“So let me guess,” the x-ray technician said to the rower waiting for the verdict on their injury. “You’ve recently been in a bar fight?”
“What? No…” said the rower.
“A motorcycle accident, maybe? Fender bender?”
“No, I’m here because of a crew injury,” replied the rower.
“No way!” the tech replied, “Normally, a rib fracture like this one are characteristic of high impact trauma. How did you manage to do this rowing?”
It’s a good question really. Why does a sport with no contact fracture rib bones?
Rib injuries come from newer rowing technology, a change in training type and weakness in other parts of the body.
According to World Rowing, rib injuries have increased significantly since the 90s. Boat technology has moved away from more springy wooden shells and oars to stiffer composite material which makes the impact of the catch more jarring for the body.
The rise of the erg also plays a role in the rib drama. Since stationary rowing is now an inescapable part of training, rowers have to spend more time pushing against a machine that doesn’t move. Modern training plans, with higher volumes, put more strain on bodies and leave less time for recovery. Fatigued bodies try to find a way to use muscles that are less tired, but aren’t strong enough to take over for the normal systems. These little muscles are the ones that cause problems.
Rib problems can be triggered by a sudden increase in training volume, switching sides, switching from sculling to sweep or doing long hard pieces at low rates.
Here’s a quick-and-dirty, simple, biomechanical summary of what’s up, according to StrengthcoachWill who wrote this article for Row Perfect last January.
To the left is the Serratus Anterior muscle (SA). It surrounds the ribs and moves the arm forward. At the catch, the SA flexes and picks up the load of the boat. As the rower continues throughout the drive, the SA stays flexed and releases at the finish when the oar leaves the water. It’s work isn’t over though: On the recovery the SA has to contract again to move the arms away from the body. The entire time the rowing motion is happening, the SA is cycling through a contraction pattern. It works tirelessly and because it’s in a weird spot, it’s often forgotten about when stretching. One of the reasons that rowers often have hunched shoulders is because of tight SA muscles.
The other part of this story has to do with the muscles that oppose the SA. The rhomboids counteract the SA and prevent torque from being placed on the lower ribs. Without the rhomboids to pull against the force that the SA produces and stabilize the ribcage, the rib bones would be twisted and pounded until they start to splinter.
It varies from person to person, but if the rhomboids, shoulder muscles, pecs, lats etc are aren’t strong enough to match the power of the SA or they are doing the work another part of the upper body should be doing, the ribs will experience extra strain: something like a runner getting shin splints.
This is called a stress reaction and is the pre-fracture step to a rib injury. The rower will have throbbing or soreness when reaching for a doorknob, turning over in bed or breathing deeply. At this point the rib bones are very irritated, but not broken.
If it’s caught early, the rower could spend 2 weeks cross training and be OK for the rest of the season. If the rower keeps training, the rib will likely fracture. When the bone fractures there’s generally a painful “popping” sensation. It’ll be obvious to the rower that it’s broken.
The only way to treat the rib injury is to stop putting stress on it so that the bone can heal. If it’s the finals of the IRAs, Worlds, Olympics, whatever, a rower can get away with rowing on stressed ribs. They could tape it up with KT tape but the only way to get rid of it is to stop rowing for a length of time (anywhere from days to months depending on how bad it is.)
Although it is safe to row 2 months after a rib injury, the bone still isn’t totally healed. A healing bone will go a little bit overboard to protect itself. It builds up bone deposits and will have a lump over the fracture site when it’s done. That lumpy callus eventually gets filed down by the body, but the lump will stay on the bone for a year or more.
At the end of the day, the best way to prevent rib injuries is through stretches and strengthening exercises. This article from Princeton University does a really good job of summarizing preventative measures.
Since I wrote this article I have gotten a rib injury (9/17/17). I took a month off after U23 Worlds (where I had been rowing the 8+) and started rowing full time in the single. My lats were started getting really sore about 3 weeks into training and I thought that’s just what happens when you scull.
I rowed about 80k past normal soreness, which was stupid. I stopped when it felt like my bone was separating from the muscles in my side.
I had given myself a stress response in the bone. It had splintered but it hadn’t yet broken. Because I stopped before I heard or felt a “pop” I will be able to cross train for one or two weeks and hopefully be ok.
(Edit from 12/20/17)
I did take a week off, but I came back too soon and put a ton of stress on the bone. After my workout I sneezed and had a horrible shooting pain in my side, which was the bone fracturing. I had to take 8 weeks off after that (ie 150+ minutes of cross training alone everyday for almost 2 months. NOT WORTH IT).
Importantly I learned:
Don’t be a hero. Don’t try to do the rowing motion until you can go from lying down to sitting up without pain. If you let it heal completely it’ll be fine, but if you come back before the bone is healed it’ll be a recurring problem for as long as you keep rowing.
DO NOT TAKE ANY ANTI-INFLAMMITORIES (IE ADVIL) OR ICE THE AREA
You want to site of the bone to stay inflamed so that it can heal. If you do either of these things you inhibit the body from sending blood and other helpful biological healing mechanisms to your rib.
I also learned the National Team trainer’s theory that rib problems come from weaknesses in the shoulder or upper torso. I had tolerable shoulder pain for most of my senior year of rowing, my trainers in college treated it, but never addressed the root issue. It developed into having tendentious in my rotator cuff. So if you’re having issues get them looked at before it creates other issues. Compensating for a larger problems created the stress that broke my rib.
At the end of the day, the main lesson with rib injuries is don’t be a stupid. If you start to feel shooting pain in your ribs at the middle of the practice, stop. If it hurts to breathe, tell your coach. If you’re rowing the opposite side, make sure you’re doing extra strength and stretching. Go forth and use this knowledge to make sure you’re not the one sitting on the launch watching practice because of something as silly as a rib fracture.