Packing stretch injury

[akwaman]

Despite being warned to be careful about doing packing stretch exercises and feeling that I was being careful, after doing thses exercises after a few months' hiatus, I ended up with bloody sore left side of the chest.
Thinking nothing of it, I continued to freedive the next four days despite the discomfort (my chest actually felt better in the water during dives). It got really painful on the 6th day after I first noticed it, on a day I didn't freedive.

The pain covers from under my collarbone where it attaches to the breastbone to the shoulder, the front part of the chest. At its worst, the pain radiated down to my elbow and wrist, making me fear I herniated a disk around the thoracic vertbrae (but that pain has subsided and that fear is gone). I still get the pain when my shoulder is rolled forward, when i slouch, or when I stand up straight. My neck and left-side trapezius feels really stiff 12 days later, the pain feels like it's in my shoulder joint.

Anyone else experience something like this? How long before 100% recovery or how long until you starting freediving again?

I plan on going back into the water in 3 days, the deepest we train is 35m - piece of cake for me (I do 30m FRC dives). Anyways, I think I'll take it extra careful on the packing exercises from now on...

 

[rddk]

Sorry but did you went to the doctor? That's the first thing to do for check that everything is ok.

 

[Rik]

Packing can cause serious injuries. Although it still could be a muscular injury, it might also be lung related. I see you are giving your residence as Amsterdam. If you are living in the Netherlands, please send me an PM.

 

[Will]

A competitor at our event last week collapsed one lung and had to be airlifted to hospital: this was from dry packing exercises.
These manoeuvres are very powerful, and need to be approached extremely carefully and slowly, preferably with supervision from someone who has a lot of experience with yoga and/or lung stretching for freediving, and only after a thorough medical examination of lung function.

 

[Simos]

A competitor at our event last week collapsed one lung and had to be airlifted to hospital: this was from dry packing exercises.
These manoeuvres are very powerful, and need to be approached extremely carefully and slowly, preferably with supervision from someone who has a lot of experience with yoga and/or lung stretching for freediving, and only after a thorough medical examination of lung function.

Blimey I knew packing exercises are to be approached with a lot of caution but didn't realise it can lead to lung collapse! Was he just stretching the lungs by packing or doing further body stretching after having packed?

 

[Will]

He was combining it with physical stretching in a rather imprudent fashion.
I've heard that someone actually died from packing in a swimming pool, though the incident was kept very quiet for reasons I'm not aware of.

 

[Simos]

Unfortunately from the very little I read about these injuries there is a decent chance of them reoccurring once they've happened so I guess you need to be extra careful for a while if you have had something like this happen to you. I am guessing further packing after such an injury is a no-no for a while, anyone know for sure?

 

[Rik]

To my knowledge, someone died in the swimmingpool, some 30 years ago. I am not familiar with an recent fatal incident, but like to know more if possible.

Other incidents included air in the bloodstream, air in the tissue between the lungs, spitting blood after packing with (possible) long term health effects. Lungpacking might also play an underestimated role in some of the DCS incidents in deep dives.

As noted earlier in the tread, the combination between lungpacking, especially with volumes higher then normal, with, pressure increasing movements (yoga postures, and no fins disciplines), might play an important role in some of the worst accidents.

This is somewhat discussed during the 4**** freediver AIDA course, but since so many are doing it without having the proper knowledge or awareness of the risks involved, we need to spread more knowledge out in the open.

Meanwhile, I think it is also fitting to ask freedivers to be vigilant for fellow freedivers who are abusing lung packing, because lung packing incidents do not only affect those affected, but can also have far reaching effects for the sport as a whole.

 

[mattbigblue]

I'm struggling with similar sympthoms on my shoulder quite a long time now. It's a little bit different and happened on a different occasion, however I would advice You to see really good osteopath. If You won't do anything about it, it won't dissapear and after long time it will take more time to recovery, cause You will need all add-up side effects got treated as well. Of course proccess would be slower..

My osteopath told me, if I would get to him after this accident, it would be 10mins and it would be gone..Now it takes long time to heal :/

 

[efattah]

Packing can stretch your spinal cord quite violently so it is not impossible that you could suffer some type of back injury or even shoulder injury as a result of it.

I think it is important to understand that lung volume doesn't make that big of a difference when diving. In my case the difference in diving with 11L versus 4.5L results in a 40% increase in depth or 30% increase in dive time (and/or static time), which is not much considering the VC lung volume is increased 2.44 times.

 

[hogphish]

Chest or back pain subsequent to packing should be considered a pneumothorax until proven otherwise. An inspiratory and expiratory chest x ray may be diagnostic but if the pneumo is small (less than 5 or 10%) it may not be evident. The diagnostic image of choice is a chest CT. Packing also may cause a pneumomediastinum or air in and around the esophagus and heart. All of these injuries can cause refered pain to the shoulder and or arm.

 

[akwaman]

Dear Folks!

Thank you for your input in this thread. When my complaints first appeared as described in the kick-off to this thread, they were an irritation, a curiosity and then somewhat of a concern as your replies came in.

Some of you guys suggested the possibility of lung overpressure. Wow, that was heavy!

I contacted Divers Alert Network to see if they would fund the recommended CT scan. I’d have to front the cash and they would see if it was a “Diving-related accident”, meaning that if it wasn’t a lung barotrauma, I’d be stuck with the 700 euro bill. I’m stuck in Thailand, with a tight budget and limited employment, the treatment of lung barotraumas is just to take it easy, so I figured I didn’t need to get the scan. I contacted DAN and told them as much. They replied saying if I didn’t get the scan, I’d be declared UNFIT to dive and any subsequent injuries would not be covered as the insurance (which I had just paid for the next year) would nullified. Hmm…

The lightbulb went on when I realized I had regular health insurance and contacted them in the Netherlands. They would cover the scan.

The CT scan revealed NO LUNG BAROTRAMA
but
“Degenerative change of cervical spine at C%, C6, C7 with osteophytes” (doctor explained this could be just due to normal ageing – I’m 49 years old)
“Mild neural foramina narrowing of C6/7 of both sides is observed” (doctor explained this could be where the nerve root is being compressed)

The doctor’s recommendation is there is no serious neurologic abnormality so it would just take another month for symptoms (intermittently sore left side collarbone, chest, shoulder, referring pain down to elbow and wrist) to disappear. If not, time to get an MRI scan to see if there is a lesion on the nerve root.

Pinched nerve, just as I had originally suspected. Stretching while packing can seriously misalign your spine and one of the discs or vertebrae could’ve “dinged” the nerve root. Or was it not the packing stretching, but the FRC dives where my lungs were so compressed, one slight (unconscious) twist of the head might have done something to the nerve root between (the degenerated i.e. “ageing”) C6/7? Anybody have opinions on this?

Anyway, I am continuing to do posture exercises, swimming front crawl and am very mindful of when the soreness pulses and correct the posture. It does help. Symptoms are SLOWLY alleviating.
Freediving? Yes! But no FRC’s to where the pressure on the sternum and larynx is strongly felt. So taking it easy in that respect.
Packing? Funny enough lotus position sitting with full lungs and a few packs for slight lung pressure relieves the pressure on my neck and therefore ensuing symptoms. BUT NO PACKING STRETCHING.

So I am unclear of whether it was an injury resulting from pack-stretching or from FRC diving.

One thing I am sure of is that the Diver’s Alert Network is useless for freedivers if there is no lung barotrauma or DCS. Other injuries (such as freediving) fall under their peripheral coverage and if the injury occurs outside your country of residence after a certain time, depending on your plan, say 60 days in my case, they will not be covered.

Happy and mindful diving.
Pete