Management of rowers with rib stress fractures

Stress fractures of the ribs in rowers occur mostly along the anterior axillary line, but also anteriorly and posteriorly. Management has previously consisted of rest, but symptoms can recur on return to training. Earlier return to rowing can be achieved with management that includes ice and TENS for pain relief, pulsed magnetic field therapy and passive mobilisation of the thoracic spine and costovertebral joints. Aerobic fitness is maintained with stationary cycling. Rowing is progressively introduced according to symptoms and strapping is used to support the ribs during training. Posture and technique is reviewed with the coach to eliminate unusual movements of the shoulder girdle.