While the true acute injury is not nearly as common as the overuse injury, they do occur. Sudden muscular strains and joint sprains of the spine can happen when fatigued and posture suffers. Any position of over-reach at the catch, or slumping at the finish put the joints of the spine under higher loads. If a sudden movement of the boat occurs while in these positions, then a joint injury is possible. The same postural and technical faults mentioned above can equally cause overuse injuries when repeated thousands of times over miles and miles of training.

The basic rules of injury management are still based around two acronyms. P.R.I.C.E and do no H.A.R.M.

P Prevent further injury. This means stop doing the action that is causing the pain. If in the middle of a training session, you are much better off telling your coach about the problem, rather than continuing on in pain and risking further damage.

R Rest. This is tied into the above section. Out of everything that medicine has to offer athletes, rest is the bodies’ most powerful way of recovering from an injury. Obviously we try our best to keep someone training when ever possible, but if in doubt err on the side of caution. This may mean relative rest. Where the problem is a back or rib injury for example, an athlete may still be able to swim or use an exercise bike without loading the injured area. It is important to maintain as much cardiovascular fitness as possible.

I Ice. In the early stages of injury, ice is very effective in controlling swelling and inflammation. In many injuries sustained by rowers, swelling is not immediately apparent, but this does not mean that ice is not needed. Even for an acute back injury, ice can be very effective in managing the associated muscle spasm. The quicker you can get the ice on after first noticing the pain, the better. How long to keep it on for depends on the depth of the tissue you are trying to influence. For tendons in the forearm I would advise about 15 minutes, for the lower back I would stretch that out to 20 minutes. Repeat this every one to two hours if possible. There are some muscle tightness problems that may benefit from heat, but unless specifically advised to do so I would stick to ice.

C Compression. This is useful for controlling swelling. In cases like ankle, knee wrist or elbow sprains; it is easily applied with an elasticised or tubular bandage. Even some of the wetsuit material sports supports can do the job. For problems in the spine or shoulder it is less relevant.

E Elevation. Where swelling is an issue, elevation is the most effective way of reducing it. Once again, great if you have an ankle or knee injury, but not as relevant for a low back injury.

The acronym of do no H.A.R.M represents what not to do after an injury.

H Heat. As discussed above, ice is the best for acute injuries. Heat will increase the blood flow to the area making the bleeding and swelling worse.

A Alcohol. After an injury it is tempting to feel sorry for your self and have a consoling drink – don’t! Alcohol thins the blood and makes swelling worse. Even when you can’t see swelling, as in the lower back, it is still there.

R Running. This means stop ongoing exercise. Continuing to exercise the area will cause further bleeding and tissue damage. This ties in with the relative rest discussed above.

M Massage. While massage of tight structures can sometimes help injuries, massage through the immediate area should not be done for 48 – 72 hours after injury. Otherwise the damaged blood vessels will be reopened causing further bleeding and swelling.

Although it is not always easy, I would try to get an opinion on the problem as quickly as possible. Always tell your coach about the problem. They have a wealth of experience and may have seen the same problem before. Hopefully you don’t have a coach who just calls you a “wuss” and tells you to train on!! They may be able to tell you if there is a technical fault contributing to your problem.

A physiotherapist, doctor or massage therapist should be able to give you an opinion on what the problem is and what to do next. Make sure that whoever you see, they have good experience in dealing with sports injuries. The advice I have heard from some professionals without good sports knowledge has been quite enlightening. Once again your coach may be a good source for an experienced professional.

Do not try to train through the problem and ignore the pain unless you have a good understanding of the problem. I let some athletes continue training, but only if I am confident that they will not make it worse by doing so.

Editorial by Ivan Hooper

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