Diaphragm Spasm
I have a question looking for additional experience. This past Sunday, I raced Raleigh 70.3. The swim and bike were going mostly according to plan and then I hit T2. I racked the bike and started the run. Immediately, I had pain where the normal side stitch would be (upper right) but the pain was way beyond that. It hurt to breath. After about 3/4 mile in I stopped and tried to raise my hands over my head and it did nothing. The pain was still there and still hurt to breath. The pain did reduce but touching the area or even a slight jog immediately shot the pain back up. There were times I felt nausea but I didn't vacate my stomach. At mile 5 I thought I really was going to lose it all but just heaved a bit and I went on. Every aide station I took in fluids and liquid calories (coke and perform) and water. The pain never left. At mile 9, 10 and 11 I managed to jog between aid stations. Mile 12 I got hit all over again by the pain. I am here 3 days post race. I still feel the area. The pain is not as bad but I do feel it on a complete exhale and at times just laying there I feel it. It doesn't hurt bad it just reminds me that there is a trouble area.
I swam today, race +3 for maybe 1.5k. I felt it with the right arm pull slightly. I jogged 10 minutes at a slow pace. I barely felt it at all except a couple of moments where the area let me know but nothing prolonged or really sharp. But post race +3 was much better than +2 etc..
I have done so much internet reading on the symptoms. I just have no idea. I did go to the dr and no big issues. I've had side stitches and ran through them. This was way beyond that. The run is my strength in tri's and I have not experience anything like this.
I am leaning toward those diaphragm ligaments being inflamed or irritated in some way. Race nutrition was just like my half in Charleston 6 weeks prior and my weekly long bike /brick on sat. I am not sure what caused this or reasoning. I am looking toward several factors including pre race meal (night before) as my day of meal was used many times. But I am only guessing. Anyone with any experience with this?
Comments
Any recent "new" work on that area? Excessive raking / yard work?
Proud of you for finishing, but let's figure this out...hopefully Kar-Ming can help too!
I went through several hospital visits and MR and CT scans, videocamera in stomach etc, etc... Eventually we discovered that it was not a stomach or a colon problem as first though, it was a muscle problem.
Long story short, my Psoas was wrecked.
After discovering that, I found a good Chiropractor and a Sports Massage therapist. It took a number of very painful treatments, but within a month, I went from only being able to run 7-8 minutes to running normally.
It is upper. Splitting the stomach in the quadrants it was upper right. It was below and above the rib cage. Now, as I push on the area it is a dull pain. If I stretch my right arm straight up I feel the tenderness. When I exhale completely I feel it now to a much lesser extent. It feels like it is under the abdominal muscles. Did that answer it?
Morning of: But, I think it could be more than just that however. Two bagels and a naked juice smoothie (1/2 with beet juice) at 4 am. 5:30 to 6:30 bottle of two scoops of EFS. 10 minutes before swim start power bar gel.
Here's why I think two days out could be included: Driving to Raleigh I stopped at a Subway at 11:30. I ordered a footlong club on white bread. I ate half immediately and half about 2 hours later. About an hour after the first half was gone I felt hungry and knew I had cleared that sub. I noted it that I was happy I was moving it so quickly. Two hours later I ate the rest of it. Again cleared it. I drove the bike course to check elevation and then checked into hotel. I went to a local Italian place and ate lasagna. I had a salad and some bread. The lasagna was not of a big portion but as I look back I was unhappy with the amount of oil. Afterward, I felt heavy in my stomach.
Next morning as usual I ate a bagel with a couple of chunks of pineapple with two cups of coffee. I did a slight jog very easy pace. The day before was no exercise. Total run was 30 minutes at a slow pace with a few pick ups. I got my bike and drove to check in. Drove by a subway and happy with what I cleared before I ordered another foot long sub (club) on white. Ate half driving to bike check in and half coming back. I don't feel I cleared it quickly like before. I waited for a little bit to let it clear before dinner. At 7 pm I went to same italian place and ordered some penne pasta. It came with some sausage and spinach. I didn't each all of the sausage or spinach. This was only in a tomato sauce but again it seemed oily. That night I really felt heavy. The next morning I ate because I knew I needed to. I still felt the night before meal. I think this scenario set me up to not absorb like I should. My take away is to try and make my own meal or if driving bring my own. But I think that is only a part of the story. I went out on bike course. First third was 242 watts, second third 232 and last third was 222. The 222 is .75 IF. I was taking in my nutrition just like I had on every Saturday and Charleston half. But I slightly threw up. Like a burp with material. I just felt I was topped off and I allowed myself more time to make sure I was absorbing. I finished my one bottle of EFS and took a water bottle at mile 16. I sipped on the water to see if that would help but still took in sips of the gel flask with water for more calories etc.. At the end of the bike, I had a bottle of EFS 2 scoops, 1 bottle of 2 scoops of Ultragen and 1 EFS gel flask. 920 total calories. Gel flask had about 1/4 left. I took in one bottle of water at mile 16. I tried to take another at mile 45 but they had removed the caps and therefore I took a sip and tossed it.
Just some side notes: I swam yesterday and felt it with the right arm catch. I jogged slowly for 10 minutes and slightly felt it a few times. I feel it on a cough but not a sneeze.
No new work on the area. I do core work but stopped 10 days out. The conditions of my breakfast were comfortable. I would eat part of the bagel and then get my bottles ready. Eat some more, drink some coffee and just do other tasks to be ready. I made sure I had all my equipment in my three bags, (Run, bike and morning clothes bags). Pretty mundane. I was done eating by 4:30 and done with smoothie concoction before 4:45-5.
Here's my take on what I think based on all the information.
The Lasagna from two days out, provided the first slow moving items to hit my belly and it really hampered me absorbing. The next day it was the penne pasta that blocked it even further compiled with all the days food. This allowed a bigger than normal build up. I think the bagels would have been okay come race morning but the smoothie piled on just really brought it to a crawl. This was noticed when the energy level was not the best on the back half of the bike and of the few up chucks while on the bike. I think this also led to more weight in the belly (area) possibly liver etc...this combined put on extra weight/stress on the ligaments with the diaphragm and liver. That is why it is still tender to normal poking and proding but getting much better. I also notice the still tender area after I have eaten one of the bigger meals (Breakfast, lunch and dinner). The weight seems to bring the tender area to remind me its tender. I wouldn't call it pain, just a reminder. I also felt it on the right arm catch of the swim and just a few times on a slow 10 minute jog. I think added expectations (stress) caused the abdominal area to have more pressure applied, therefore aggravating the situation. I know have to figure out to get this thing to either completely relax if its ligament or diaphragm to relax if it is over stressed. I think the absorption will take care of itself. The area is tender and needs to heal. Kind of like a muscle cramp.
Check out this stretch:
http://chiropractorkeller.com/wp-content/uploads/2010/07/Iliopsoas-Stretch-1.gif
If you lunch and lean your shoulders back as you tip the pelvis forward, you should feel it. If you then put your arms over your head you should really feel it.
IF so, you want someone (PT, ART) to work on your psoas...which is the equivalent of someone trying to take your wallet out of your back pocket by reaching through your abdomen. Joy.
Even if you doubt me ( i defer to your own knowledge of your own abdomen! ) it's worth getting someone to check it out....at the very least you can rule it out!
I sent a message on that.
Enormous with some nice graphic detail!
Find a good sports chiropractor and prepare yourself for some painful treatments.
When I has it, it cleared within a few months and is now completely gone.