Cause/Remedy of Recurring Freestyle Intercostal/Rib Injury?

[JamesS]

Hi All,

I'm looking for any experience/advice/thoughts on what is rapidly becoming an extremely frustrating and limiting problem for me!!! Basically, having never injured my ribs/intercostals before, since taking up swimming it appears that unless I change something I'm going to keep injuring them whilst swimming freestyle. There appears to be very little information generally available and almost nothing specifically relevant to swimming about this type of injury (I only recall finding one blog/article about a competitive teenage US female swimmer who suffered it but recovered and seemed to be fine as it didn't mention any problem of repeat injury).

I'm guessing I have a muscle weakness/imbalance somewhere (Lats?) that is making me susceptible, as I'm not using paddles or anything to increase required force. Until I actually get injured, it doesn't *feel* like I'm risking injury through overload doing avg. 3/4 sessions, 4km to 7km total per week. I guess most people reading this do far more! I undoubtedly do try and maximise distance per stroke via stretch and apply reasonable force to the water, accelerating my arm/hand once I think I've got a good catch, but would be surprised to hear the cause is applying too much force as most of my training is pretty slow and I don't think my spl is particularly special (main sets @ ~2m:00s/100m; SPL normally 18 to 22 for 20m pool).

Can anyone help? Any ideas what I'm doing wrong? And how to minimise chances of recurrence? (I've included more detail/background below in case it helps).

Many, many thanks in advance to anyone that can help!

Further background/detail:

• Experienced runner (38yrs Male, 178cm, ~70kg) decided to take up triathlon this year at least partly to force me to learn to swim freestyle properly
• Prior swimming experience = general uk school tuition i.e. "survivial swimming"
• Read/watched TI & Swimsmooth books/DVDs, as well as many Internet articles, blogs and videos
• Started frontcrawl training approx. Oct/Nov 2013 averaging 3 or 4 sessions and ~4km to ~6km per week until January 8th
• Pain in left rib built until 8th Jan when I had to cut a session short because it felt like I was going to do more serious damage
• Tried to keep running/cycling through, caught family lurgy and during one sneeze felt likely proper tear of intercostals, then so painful (worst pain I've ever experienced!)I booked in to see doc who said take a week of total rest and see how you feel... which I did and felt good enough to start run/cycle training again
• Improved significantly to cautiously get back in the pool 26th Feb (7 weeks after last swim session) and do 3/4 sessions ~3km per week for 2 weeks
• Feeling good (no pain) so ramped up to 3 to 6 sessions ~ 6km per week;
• 9th April did first continuous 1600m in pool;
• w/c 14th April started doing main set training @2:00 pace 100m and 200m intervals (using tempo trainer) - finally started feeling like I was doing some training that might help me go faster and yes you guessed it...
• 19th April significant discomfort (not agony - no tear felt) back in same left rib area - stopped swimming and not got back into pool since
• Trying to continue cycle/run training but experiencing discomfort right now.

James.

[jenson1a]

I can sympathize with your pain. Have you seen a doctor?

Not too long ago, I developed a really bad cold and had severe pain in the left side of my chest. Fearing the worst, I saw a doctor and he diagnosed the pain as costachondritis.(sp?) He said that it could take anywhere from 2 weeks to a year to heal. I did very little free style for several weeks and concentrated more on balance exercises. It took about 2 or 3 months before the pain subsided. So far, I have had no recurrences.

Wishing you the best of luck and hope you find a remedy

Sherry

[JamesS]

Hi Sherry,

Many thanks for the quick reply. Yes I did originally see my doctor, and although he didn't offer me any scans my symptoms first and second time around make me pretty certain it is indeed a case of Costochondritis.

However, re-reading your post and double checking my research I notice in addition to the listed likely causes (overuse, rib injury and severe coughing) there may be an additional aggravating factor of upper respiratory tract infections. It does now occur to me that I suffer quite badly from what I call "swimming pool colds" i.e. after a swimming pool session my nose is streaming for the next day or so. I've just treated them as an inconvenience to date. Perhaps I need to buy a nose clip or learn to exhale through my nose when I can get back in the pool!?!?

Thank you very much again for this potential insight!

James.

[CoachDavidShen]

I would also get it checked out by a good PT/chiro. There could be many reasons for your problem. I would get your ribs checked as well. One of them could be popped out of place in the back spine. It is also possible that this was a problem that's been around for a while. Under developed swim technique can aggravate. But diagnosing on this forum is very hard. I would go see a good PT/chiro first. Get pain free and then we can look at preventing the problem for the future.

[Raini]

Hello James.
Your streaming nose could possibly be a chlorine sensitivity. It's a common problem and a nose clip is the easiest solution if you don't want to use antihistamines, nasal sprays or nasal washes. Personally I'm not happy to rely on tablets and sprays as I swim 5/6 days a week and the nasal wash didn't work so I bought a nose clip. Problem solved.

[CoachSuzanne]

Originally Posted by JamesS

Hi All,
I undoubtedly do try and maximise distance per stroke via stretch

James.

When you do this what are you stretching? are you letting the shoulder blade float forward to get the reach or are you curving the spine causing hte ribs to separate more than then need to (and probably causing more drag as a result).

If you are overreaching every stroke, you are also slowing down ever stroke which means needing to apply more force to speed back up, in addition to placing your rib cage, spine & shoulder in a less than optimal position for levrage which can lead to injury.

Have you had your stroke videoed?

[CharlesCouturier]

Originally Posted by JamesS

Hi All,

I'm looking for any experience/advice/thoughts on what is rapidly becoming an extremely frustrating and limiting problem for me!!! Basically, having never injured my ribs/intercostals before, since taking up swimming it appears that unless I change something I'm going to keep injuring them whilst swimming freestyle. There appears to be very little information generally available and almost nothing specifically relevant to swimming about this type of injury (I only recall finding one blog/article about a competitive teenage US female swimmer who suffered it but recovered and seemed to be fine as it didn't mention any problem of repeat injury).

What exactly is leading you to think that you may have ribs/intercostals related injuries whilst swimming? What was your diagnostic process?

[JamesS]

Originally Posted by CoachDavidShen

I would also get it checked out by a good PT/chiro. There could be many reasons for your problem. I would get your ribs checked as well. One of them could be popped out of place in the back spine. It is also possible that this was a problem that's been around for a while. Under developed swim technique can aggravate. But diagnosing on this forum is very hard. I would go see a good PT/chiro first. Get pain free and then we can look at preventing the problem for the future.

OK sounds like great advice thanks. I do have to say I would be surprised to find I have had a rib out of place as I haven't experienced any recurrent chest/back pain previously and the pain did totally go away in between injury #1 and #2. However, at this stage of the season I can't afford not to get it checked!

[JamesS]

Originally Posted by Raini

Hello James.
Your streaming nose could possibly be a chlorine sensitivity. It's a common problem and a nose clip is the easiest solution if you don't want to use antihistamines, nasal sprays or nasal washes. Personally I'm not happy to rely on tablets and sprays as I swim 5/6 days a week and the nasal wash didn't work so I bought a nose clip. Problem solved.

Thanks Raini. I think I'm going to try saline spray and buy a nose clip as back up.

[JamesS]

Originally Posted by CoachSuzanne

When you do this what are you stretching? are you letting the shoulder blade float forward to get the reach or are you curving the spine causing hte ribs to separate more than then need to (and probably causing more drag as a result).

If you are overreaching every stroke, you are also slowing down ever stroke which means needing to apply more force to speed back up, in addition to placing your rib cage, spine & shoulder in a less than optimal position for levrage which can lead to injury.

Have you had your stroke videoed?

Hmmm, well I believe I'm doing the shoulder shift with body rotation to make the stretch and aiming to have my body/spine in a straight line front to back. Keeping legs up etc. I'm also consciously trying to avoid inserting a dead-spot at the front of the stroke to avoid the excessive re-acceleration forces.

Unfortunately, I have not got my stroke videoed yet. In fact it was next on my list before getting injured again.

Given the likely chasm between my own perceptions of what I'm doing and the reality I suspect your suspicions remain valid however. I do feel as though I'm having to apply a lot of force to still go relatively slowly - I have been assuming that is because my pulling muscles are relatively weak because I don't yet have "swimmers muscles" from multiple seasons of training. But perhaps the reality is my stroke/drag is much worse than I'm expecting. Time to get it videoed as soon as I can get back in the pool! Many thanks for your input Suzanne.