rib/side discomfort

[casey]

Friends,
I have not seen any kind of medical professional yet, but I thought that maybe my problem would be obvious to someone and I could get some advice right away.

I have noticed over about a week now a discomfort, not quite severe enough in my mind to call it 'pain', in my side and chest, right in the middle of the rib cage, around to the pectoral. Breathing feels uncomfortable but I can't explain exactly how. That is, if I think about it and try to take a normal breath I always can. But just during regular activity or inactivity I notice that breathing does not feel normal. I have only noticed a sharper pain directly in the middle of the left side of my rib cage when lying down with my left arm outstretched or reaching up for a pull up or something. And when I was working an upper shoulder circle with the left arm I felt a pain shoot from the side through the left pectoral all the way to where it attaches at the breast bone. Not a great pain, just enough to make me stop and say ow.

I practice with clubbells, working swipes on a density program with the 15s for the last couple of weeks, some kettlebell exercises, bent presses along with the GS disciplines, and a few calisthenics. I didn't notice any particular time where I thought I might have picked up an injury. As I said I think it has been with me for over a week but I didnt realize what it might be until a few days ago, and I was continuing my regular program up until then.

Any advice anyone has will be greatly appreciated. As I said I plan to see a doctor, but I want to know if anyone can tell me helpful things to do now as well as things to definitely avoid.

Thanks in advance,

Casey Patrick Reilly

[rbibbs]

Had an intercostal tear before Casey? First thing that comes to mind. This test isn't conclusive, but it will reveal some ICTs. With a good breath, close your mouth, hold your nose, and go through the "motion" of breathing out. Ok now breathe out, almost all the way. Block nose and mouth again, and go through the motion of breathing IN. If either of these tests produces the characteristic pain, good chance you've torn a little intercostal fascia.

ICTs are furtive. I've had several. Some I knew immediately I'd done it. Others didn't show up until after I stopped the activity. Of course, this is an "internet diagnosis", based on what you said, and what I've experienced. You're right, go ahead and go to the doctor, chest pain is not trivial. But if it's an ICT, relax, do what you can that doesn't kill you, and expect to wait about 6 weeks for it to repair itself.

Oh, to expand on that "doesn't kill you".. if you're doing an exercise that really threatens to tear it further it will let you know, hopefully in time. Don't do "extreme" stuff, maybe back down to a maintenance level with things that put loads on the rib cage.

Rick

[casey]

Mr. Bibbs,
Thank you for your response. I tried the tests (though I didn't want to push too hard) but I still couldn't tell for sure. I have mentally adopted this explanation though, because it is comforting. It sounds like it has been your experience that one can perform regular exercises without straining and not irritate this kind of injury?

Thanks again

Casey

[rbibbs]

I'm going largely by your description that it's most evident when extending the left side of your ribcage. If it's a superficial pain, right under the muscle, that you can put your finger on and feel 'something not right'... it's likely a minor intercostal tear. Anything that feels internal, gets progressively worse, or if it doesn't repair itself in 6 weeks, you want to refer to a physician.

The last time I got one was from overexerting grappling. It stopped me in my tracks, almost like someone had put a lit cigarette to my ribs. I stopped training for that night, but returned and continued training the next day, and throughout recovery. I did moderate my intensity, and favored/protected that side until it stopped bothering me.

If you genuinely strain it during recovery, that restarts the 6-week clock. That's about the worst than can happen. You don't have to stop, IMO. Just lighten up until it's solid again.

Rick

[cobb]

Casey:

Here's one other thought for you that MAY apply - particularly if the breathing tests that Rick described were inconclusive. Periodically, due to either microtrauma or, more likely, a slightly off-balanced ballistic exercise, the small muscles attaching the head of the rib to the spine can spasm. This spasm then tends to show itself in a wide distribution of pain along that rib. While this more often shows up as "back" pain, it can present anywhere along the course of the rib dependent upon the spasm location and subseqent intercostal nerve irritation.

You may want to focus on mild lower cervical and thoracic circles and infinities to mobilize the costo-vertebral joints and see if that has any effect.

There are lots of other potential problems, so take this with a grain of salt, see your Dr., and keep us advised!

Dr. C

[casey]

Thanks for offering this explanation. Is it possible that moving the region, in a thoracic circle or infinity for instance, could aggravate an injury there? My feeling is that mobility is always helpful, but is there any possibility that it might not be?

I guess that is very broad, and there is always a possibility. Maybe to narrow it down a little I could ask whether a muscle pull or spasm can ever be aggravated by movement drills.

Thanks, and I will see you in Annapolis,

Casey

[rbibbs]

I like analysis Casey, especially since you couldn't localize it to a spot. You can put your finger on a tear and clearly feel it with pressure. And 'behind the pec' is not a typical place for a tear you don't remember getting. Under the 'muscle spasm' analysis, you can forget the 6-week clock thing, and unstrained motion is the best thing for it.

Thanks very enlightening! I didn't know there were muscles joining rib to spine. And I thought I'd already had all the rib problems short of breaking one.

The synergy in this forum is awesome.

Rick