (einseitig) und Skullen (beidseitig).
Anforderungs- und Belastungsprofil
Rudern ist eine klassische Kraftausdauersportart. Die Ruderbewegung umfasst eine zyklische Beanspruchung der Oberschenkel- und Gesäßmuskulatur (Druckarbeit) sowie der Arm-, Schulter- und Rückenmuskulatur (Zieharbeit). Aus leistungsphysiologischer Sicht gilt es, die Ausdauer und Kraft gleichermaßen zu trainieren und technisch „im Boot“ umzusetzen. Die Energiebereitstellung im Wettkampf erfolgt zu etwa 80 Prozent aerob, zudem ist eine hohe anaerobe Mobilisationsfähigkeit erforderlich, so dass nach den Rennen maximale Laktatwerte von 15-20 mmol/l gemessen werden. Erfolgreiche Ruderer benötigen überdurchschnittliche Hebelverhältnisse, die mittlere Körpergröße im Männer-Achter liegt um 1,99 Meter, im Frauen-Achter um 1,85 Meter.
Rudern ist eine relativ verletzungsarme Sportart. In einer aktuellen prospektiven Studie liegt die mittlere Verletzungsrate bei 3,67 pro 1000 Stunden mit im Schnitt 2,2 Verletzungen pro Athlet und Jahr. Davon betrifft die Hälfte die Wirbelsäule (siehe Tabelle).
Tabelle: Verletzungslokalisationen im Leistungsrudern während einer zwölfmonatigen prospektiven Studie
Lendenwirbelsäule 31,82 %
Knie 15,91 %
Halswirbelsäule 11,36 %
Handgelenk 9,09 %
Iliosakralgelenk 6,82 %
Brustwirbelsäule 6,82 %
Oberschenkel 4,55 %
Schulter 4,55 %
Sprunggelenk 4,55 %
Wade 2,27 %
Fuß 2,27 %
aus: A 12-month prospective cohort study of injury in international rowers; Wilson F, Br J Sports Med 2010;44:207-214
Akute Verletzungen
An akuten Verletzungen kommen Fingerquetschungen und -schürfwunden sowie Scheuerstellen an den Waden, am Brustkorb, in der Leiste, in der Gesäßfalte und als mitunter imponierende Blasen an den Händen vor. Beim so genannten „Ruderkrebs“, bei dem das Ruderblatt nach dem Durchziehen nicht aus dem Wasser geführt und mit der Fahrt weiter nach vorne gedrückt wird, sind schwere abdominelle und Thoraxkontusionen mit unter anderem Leber- und Milzrupturen sowie Rippenfrakturen möglich. Die meisten schweren Verletzungen werden aber eher durch Stürze am Bootssteg oder beim Ausgleichstraining sowie selten auch bei Bootskollisionen mit anderen Ruderbooten oder Binnenschiffen verursacht.
Chronische Verletzungen
Die häufigsten Überlastungsschäden treten im Bereich der unteren Wirbelsäule auf. Dazu zählen Osteochondrosen, Bandscheibenschäden, Spondylolysen, Radikulopathien und funktionelle Störungen. Ursächlich sind die erheblichen Scherkräfte und Kompressionsbelastungen während der Ruderbewegung. Als besonderer Risikofaktor gelten auch lange Trainingseinheiten auf dem Ruderergometer.
Im Bereich der Kniegelenke treten femoropatellare Schmerzen (Patellaspitzensyndrom, retropatellarer Knorpelschaden) und Tractusreizungen auf. An den oberen Extremitäten finden sich Tendinitiden („rower`s wrist“) sowie selten ein Karpaltunnel- oder ein funktionelles Kompartmentsyndrom. Schmerzhafte Muskelverhärtungen sind meist durch einseitige Dauerbelastungen, falsche Grifftechnik und falsche Stemmbrettwinkel bedingt. Bei knöchernen Thoraxbeschwerden muss an Ermüdungsfrakturen der Rippen gedacht werden. Gerade bei jungen Sportlerinnen gelten als Risikofaktoren von Stressfrakturen eine reduzierte Knochendichte, Menstruations- und Essstörungen sowie Muskelschwäche. Selten werden Stressfrakturen im Bereich des Schlüsselbeins, der Elle, der Mittelhandknochen sowie an Schien- und Wadenbein beobachtet.
Spezielle Rolle des betreuenden Arztes
Neben der regelrechten Behandlung der Verletzungen muss der betreuende Arzt insbesondere bei der Vorsorgeuntersuchung auf relative Kontraindikationen zum Leistungssport Rudern achten. Hierzu zählen eine signifikante Spondylolisthesis ab Grad II, bekannte Bandscheibenschäden, ein florider M. Scheuermann sowie eine femoropatellare Knorpelschädigung. Aus internistischer Sicht gelten dieselben Kontraindikationen wie bei anderen dynamisch und statisch eingestuften Sportarten. Bei oraler und infiltrativer Medikamentengabe müssen die aktuellen Anti-Doping-Richtlinien berücksichtigt werden.
Übersicht: Empfehlungen zur Vorbeugung von Verletzungen und Erkrankungen beim Rudern
- Vermeidung von muskulären Insuffizienzen, Dysbalancen und Verkürzungen des Rumpfes, der Hamstrings sowie der Unterarme
- Vermeidung von zu langen Ergometertrainingseinheiten
- gute Rudertechnik mit regelrechter Griffführung
- Ausgleich von Beinverkürzungen > 5 mm
- wettergerechte Kleidung
- Benutzung der eigenen Trinkflasche zur Infektvorbeugung im Großboot
- Bootsbegleitung in sehr kalten Gewässern, z.B. in der Höhe.
Autor: Dr. med. Christian Nührenbörger, Médecine du Sport, CHL Luxembourg, ist Mitglied der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin und ehemaliger Kaderarzt des DRV
Ich entschuldige mich aufrichtig für diesen Kommentar! Aber ich teste einige Software zum Ruhm unseres Landes und ihr positives Ergebnis wird dazu beitragen, die Beziehungen Deutschlands im globalen Internet zu stärken. Ich möchte mich noch einmal aufrichtig entschuldigen und liebe Grüße 🙂
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