Magnetic Resonance Imaging Diagnosis of Rib Fracture in a Competitive Collegiate Rower: A Case Report

Competitive collegiate rowing has a long history, dating back to the nineteenth century. The oldest American intercollegiate athletic event on record is the Yale-Harvard boat race in 18521. While the mechanics of the sport remain largely unchanged, the extent of training and level of competition for collegiate rowers continue to increase. Competitive rowing is no longer a seasonal sport; these athletes are involved in year-round training, on ergometers (rowing machines) and in the water. This level of training, combined with the specific repetitive movements involved in rowing, makes elite rowers especially susceptible to injury. The mechanics of the rowing motion can be analyzed in four phases: catch, drive, finish, and recovery. The catch phase is when the rower’s legs and back are fully flexed and the arms are extended as the oars enter the water. The drive phase is when the legs extend and the back slightly extends, followed by flexing of the arms to accelerate the oar through the water. The finish or release phase consists of the elbows drawing the blade through the water as well as movement of the handle down to remove the oar from the water. The recovery phase is when the oar is brought back to the starting position. The timing and magnitude of these motions can lead to strain and overuse injuries2. It is therefore not surprising that back injuries are very common among rowers. The differential diagnosis for back pain in a rower includes muscle strain, ligament and/or tendon injury, tear of the anulus fibrosus, or stress fractures. Although stress fractures of the ribs are rare in the general population, they have a relatively high frequency (6.1% to 22.6%) in competitive rowers3,4. While stress fractures have been long identified as a consequence of vigorous …