The recent BBC article featuring GB Rowing Team athlete and World Champion, Hannah Scott, has gained a lot of attention, and rightly so.
Scott discusses how she thought that having broken ribs while rowing competitively was normal, especially for female athletes. This is truly shocking.
She took part in a study led by British Rowing, with support from the UK Sports Institute and researchers from Manchester Metropolitan University. Their aim was to increase the understanding of rib stress injuries in high-performing female athletes, and solutions to help support and treat them. In the BBC article, Scott mentions that the ongoing Project Minerva study includes taking saliva samples to obtain data about hormones, tracking menstrual cycles, and training markers like heart rate. All this data is then collated to personalise participants’ training regimes.
Scott’s results showed that two factors had the biggest influence on her hormone levels: under-fuelling, and relative energy deficiency in sport (RED-S). These may seem unsurprising, but finding a resolution is often easier said than done. The two quotes below – originally from Scott in the BBC article – hold such weight that they are worth re-quoting.
“Fuelling for women is so important because it gives us the energy to train every day while also being able to help our bodies to function. I don’t think as women we’ve always had the stance of fuelling our bodies for those purposes, there’s definitely a stance in society that we have to look a certain way.”
“But with this project, we’ve realised the importance of eating, looking after yourself, recovery and making our body strong for performance, not just to look at.”
As both a physiotherapist and female athlete, I feel an added responsibility to increase awareness around this subject. I have seen, assessed, and treated enough rowing-related rib injuries to tell you that they should not be considered a ‘rite of passage’ that prove you’re a high performance athlete. Not only is it uncomfortable and painful, but leaving any injuries untreated is detrimental to your health for life.
The biggest and best thing you can do is to educate yourself on chest injuries and their differentiating factors. Sadly, these injuries are more common than any physio, coach, or athlete would like to admit. If you can recognise some of the warning signs and triggers, then you will be much better-equipped for managing any injuries you incur.
I am on a mission to help athletes help themselves when it comes to chest injuries, and below I outline a brief guide for handling chest-related injuries.
1. Seek context and clarification
‘Chest injuries’ is an umbrella term for any pain that you get in the chest area. There are different levels to these types of injuries. Don’t panic and assume the worst, and don’t assume that all chest and rib pain is immediately a rib stress fracture. The infographic below is a good point of reference for this.
2. Read the British Rowing guide
The GB Rowing Team has a guideline for diagnosing and managing rib-related injuries – read it. Knowledge is power.
3. Modify your training accordingly
If you have consistent chest wall and rib pain, you need to modify your training to offload your ribs and reduce the intensity of work to allow your body to rest.
4. Pay attention to the red flags
The main red flag is any pain when coughing, sneezing, inhaling, laughing, pushing or pulling doors, rolling over in bed, or lying on your affected side. Any of these are possible indicators that you are loading your body with more than it is able to manage.
5. Avoid movement that aggravates the injury
Finally, if certain movements are aggravating your symptoms, you should be trying to avoid them in the early stages of rehabilitation. However, that does not mean you should avoid all activities. Do more of the things that are not provocative and less of what is.
Sophie Hudson is a qualified physiotherapist
Image Credit: Benedict Tufnell
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