I received an email consultation question from a woman today and while it’s private, as consultation are, I want to share the basic information with you in case you know someone who is having this problem.
She is involved with competitive rowing and is on the water several hours every week. Lately she’s been having pains that feel like a knife is being pressed between her ribs when she’s breathing hard. Her doctor’s aren’t finding anything, and it’s really only a problem when she is exercising. This makes sense since heavy exercise causes you to take much deeper breaths and to do it rapidly. This is a slightly altered copy of the response I sent to her:
Rowing naturally causes a long list of repetitive strain injuries in muscles from your neck all the way down to your knees, and if you’re bracing with her feet as you rows, even your lower legs are involved. Did you look at the Home Page of www.julstro.com? There is good information about repetitive strain injuries there, plus I suggest you both read the sections titled “Muscles and Pain” and “What’s happening Exactly.” Then I suggest you go to the Muscle and Joint Pain forum and read through the threads, especially the thread that describes the Julstro Protocol. That will give you a lot of information about the muscles that cause pain from the mid-thoracic all the way to the calves.
When the psoas muscle is tight it is pulling on the lumbar vertebrae and rotating the pelvis down in the front and up in the back. This causes a low back muscle called quadratus lumborum (QL) to shorten and pull on the 12th rib every time she tries to sit down. The ribs are all attached by intercostal muscles, so if the 12th rib is being pulled down, so are all the other ribs. In order to breath in the ribs need to open which means the intercostal muscles need to lengthen, and then to breath out the intercostals need to contract to pull the ribs closer together. They are already being stretched (so they can’t lengthen more) when the QL is pulling down on the 12th rib, and the pressure of the QL pulling won’t let them contract – plus try to breath out and contract the muscles will cause a pinching type of pain, like a needle is being pushed into the ribcage.
Having said all of that, you’ll understand it much better as you read the thread slowly, visualizing all of the various steps and how your body will react to each movement of the bones. Everything is so interconnected, yet so many medical professionals look at one tiny piece and try to work it out without looking at the entire picture.
After you have done the full Julstro Protocol, then look at the book and find the picture of the guy pressing his fingers into the intercostal muscles between the ribs. The description will help you understand the movement necessary to release the intercostal muscles. It is a long self-treatment, especially in the beginning when you need to do all the steps, so once a day is enough. As you release spasms you can cut the treatment down to just doing (in this order) the quadriceps, quadratus lumborum, intercostals treatments, and then the iliopsoas stretch.
Whether you get sharp pains between your ribs while cycling, running, exercising at the gym, or doing an endurance event, the odds are good that this series of treatments will help a lot.
Wishing you well,