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ROWERS HEALTH

The following information is based on a presentation given by the coaches to the rowers.  It covers important information including sleep, nutrition, hypothermia, blisters and Weill’s Disease a rare but serious infection transmitted from river water.

Food

Do not be surprised if your appetite increases: this is just due to the extra energy your body needs to fuel the training sessions you are doing. Eat well but stay away from fat laden foods and foods high in sugar.  To give you the energy you require, eat foods high in complex carbohydrates (potatoes, pasta, bread, cereals etc).  Ensure you have a daily intake of protein (fish, white or red meat, dairy products). Always include fruit and vegetables in your diet.

Remember you are what you eat; there is little point in training to get stronger and fitter if you do not then give the body the nutrients it needs to grow and develop. If you are getting tired at school, it will probably be more to do with your diet than the amount of training you are doing.

Ensure you drink to replenish the body of the fluids that it loses through exercise. Water and squash are good. Pure fruit juices are normally concentrated and actually dehydrate so water them down half juice and half water.

Tea, Coffee and Coke all dehydrate the body, so avoid before or just after training.

Sleep

Exercising and training takes energy from the body, and although this can be replaced with a good diet, it is still necessary to get the correct amount of sleep. Your body recovers and repairs itself during sleep, so to get stronger you need rest. Try to get an average of 9 hours sleep each night. Getting to bed at the same time each evening will encourage a good sleep pattern that allows maximum recovery.

Hypothermia

Here are some fundamentals about hypothermia

Prevention

• Avoid exposure.
• Terminate exposure.
• Never ignore shivering.
• Beware of exhaustion.
• Detect hypothermia.
• Be prepared.
• Avoid exposure.

STAY DRY. When clothes get wet, they lose about ninety percent of their insulating value. Wool loses less as does many of the new synthetics. Wet Cotton is worthless.

BEWARE OF THE WIND. A slight breeze carries heat away from bare skin much faster than still air. Wind drives cold air under and through clothing. Wind refrigerates wet clothes by evaporating moisture from the surface.

WIND MULTIPLIES THE PROBLEMS OF STAYING DRY. If you have been in the water and you are wearing a T-shirt that is wet, remove it and you will retain more heat. Direct sunlight on the skin helps in the warming process.

UNDERSTANDING COLD. Most hypothermia cases develop in air temperatures between -1 and 10 degrees. Most outdoor enthusiasts simply can't believe such temperatures can be dangerous. They fatally underestimate the danger of being wet at such temperatures. Fifty degree water is unbearably cold. The cold that kills is cold water running down your neck and legs, and cold water removing body heat from the surface of your clothes.

Detecting Hypothermia

If your group is exposed to WIND, COLD, OR WET, think hypothermia. Watch yourself and others for the symptoms:

• Uncontrollable fits of shivering.
• Vague, slow, slurred speech.
• Memory lapses, or incoherence.
• Immobile, fumbling hands.
• Frequent stumbling.
• Drowsiness (to sleep is to die.)
• Apparent exhaustion. Inability to get up after a rest.

Treatment

The victim may deny he/she is in trouble. Believe the symptoms, not the person. Even mild symptoms demand immediate treatment.

• Get the victim out of the wind and rain.
• Strip off all wet clothes.
• If the victim is only mildly impaired:
• Give him/her warm drinks (only small amounts).
• Get him/her into dry clothes and a warm dry sleeping bag. Well-wrapped warm thermoses placed in the crotch and under the arms anywhere the main arteries are close to the surface of the skin, will hasten recovery.

If the patient is semi-conscious or worse:

• Try to keep him/her awake. (Do not give hot liquids by mouth.)
• Leave him/her stripped. Put him/her in a sleeping bag with another person (also stripped) to transfer heat. If you can put the victim between two donors, skin to skin contact is very effective treatment.
• Warm the torso only - not extremities.
• Transport the victim as soon as possible to the closest hospital for monitoring. It takes a very long time to warm the inner core and only a rectal hypothermia thermometer is long enough to find out what the inner core temperature really is. DON'T DELAY!

Some Points to Remember

• While in the water, do not attempt to swim unless to reach nearby safety. Unnecessary swimming increases the rate of body heat loss. Keep your head out of the water. This will increase your survival time.
• Keep a positive attitude about your rescue - this will increase your chances of survival.
• Sudden immersion in cold water cools your skin and outer tissues very quickly. Within 10 or 15 minutes, your core body temperature (brain, spinal cord, heart, and lungs) begins to drop. Your arms and legs become numb and completely useless.
• You may lose consciousness and drown before your core temperature drops low enough to cause death.

Weill's Disease

The risk of contracting Leptospirosis from recreational water is small, however the serious nature of the disease is such that we must be aware of the dangers and should take simple precautions to reduce the risk of infection, viz:

• Cuts and abrasions (including blisters) should be covered with waterproof dressings.
• Wear footwear to avoid cuts and protect feet when paddling in the water (launching a boat).
• Shower after contact with the water.
• Wash hands thoroughly before eating and drinking.
• If 'flu' like symptoms develop shortly after contact with the water (1-3 weeks) then your doctor should be contacted and advised of the circumstances of exposure.

Please also read this link from British Rowing:

www.britishrowing.org/news/weils-disease-leptospirosis

Blisters

Blisters are a common complaint for young rowers, especially on training camp.  Some contrasting suggestions from various people’s experience. Read, try, experiment for yourself.

Avoiding Blisters:

• Row lots and lots and keep rowing regularly - eventually your hands will harden in all the right places.
• Maintain a loose, relaxed but correct grip on the handle.  This is also something that develops with time.
• Use Surgical Spirit on your hands.  Surgical spirit is available over the counter at the chemist and is fairly cheap.  Rub it onto the unbroken skin of the hands as often as possible.  Over time this will help to toughen up that young tender skin.
• Find a piece of smooth wood.  Regularly rub over your hands until tender.
• Keep your oar handle clean  - soak and scrub with abrasive cleaner after an outing to get out the dirt and grease.  This will help with the controlled loose grip.
• Try rubbing a SMALL amount of vaseline into your hands before any long outings. Apparently this helps by lubricating  between the layers of skin....

Treating Blisters:

• Don’t deliberately burst them (or do...see next page!).  If there is time for the blister to deflate naturally before the next outing, try to let it do so.  
• Keep any areas of broken skin really clean - the most important thing.  Wash!  Apply antiseptic frequently   (Savlon Dry is very good but not so cheap)
• Let blisters and broken skin dry out - keep uncovered wherever possible, even if that means reapplying tape etc. before the next outing.
• Do cover damaged skin for rowing - Easy on the fingers, less easy on the palm (if you get blisters in your palm, ask yourself whether your grip is right!).  My favourite protection is:

• one small piece of Micropore tape the wrong way up to protect broken skin,
• secured by some more turns of Micropore,
• and then covered with Zinc Oxide tape - a cloth plaster which provides a strong, hard wearing and slightly flexible top layer.    

• Micropore tape and Zinc Oxide tape can be bought from the chemist.  Use of one only is entirely adequate. There are cheaper but less ideal options.
• If your hands get really bad, ask permission to row in fingerless cycling or yachting gloves for a couple of outings while your skin heals.
• It is worth taking some appropriate tape to rowing if doing a lot of training, and certainly bringing supplies to training camp.

How to Treat Rowing Blisters

A blister occurs when the outer layer of skin (epidermis) separates from the next layer (dermis). A small pocket of fluid develops to cushion the skin from further damage until it heals. Usually, blisters take 3-7 days to heal naturally- the liquid is reabsorbed into the body, new skin grows and the skin on top dries and sheds off. Rowers often find draining blisters is the best way to manage them without having to take time off training.  

• Start by washing your hands thoroughly with soap and warm water.
• Soak a pin in alcohol/antiseptic to fully disinfect it.
• Pierce the lower edge of the blister, close to where it joins normal skin and softly squeeze the liquid out onto a clean tissue. Leave the covering of skin behind as a natural bandage.
• Apply antiseptic cream such as SAVLON ANTISEPTIC SKIN HEALING CREAM to the blister.
• Leave open to the air to breathe when not training (especially overnight), otherwise the skin will go soggy and not heal.
• If training, cover the blister with a fabric plaster as a protective base layer over the wound (try ones especially made for fingers- ELASTOPLAST FINGER STRIPS) and then wrap around zinc oxide tape/ Micropore surgical tape or even electrical tape to prevent the plaster rolling off with friction. Take extra tape with you in the boat so that you can quickly reapply layers when you have a drink break.
• Specialist blister plasters are not usually effective for blisters on your hands and fabric plasters are more likely to stay on than waterproof plasters. Spray on plasters or ‘second skin’ products are also not very effective and it is much better to strengthen your own skin rather than covering it with products.
• After a few days, if you find that the skin over the blister is torn it may be best to trim the excess skin away using a pair of sterilised scissors or nail clippers- DO NOT bite or pull the skin off, this might damage the healthy skin around the blister. Leave the blister open to the air to dry as much as possible and keep the area clean using antiseptic cream.
• Everyone is different, therefore it is important to try products and come up with your own blister treatment regime which works best for you.

Watch Out for Signs of Infection

Pus (milky white/yellowish or greenish liquid), warm and red skin around the infected area and the formation of thin red streaks which lead away from the blister. If you think your blister is infected go to a doctor before the symptoms get worse.  

Avoid Infection

Wash your hands-especially after training in the gym or on the river, use alcohol hand gel (if the blister is not open), change bandages frequently and don’t put your hands in river water. You should try to let small, painless blisters heal by themselves if they are not affected by rowing because the skin covering is the best protection against infection.

Other Tips

• Stay hydrated, especially when exposed to the sun for long periods of time. This will help to keep the tissue of the hands plump.
• Make sure you are eating a healthy diet including plenty of Vitamins A and C to help to prevent infections, boost circulation and improve healing.