Pain at bottom of sternum

Yoga Discussion General Yoga
#1

Hi all,

I’m a healthy, fit, 24 year old male who tried yoga for the first time about two weeks ago. I actually did the yoga routine from the “p90X” program if any of you are familiar with it.

Since then, I’ve been feeling pain just below the bottom of my sternum and maybe a centimeter to the left. I can actually feel a lump there, and when I put pressure on it, it is quite painful. I can actually see it bulging out if I look in the mirror after a deep breath and leaning back slightly. Pushing on it makes me feel slightly nautious, and I can feel it all the time as a dull, uncomfortable pain.

I’m fairly confident that the position he called “vinyasa” is what caused this problem. It’s where you lay on your stomach and, with your elbows tight to your sides, lift your torso and arch your back. I’ve never done this type of stretching before and I think that I may have pulled something in there. Maybe stretched cartilage or something? I don’t know. The last time I did the yoga was about 5 days ago and the pain hasn’t gone away. Has anyone experienced anything like this before? Any advice?

Thanks so much.

#2

Doctor.
I’m not one, but that sounds like what my aunt described when she had a hiatal hernia.

Mind you, this is anecdotal. But – is the lump still there?-- it’s probably the safest way to go.

#3

[QUOTE=Techne;19494]Doctor.
I’m not one, but that sounds like what my aunt described when she had a hiatal hernia.

Mind you, this is anecdotal. But – is the lump still there?-- it’s probably the safest way to go.[/QUOTE]

Thanks for your help.

I looked up the symptoms of a hiatal hernia and it seems like if you do show symptoms, they should include chest pain, heartburn, difficulty swallowing, coughing, belching, and hiccups. The only thing I’m feeling is the pain at the base of my sternum, which I believe is called the “xiphoid process”. Earlier I went to the mirror and sucked in my stomach as much as I could, and the “lump” I’m feeling is exactly where the xiphoid process is. Is this bone connected/surrounded by muscle/tendon/cartilage that can be strained?

#4

YogaToga, welcome to the forum, though it is unfortunate that you found your way here via an injury. A person can separate the xiphoid process from its position on the sternum in a number ways and direct impact is not always necessary due to the nature of this jointed process. The location of the pain and the visual “lump” is enough to warrant a visit to your doctor to get an definitive answer on what is happening. A broken or dislodged xiphoid can migrate and cause serious injury to your diaphragm, lungs and even to your heart. With these risks to your organs, you can see the importance of seeing a doctor so that if this is the situation, that you can have it removed while it is near its point of origin.

Please update us to your situation.

Kind regards,
Nichole

#5

[QUOTE=Nichole;19501]YogaToga, welcome to the forum, though it is unfortunate that you found your way here via an injury. A person can separate the xiphoid process from its position on the sternum in a number ways and direct impact is not always necessary due to the nature of this jointed process. The location of the pain and the visual “lump” is enough to warrant a visit to your doctor to get an definitive answer on what is happening. A broken or dislodged xiphoid can migrate and cause serious injury to your diaphragm, lungs and even to your heart. With these risks to your organs, you can see the importance of seeing a doctor so that if this is the situation, that you can have it removed while it is near its point of origin.

Please update us to your situation.

Kind regards,
Nichole[/QUOTE]

Thanks Nichole.

Just out of curiosity here - if my xiphoid process is dislodged, are you familiar with what options there are to fix it? Are you saying there is actually a surgery to remove it completely? Is it a fairly common injury that can heal on its own?

Maybe I’m just trying to comfort myself, but I did feel that lump there a long time ago. It was after learning CPR, and feeling around my own rib cage. Only then it wasn’t tender like it is now - it just felt like a bone. I’ve also asked friends to find their xiphoid processes and put pressure on them, and they also tell me it causes pain and nausea, so I am hoping that I have just irritated mine by hyper-extending some muscles in there.

I won’t be able to see a doctor until June 12th at the earliest, but I will do that.

Thanks again for your help.

#6

Hello YT,

I’m familiar with the P90X program including the “YogaX” portion of the program. I found, in my own body, that particular set of postures and sequencing to be quite aggressive. To me, it is not at all appropriate for a person who does not have a very active life AND a pre-existing asana practice of some vigor, not to mention clearance from one’s health care provider of choice.

Relative to your lump, the xiphoid process et al…please do not belabor this in your own thoughts. Rather go and have it examined. This is a fine place to turn if you want some holistic direction for healing but it is not a fabulous place for diagnosis. Advise you discontinue the YogaX program until you get an “okay” and if you are doing the rest of P90X then I suggest not doing the Ab Blaster work nor the plyometrics (until cleared to do so).

gordon

#7

[QUOTE=InnerAthlete;19504]Hello YT,

I’m familiar with the P90X program including the “YogaX” portion of the program. I found, in my own body, that particular set of postures and sequencing to be quite aggressive. To me, it is not at all appropriate for a person who does not have a very active life AND a pre-existing asana practice of some vigor, not to mention clearance from one’s health care provider of choice.

Relative to your lump, the xiphoid process et al…please do not belabor this in your own thoughts. Rather go and have it examined. This is a fine place to turn if you want some holistic direction for healing but it is not a fabulous place for diagnosis. Advise you discontinue the YogaX program until you get an “okay” and if you are doing the rest of P90X then I suggest not doing the Ab Blaster work nor the plyometrics (until cleared to do so).

gordon[/QUOTE]

Hi Gordon,

I was pretty surprised as well at the level of fitness p90X requires! I’m 5’10", 185 lbs and have been working out for about 8 years. I could barely finish the yoga portion - although flexibility was never my fort? haha. I want to increase my flexibility though before I join a mixed martial arts club (wrestling, jiu jitsu, muay thai, boxing).

I’ve booked an appointment with a doctor for June 12th, but I’m hoping the pain will be gone by then!

Thanks for all the help.

Brennan

#8

So, Nichole and IA – is this the sort of symptom that warrants a visit to Urgent Care? (in my area, there are medical facilities that specialize in non-appointment, but also non-gunshot care.)

#9

To anyone else experiencing similar symptoms, or who are interested in this:

After a lot of searching, I came across this article from the Department of Accident and Emergency, Rotherham District General Hospital, Rotherham, UK, that seems to mirror my exact situation - although our injuries were caused by different things. They call it an avulsion fracture of the xiphoid process.

[I]Introduction
Avulsion fractures are very commonly seen in limb injuries, usually resulting from a force pulling the tendons or ligaments which avulses the bone at its attachment. We report an unusual case of avulsion fracture of the xiphoid process.

Patient
A 53-year-old gentleman presented to Accident and Emergency complaining of epigastric pain and a lump over the epigastrium.

He had no previous cardiac or gastrointestinal history. He stated that pain occurred suddenly while he was using a winding gear. The winding gear jammed on the down stroke and he immediately felt a pain. He described this as a dull ache with no radiation, worse on movement, inspiration and palpation. He denied any direct trauma to the chest or shortness of breath, palpitations, nausea or heartburn.

On examination, the patient had localised severe tenderness over the xiphoid process, with no other findings in the chest or the abdomen.

An anterioposterior (AP) and lateral chest X-rays were performed, the AP was normal, but the lateral view showed a fractured xiphoid process. (Fig. 1) ECG was normal.

No specific treatment was given other than analgesia. By 9 months, he reported a gradual resolution of his symptoms over 3 months. He retains a residual bony hard lump, approximately 1–2 cm in size, at the base of the xiphisternum, which is no longer tender.

Conclusion
Extreme tension on the abdominal wall muscles can cause a force powerful enough to pull the xiphoid process causing an avulsion fracture.

A literature search has revealed no other such cases.[/I]

The symptoms he describes, and the manner in which the injury occurred lead me to believe this is exactly the same injury I’m suffering from. I will bring it up at my doctor’s appointment next Friday, and update with his opinion.

As for myself, I’ve been living my life as usual (minus the yoga) - still working out with no major issues. I don’t want to stop exercising because of this unless my doctor specifically tells me to stop. There is some mild pain when I do exercises where I puff my chest out, like pull-ups, and some pain when I do ab exercises. Generally though, I feel like the pain has subsided a little bit - maybe 80% of what it was a few days ago. I really hope it won’t take a year to heal!

Brennan

#10

I have sternum problems as well.

#11

Rick,

Perhaps you would like to share what you have experience or still is experiencing, it may shed light on this problem for the original poster and it might be educational for the rest of us who read it, don’t you think?

#12

[QUOTE=Techne;19561]So, Nichole and IA – is this the sort of symptom that warrants a visit to Urgent Care? (in my area, there are medical facilities that specialize in non-appointment, but also non-gunshot care.)[/QUOTE]

For some I suppose it is. To me it depends on the way in which one choose to lead their life. For me personally I try not to go to western medicine providers. However if for that person they are concerned or worried then it’s best to have it looked at by whomever they value. Otherwise the mental energy of worry and concern can make for some unpleasantness.