Mountain biking causing chest pain

I love what I do, but I don’t mind admitting I am a little envious if other people’s jobs, or more specifically, lifestyle choices sometimes 🤩

A returning client, and long term friend, works through the winter, saving the pennies, and then goes off cycling with their partner for 4-6 months through Europe. Awesome!
Now I’m a fan of the road, they prefer the very steep off road stuff, but I can appreciate what an amazing lifestyle this offers. Thankfully, I’ve also done enough off roading to understand the extreme stresses this can place on the body.

I had a call a few weeks back to say they were calling their trip to a close early as they’d been having some chest pain and difficulty breathing, and they’d like my opinion.
After insisting they go to the hospital to rule out anything sinister 😱 which they did and all was fine, we met up in clinic to have a look at what might be happening.

What was going on? After a long ride up a mountain (most people use the chair lift) they were on a 45-50 minute decent. About 10 minutes in they noticed a tightening in the their lower ribs, extending down into the lumbar / abdominal region, as well as up into the shoulder area.
For those of you that haven’t done this kind of riding, the safest way to get down, is not to stop or slow down, keeping it fast ‘glides’ you over the rough stuff and keeps you on track. And so they persisted until the bottom. They did some stretching, and things eased a little, but that evening and for the following three days their diaphragm went into spastic contraction. They couldn’t breath properly no matter what position they were in, and the pain was still radiating up to the shoulder, they even contemplated calling the ambulance a few times. You can see why I wanted them to get checked out at the hospital 👨🏻‍🎓

Upon testing we found one side of the diaphragm over active and the other under active. We also found large sections of iliocostalis, the QL, the internal and external obliques dysfunctional. These are all muscles of the intrinsic and extrinsic core (we also tested the other muscles including PF to ensure these were functional). After a little release and activation work, things were looking and feeling a lot better, but that still left the shoulder pain unresolved.

After establishing the scapular stabilisers, rotators and neck flexors were in a local relationship, and the glenohumeral joint was decompressed, we were able to address this fully as well.

HW was assigned and off they went with a much lighter step in their feet.
I saw them again this weekend, and they’d been out riding with no ill effects, nothing like the terrain experienced abroad, but a good start.
We did a little clean up work, and worked on breathing drills and pendulums to integrate into their warm up. We also looked at modifying their breathing technique on the bike so as not to loose intra abdominal pressure and keep their diaphragm moving effectively. This should help them a great deal, and provides opportunities for self care without becoming reliant on their practitioner 🧠💪🏻👍🏻

A winter seasons racing awaits 🚵‍♀️

If you’ve got any questions or comments please give me a shout 😊

Image credit Pexels free

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