Helen Julia Lavelle
Cambridge University Women’s Boat Squad, UK
Title: The Cambridge protocol for the prevention and management of rib stress fractures in elite rowers
Biography
Biography: Helen Julia Lavelle
Abstract
This paper reviews the latest hypotheses concerning the aetiology of rib injury and proposes reasoned prevention strategies. In addition to it, it explains a structured method to assess the severity of the lesion and therefore the likely period of interrupted training. Rib pain constitutes a major cause of training and competition days lost. It may afflict any rower but is a common injury in athletes training for more than seven sessions a week and can result in long periods of lay off. Rib pain lies within a continuum with an occult stress fracture needing 6 to 12 weeks to heal adequately to withstand intensive training whereas a minor periosteal reaction may settle in just a few days. The Cambridge protocol assessment tool helps the clinician determine the severity of the lesion and therefore how long the rower may need to recuperate. The Cambridge protocol guides the medical team looking after these patients through techniques to keep the athlete fit whilst unable to train fully and then a careful graduated return to normal training and competition. The paper will also review the issue of bone density and the evidence to support the use of Exogen (ultra sound bone stimulation) and spinal logic (electromagnetic energy) to accelerate bone healing and improve bone density.