Apr 30, 2011

Listening to your Body Part One - Medical Challenges resulting from Tampa Bay Swim

Listening to your body - Tampa Bay Injury

Medical follow up yesterday after last weeks Tampa Bay muscle pull(s) of the under arm area appear to have identified the inter-costal's (no not inter-coastal's). My coach Marcia Cleveland, the Doc's and Paul Sullivan helped finding this out and below is a nice layman version of what it looks like and treatment. 

Good news is that my stabbing pain has subsided, muscle tenderness and soreness specifically in this area still persists. I got in for the first time this morning and swam a very easy 1500 yards and felt pretty good however the shoulder and arm recovery are noticeably tight and tender. 

At this point I am doing 3 days a week of PT, oral steroids and celebrex to reduce inflammation. I plan to continue to easily swim this next week to see how it progresses but focus on alternative exercises to keep fitness in the forefront.

Here is a nice article my coach Marcia found for me that illustrates the injury. Here is also a link

The thoracic spine consists of twelve vertebrae which each connect to a pair or ribs. The upper seven ribs are connected directly to the chest bone/sternum and are termed true ribs whereas the lower five ribs do not attach directly to the sternum and are defined false ribs.

Thoracic spine, ribs and Intercostal muscles

The intercostal muscles consists of several groups of muscles ((internal and external intercostals and subcostal and transverse thoracic muscles) which are located between the ribs and function to move and stabilise the chest wall.
These muscles can become strained often as a result of rapid twisting of the torso and are common in sports such as basket ball and tennis.
Muscle strains have three gradings:
  • Grade I Strain: This is a mild strain and only some muscle fibers have been damaged. Healing occurs within two to three weeks.
  • Grade II Strain: This is a moderate strain with more extensive damage to muscle fibers, but the muscle is not completely ruptured. Healing occurs within three to six weeks.
  • Grade III Strain: This is a severe injury with a complete rupture of a muscle. This typically requires a surgical repair of the muscle; the healing period can be up to three months.
Symptoms commonly reported are either a sharp, stabbing pains when breathing to a ever-present, painful ache or soreness located around the ribcage.  The pain is aggravated by deep breathing, side bending and twisting.
The degree of disability along with the rate of recovery will depend on the grade of the muscle strain. Given above is a general guideline as to the rate of recovery from a muscle strain per se however, the healing time may be longer due to our constant need to breathe and therefore low grade irritation to the healing site

There is a degree of cross over between the symptoms of a rib fracture and an intercostal strain and so before treatment commences it is pertinent to have a thorough
orthopaedic and neurological assessment.

Once an intercostal muscle strain has been diagnosed, the intial stages of care will be focused on reducing the inflammation and bleeding at the injury site through rest and icing.

Looks Like a level 1 or 2 so this is good news. Just another life challenge in the Journey to cross the English channel.


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