## 4 Discussion  
To the best of our knowledge, this study might be the first to investigate the epidemiological characteristics of rowing-related injuries among Chinese athletes aged 12-24 years. Over one-third of the athletes experienced at least one rowing-related injury. Most of them were gradual-onset injuries. Lower back injuries ranked first, followed by injuries to the knee and shoulder. In addition, the incidence of injuries was significantly greater in female rowing athletes aged \(>\)18 years than in male rowing athletes, independent of age. Moreover, female rowing athletes aged \(>\)18 years showed a significantly greater injury incidence than those aged \(\leq\)18 years. Regarding injury incidence, a retrospective study of elite international junior rowers (median age: 18 years) reported that approximately 47.9% of all 104 rowers had experienced at least one rowing-related injury, and the injury incidence rate per 1000 training sessions was 2.10 [3]. In addition, a retrospective study of 160 master rowers (aged 27-60 years) reported that 21.5% of the rowers experienced at least one rowing-related injury, and the injury rate was 2.25 injuries per 1000 training sessions [4]. In this study, 38.2% (50 males and 29 females) of all rowing athletes reported at least one rowing-related injury, and the injury rate per 1000 training sessions was 2.16, which is consistent with previous studies. A prospective study focusing on international rowers reported an injury rate of 3.67 cases per 1000 h [6]. However, we found that the incidence of injury per 1000 h was 0.46 cases in the current study, which significantly differs from the previous study. Figure 3: Incidence rate of injuries per 1000 training sessions in rowing athletes. The error bars represent 95% CI. \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline
**Variable** & \multicolumn{2}{c}{**Model 1**} & \multicolumn{2}{c}{**Model 2**} & \multicolumn{2}{c}{**Model 3**} & \multicolumn{1}{c}{**\(p\)**} \\  & OR (95\% CI) & \(p\) & OR (95\% CI) & \(p\) & OR (95\% CI) & \(p\) \\ \hline Gender & - & - & 1.00 & - & 1.00 & - & 1.00 & - \\ Male & 1.00 & - & 1.00 & - & 1.00 & - & 1.00 & - \\ Female & 1.32 (0.72–2.44) & 0.38 & 4.34 (1.75–10.76) & 0.002 & 3.52 (1.37–9.02) & 0.009 \\ Age (yrs) & 1.22 (1.09–137) & -0.001 & 1.11 (0.98–1.26) & 0.10 & 1.02 (0.85–1.22) & 0.87 \\ Height (cm) & - & - & 1.43 (1.12–1.82) & 0.004 & 1.43 (1.11–1.84) & 0.006 \\ Weight (kg) & - & - & - & 0.72 (0.54–0.95) & 0.018 & 0.70 (0.52–0.94) & 0.017 \\ BMI (kg/m\({}^{2}\)) & - & - & - & 3.30 (1.28–8.53) & 0.014 & 3.63 (1.33–9.95) & 0.012 \\ Training years of experience & - & - & - & - & - & 1.02 (0.83–1.26) & 0.84 \\ Training hours daily & - & - & - & - & - & 9.95 (0.41–2.16) & 0.89 \\ Training days weekly & - & - & - & - & - & 0.67 (0.36–1.25) & 0.19 \\ Training hours weekly & - & - & - & - & - & 1.06 (0.92–1.21) & 0.43 \\ \hline \hline \end{tabular}
\end{table} 
Table 8: Logistic regression analyses of the association of the incidence of rowing-related injuries and variables. The differences in sample size and age might explain the differences between this study (207 participants with a mean age of 16.8 years) and the previous study (20 participants with a mean age of 26.3 years). Most injuries were gradual onset, with the ratio of acute-onset to gradual-onset injuries being 1:1.70-2.80 [2; 3; 4]. Among male athletes, the ratio of acute-onset to graduate-onset injuries was 1:2.10, while that among female athletes was 1:4.30 [3]. Similar to previous studies, most injuries in our study were gradual onset, with the ratio of acute-onset to graduate-onset injuries being 1:1.57 (males: 1:1.23; females: 1:2.10). Regarding anatomical sites, lower back and knee injuries are more common in rowing athletes. Previous studies reported that the incidence of lower back injuries was 31.8-32.3%, and the incidence of knee injuries was 14.2-18.8% [3; 4; 6].