Rib Stress Injuries in the NCAA Collegiate Rowing Athlete: A Prospective Observational Pilot Study
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Context: Rib stress injuries (RSIs) are one of the most debilitating injuries that the competitive rowing athlete may sustain during their career. Rib stress reactions can result in an average loss of 48 training days per year which increase to an average loss of 60 days per year if they develop into stress fractures. Minimal research exists on these injuries and associated risk factors in NCAA women’s rowing athletes in the United States. Patient self-report injury surveys have been previously shown to be both sensitive and reliable. Objective: To document RSIs sustained and potential associated risk factors during a single NCAA rowing season in a series of female rowing student-athletes, and begin to assess the extent of the clinical problem. Design: Prospective observational pilot study. Setting: Field-based. Participants: 27 NCAA Division I and III female rowing athletes (age, 19.3 ± 1.8 yrs; height, 171.6 ± 6.3 cm; weight, 75.8 ± 9.3 kg). Interventions: A series of self-reported online surveys: a “baseline questionnaire” and 14 “weekly e-diaries.” Main Outcome Measurements: Physical training program characteristics, nutritional supplementation use, menstrual activity, and medical details regarding reported potential RSIs. Statistical Analysis: Descriptive statistics, qualitative theme analysis, and a case series. Results: A total of 3,407 hours of physical training, on-water practices and competitions were reported by the 27 participants during the 14-week study. Seven of 27 participants (26%) reported a rib cage injury, of which 4 identified as RSIs. Aggressive RSI management at onset of symptoms, immediate removal from on-water/ergometer training for several days, and return to activity soon after were observed, especially in Division I athletes. Conclusions: In our preliminary study, RSIs were prevalent in the sampled NCAA rowing population, suggesting that larger scale epidemiological studies should be conducted to determine the injury’s true prevalence, severity, management and subsequent clinical course.