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Intersection syndrome: an acute surgical disease in elite rowers
  1. Gregory Hoy1,
  2. Larissa Trease2,
  3. Wendy Braybon (Deceased)3
  1. 1Melbourne Orthopaedic Group, Melbourne, Victoria, Australia
  2. 2Emergency Department, Calvary Hospital Canberra, Canberra, Australian Capital Territory, Australia
  3. 3Victorian Institute of Sport, Melbourne, Victoria, Australia
  1. Correspondence to Dr Gregory Hoy; gahoy{at}


Objective Intersection syndrome is a relatively common condition in elite rowers and continuing conjecture over its pathology and best management often includes prolonged withdrawal from training and changes to the technique that may affect rowing outcomes.

Methods We reviewed a case series in a national rowing squad and the effect on time loss produced by the condition. We reviewed the pathophysiology. We revisited the aggressive operative management put forward in the 1960s and applied it to modern rowing workload by reviewing a retrospective case series of six international rowers who had early surgical intervention.

Results Approximately 5% of the squad suffered intersection syndrome during a 3-year period. The effect on training time was between 20% and 40% of their training time in the period. Using our understanding of the pathology as a true tendinitis of the second wrist compartment caused by fascial compression from hypertrophied first compartment muscles, we advocated earlier surgery and almost immediate return to training, which occurred at a median of 7 days postsurgery. We had successful return in five of six rowers in an accelerated programme to minimise muscle wasting and technique modification caused by the condition, achieving career goals in a matter of weeks after surgical intervention.

Conclusions We encourage early surgical management of intersection syndrome of the wrist to allow almost immediate return to training, and therefore interfere less with technique modification and time out of the water. This minimises career disruption in the elite rowing community.

  • rowing
  • wrist
  • surgery
  • sports rehabilitation programmes

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  • Contributors GH performed the surgery and developed the concept and wrote the manuscript. WB performed the relevant rehabilitation and reviewed the early versions of the paper. She passed away prior to the final manuscript submission. LT recorded the national squad data, revised and added to the manuscript and the data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement statement All patients were aware of the evolving concept of the series and engaged in decisions regarding timing of surgery and rehabilitation prior to competitions. They were able to discuss with other team members and team officials prior to decision making and data collection.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.