The Roundtable is back, and we’re joined by guest rowing physical therapist Karen Calara who draws on her 20+ years of experience in physical therapy, rowing, and strength training for a deep dive into an injury that results in some of the most missed water time of any rowing injury. The rib stress injury may start off as just a dull, ignorable ache, but can progress rapidly into a disruptive injury if not addressed promptly and correctly. Tune in to learn the mechanics of injury, what you can do to minimize your risk, and how to rehab it and return to rowing should you catch one.

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0:00: Introducing guest Karen Calara

• Website: Aligned & Balanced Rowing
• Follow Karen on Facebook
• Karen offers a variety of coaching options both in-person (Seattle Rowing Center and beyond) as well as online from single hour consultations to full coach and athlete workshops.

4:26: Injury mechanics of the rib stress injury (RSI)

• RSI is an all-encompassing term referring to general rib pain, rib stress fractures, and costochondritis. RSIs can occur on the anterolateral ribs, the sternal cartilage, and posterior ribs. See diagram below.

• Muscular: weak scapular muscles can expose the rower to risk of RSI from muscular imbalances as the internal shoulder rotators, lats, and upper traps overpower the external shoulder rotators and middle and lower traps. Weak scapular retractors can also cause the rower to lose connection at the catch and transfer excessive force to the ribcage.
• Mobility restrictions in the hips and thoracic spine can put the athlete in bad positions at the catch, through the drive, at the finish, and during the recovery that expose the ribs to excessive stress. Rowers may also compensate for mobility restrictions in the hips and thoracic spine by transferring muscular force to other areas of the body at various stages of the stroke, which can also transfer excessive force to the ribs.
• Poor breathing mechanics can create tight pec and scalene muscles, poor rib mobility, and a dysfunctional diaphragm, leading to greater risk of RSI. Rowers often breathe shallowly using their chest and neck muscles rather than deeply using their diaphragm.
• Poor technique can expose the athlete to greater risk of RSI. Reaching with the shoulders instead of the hips during the recovery, lunging at the catch, losing connection during the drive, shrugging during arm drive, and slumping at the finish are the main faults that put athletes at risk.

20:40: Breaking down injury risk by stroke phase and how you can correct it

25:35: Is there a difference between the fastest stroke and the healthiest stroke?

29:30: The importance of breathing mechanics

34:45: I have an RSI. Now what?

• Rehab and recovery plan
• How to continue to make improvements while injured

41:20: Returning to rowing

• Gradual increase of volume and intensity
• Stroke modifications
• Specific strength training

44:55: Ongoing rehab and prevention

55:05: Teaching breathing in the boat

Bonus: Hip Mobility Series from Karen Calara

Thanks for listening! If you have a question or comment, please leave it below and we’ll respond. Until our next episode, you can listen to all of our old ones here in the Rowperfect UK archives.>