Yudu - sportEX dynamics - 1999-2010

INJURY PREVENTION

tion rather than using forced wrist extension to achieve the same effect. Check that the oar turns smoothly in the gate, removing any obstruction to smooth rotation of the blade. Medical advice: This is essentially an inflammatory condition which settles with RICE. If it doesn’t settle consider cortisone injection to the carpal tunnel. Occasionally surgical decompres- sion is required to settle the condition.

Forearm Compression Compartment syndrome of the forearm can be seen in rowers whose muscle bulk development is greater than the space provid- ed within the collagenous structure of the forearm. Prevention: Gradual increase in training loads and encourage- ment to use a loose grip. Medical advice: Usually diagnosed from history and pressure studies of the forearm. If the forearm pressure studies are partic- ularly high this condition requires surgical decompression to pre- vent muscle necrosis.

Elbows Medial epicondylitis (Golfers elbow) Medial

epicondyle - site of multi- ple muscle attachments

This condition is charac- terised by pain on the inner aspect of the elbow. In the early stages of this condition pain occurs after rowing, as the condition becomes more chronic the pain occurs at the elbow as the catch is taken. Medial epicondylitis is associated with gripping the blade too tightly and with a typical grip of the blade by the inside hand.

Prevention: Check that grip is relaxed and that the hands are held in line with the forearms not deviated to the right/left. Again check that the blade is turning freely in the gate and that any resistance found is eliminated. Medical advice: Responds to technique correction and RICE in combination with physiotherapy. If not settling it may require cortisone injection and/or surgery.

Neck

Muscular stiffness (of neck and upper back) It is not uncommon for rowers to complain of this. The underly- ing cause of the stiffness is usually poor pectoral stability, by this I mean an inability to support the arms on the pectoral girdle allowing them to be suspended from the base of the neck. The sport naturally asks for the shoulders to be used in a very elon- gated position. If, on taking the catch, the shoulder blades are not “set” first, the initial load of the water on the blade pulls the arms out further. The muscle reaction to this is to tighten around the base of the neck and upper rib cage. If muscle tightening is not alleviated, the muscle becomes shortened and the blood supply to the muscle is impaired causing pain and stiffness. Prevention: Strengthening of the pectoral girdle allows the arms to be held by the subscapular muscles, this allows the upper limbs

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to be held firmly at the catch and the true power of the upper limbs to be accessed. Medical advice: Postural assessment by a physiotherapist is essential to pick this problem up and to establish a protocol of exercises for the development of pectoral stability.

Ribs Costovertebral joint strain Inflammation of the ligaments supporting the articulation of the rib and its associated vertebra together with disturbance of the normal mechanics of the joint, cause pain to be felt in the upper spine. The pain is usually a dull background ache with a sharper pain on taking a deep breath, coughing, laughing and on taking the catch. The pain may spread around the chest wall, or may be felt in the front of the chest due to protective spasm of the mus- cles between the ribs. It is strongly believed that thoracic spine stiffness predisposes to this condition.

Prevention: Maintenance of movement through the thoracic spine. This can be done by exercises such as the figure of eight exercise, and when in intensive training by loosening of the tho- racic spine using manipulative techniques. Medical advice: If treated promptly the rib head strain will set- tle quickly. Manipulation to restore the mechanics, anti-inflam- matory medication and 48 hrs rest is usually all that is required.

Rib stress fracture A stress fracture may not be a true break in a bone but it is increased bone activity caused by localised repeated stress to the bone. This presents usually with sudden onset of acute pain in the mid-axillary line, occasionally it may have been preceded by stiff- ness or aching prior to the onset of acute pain. In rowing, the localised stress is typically focused to one side (the left side if rowing bowside and the right side if rowing strokeside, ie. the side to which the upper body twists during the rowing stroke). Rib stress fractures are not usually visible on x-ray; the only conclu- sive investigation is a bone scan. Prevention: Maintenance of mobility through the thoracic spine and rib cage by regular figure of eight exercises and intermittent manipulation of the thoracic spine. Medical advice: Once diagnosed the quickest way to settle a rib stress fracture is to remove the localised stress that caused it. This unfortunately means no rowing or ergometer work until the pain has settled - usually a 3-4 week period. It is possible to maintain fitness using exercise that doesn’t load the rib.

Back Low back pain The majority of back problems feel the same to the athlete. The