Biomechanical Responses to a Six-Week Sport-Specific Physiotherapy Programme in Elite Male Flatwater Kayakers: A Prospective Controlled Cohort Study

Background: Biomechanical evidence concerning sport-specific physiotherapy in elite kayaking remains limited. Objective: This study aimed to evaluate joint range of motion (ROM), muscle activation, and bilateral footrest force before and after a six-week physiotherapy programme. Methods: Twenty-two elite male kayakers participated in a non-randomised prospective controlled cohort study (study group, n = 11; control group, n = 11). Three-dimensional motion analysis, surface electromyography, and footrest-force measurements were obtained during ergometer kayaking. Results: No between-group difference in ROM change was statistically significant (p ≥ 0.398). Only right pectoralis major activation showed a significant exploratory between-group difference in change (1.40%MVC, 95% CI 0.62–2.18; p = 0.002). Footrest force increased bilaterally within the study group (both p < 0.001) but not within the control group (right, p = 0.908; left, p = 0.815). Exploratory summary-statistic estimates favoured the study group for right and left force change (both p < 0.001). Mean bilateral footrest force correlated with mean bilateral trunk rotation in the pooled sample (Spearman’s ρ = 0.953, p < 0.001). Conclusions: The programme was associated with increased bilateral footrest force during simulated paddling. ROM and most EMG changes were descriptive. The non-randomised design, small sample, and exploratory analysis preclude causal conclusions; clinical and performance applications require prospective evaluation using direct outcomes.