Sports Medicine: Just the Facts

CHAPTER 80 • CROSS-COUNTRY SKI INJURIES 475

Perron, Brady, and Keats, 2001). Prevention with slow

progression of load and duration is ideal. Technique

modification to unload the oar may also be helpful

(Karlson, 2000).

DERMATOLOGIC PROBLEMS

• The skin of the rower is subject to repetitive trauma in
  the hand, the posterior calf, and the buttock. As a con-
  sequence, the rower may have a number of dermato-
  logic complaints referable to these locations.


• The hands of rowers are highly susceptible to blisters,
  caused by friction with the oar handle. These are con-
  sidered a badge of honor by experienced rowers, and a
  right of passage for novices. Rowers rarely wear gloves,
  as this is felt to interfere with the ability to feel the oar
  as it passes through the water. Blisters can become sec-
  ondarily infected, occasionally requiring topical or oral
  antibiotics in significant cases (Knapik, 1995).


• The buttocks are susceptible to chafing, blisters, callus
  formation, and abrasions, due to repetitive trauma
  from the small sliding seat. Blisters can become
  infected and occasionally require topical or systemic
  treatment. Changing the seat, use of a foam pad, and
  judicious use of petroleum jelly can all help to allevi-
  ate symptoms.


• Track biteis an injury to the skin of the posterior
  calves. During the rowing stroke, the legs are force-
  fully extended, and at the finish the posterior lower
  leg contacts the metal track that the seat slides in. The
  repetitive trauma of the leg hitting the track can result
  in skin breakdown, or a track bite. Athletes who
  hyperextend their knees or row with shoes adjusted
  into a lower position are particularly at risk for these
  injuries. These injuries can become superinfected,
  requiring local or systemic antibiotics. Prevention
  with padding on the end of the track and/or circum-
  ferential leg taping at the point of contact can help to
  alleviate these injuries.

REFERENCES

Boland AL, Hosea TM: Rowing and sculling and the older ath-
lete. Clin Sports Med 10(2):245–256, 1991.
Brukner P, Khan K: Stress fracture of the neck of the seventh and
eighth ribs: A case report. Clin J Sports Med6(3):204–206,
1996.
Christian E, Kanstrup IL: Increased risk of stress fractures of the
ribs in elite rowers. Scand J Med Sci Sports7(1):49–52, 1997.
Edgar M: Rowing injury: A physiotherapist’s perspective.
Sportcare J2:32–35, 1995.

Fulcher SM: Upper-extremity tendonitis and overuse syndromes

in the athlete. Clin Sports Med 17(3):433–448, 1998.

George SZ: Management of the athlete with low back pain. Clin

Sports Med 21(1):105–120, 2002.

Hagerman FC: Applied physiology of rowing. Sports Med 1(4):

303–326, 1984.

Hickey GJ: Injuries to elite rowers over a 10-yr period. Med Sci

Sports Exerc 19(12):1567–1572, 1997.

Karlson KA: Rib stress fractures in elite rowers: A case series and

proposed mechanism. Am J Sports Med 26(4):516–519, 1998.

Karlson KA: Rowing injuries. Phys Sportsmed28(4):40–50,

2000.

Knapik JJ: Friction blisters. Pathophysiology, prevention and

treatment. Sports Med 20(3):136–147, 1995.

McKenzie DC: Stress fracture of the rib in an elite oarsmen. Int

J Sports Med 10(3):220–222, 1989.

Perron AD, Brady WJ, Keats TA: Principles of stress fracture

management. Postgrad Med 110(3):115–124, 2001.

Redgrave A: Rowing injuries: An overview. Sportcare J 2:28–31,

1995.

Secher NH: Physiological and biomechanical aspects of rowing:

Implications for training. Sports Med15(1):24–42, 1993.

Stallard MC: Backache in oarsmen. Brit J Sports Med12(2–3):

105–108, 1980.

Thomas P: Managing rowing backs. Practitioner233(1465): 446–

447, 1989.

80 CROSS-COUNTRY SKI INJURIES

Janus D Butcher, MD

INTRODUCTION

BACKGROUND

• Cross-country skiing is one of the three Nordic skiing
  disciplines along with ski jumping and Nordic com-
  bined (skiing and jumping). Most historic references
  to Nordic skiing discuss its military use. Indeed, the
  sport of biathlon (skiing and shooting) has it’s origin
  in this historic relationship.


• Cross-country skiing is generally associated with a
  low injury rate and it is considered to be one of the
  highest aerobic demand activities. Although generally
  confined to the northern tier and mountain states, its
  popularity in the United States continues to grow.
  •Cross-country skiing had remained relatively un-
  changed from its remote beginnings until dramatic
  innovations in equipment and technique were intro-
  duced over the past 20 years. Currently, two very dis-
  tinct techniques are used, the diagonal stride (classic)
  and ski-skating (freestyle).