A Sickening Crunch
After He Said Cancer | A Memoir
It started with an errant golf shot in a sand trap. The sand was much harder than it should have been. Instead of hitting through the sand, my husband’s club slammed into the sand and got stuck, pushing his elbow into his ribs. Right away, he felt a lot of pain. He tried to play another hole, but the pain wasn’t letting up and left the course.
In the evening, he tried to deconstruct why it happened.
The quality of the sand in the sand trap must have been off, he said with annoyance. I had no understanding of what this meant. A golfer could get a wrist or elbow injury if the sand didn’t give way with the shot, he explained. Maybe a throng of golfers had compacted the sand in the hours before his shot? If the sand had been softer, everything would have been fine, he said without making eye contact and pacing back and forth in the kitchen.
He was especially frustrated as he was finally getting back to playing golf after more than a year off due to his cancer treatments. After his cancer surgery, he couldn’t move his arms freely until he had healed for several months. This timing overlapped with the start of his chemotherapy, and then he didn’t feel well enough to play. Finally, when he was recovering from the chemotherapy, the radiation treatments began. The radiation oncologist advised him to specifically NOT play golf during the 6-week treatment course, as he might injure the radiation-weakened muscles or ligaments.
So, he had taken an almost one year break from golf and was just getting back into it, when this happened.
After the third day that he complained about the pain, I began to wonder if I could figure out what was going on and fix it. I wasn’t a sports medicine doctor or an orthopedist, but I thought I could figure it out – and at least help the healing process. A quick internet search led me to common rib injuries that can happen during golf.
‘Intercostal’ muscle strain was the diagnosis that kept coming up. This made a lot of sense and matched the location of his pain. He must have strained his ribcage muscles from overuse on the golf course, and then the muscles spasmed after the club jarringly struck the sand. Perhaps the radiation made him more prone to muscle spasm.
“I think you might have a muscle spasm that I might be able to fix with massage,” I said confidently and explained what I had learned about golf injuries and rib pain.
I had always enjoyed massaging out muscle knots in the neck and upper back. It was relaxing and satisfying for me to use my hands to provide someone with pain relief. This had started in medical school and continued in residency with many of my medical student and resident colleagues gratefully benefiting from my self-taught skills. It was gratifying to feel muscle knots release, particularly in the neck.
He agreed and I suggested that we do the massage on the floor, perhaps downstairs on a white, plushy carpet. A bed would be too soft for me to assess the muscle tension along his ribs, shoulders, and upper back. These areas were connected, and a problem in one area could trigger tightness and pain in the others.
“Can’t we do this sitting up?” he protested, while kneeling onto the carpet. “I don’t want to be down on the floor for this.”
“Look, for me to have the best chance to figure out what is going on, it is easiest if you are lying down on a harder surface than the bed. This is best – don’t argue,” I said as my hands passed under his shirt and over the ribs on the right side of his chest.
Yikes! I could feel the problem straight away. His muscles were extremely tight over the entire chest wall, but especially bad over his right ribs. Tight as a bowstring. There was no question what was contributing to his pain. It was surprising he could even breathe normally.
I began by trying to massage out the troublesome spots by hand, but the whole area felt like concrete. He groaned from time to time and gritted his teeth. So strange to have so many tight muscles in this one area over the right side of his ribs. Maybe his golf shot had transferred a lot of force into one specific area and the muscles had frozen in response?
Imagining him in the sand trap, I could see the club hitting into the sand and then stopping cold. The force from impact would have transferred to his right arm, then elbow, and then ribs. I could see what happened and imagined how the muscles in his rib cage froze up in response.
“Turn on your side,” I said while gently pushing him. “I want to try something.”
“Try what?” he asked.
“The muscles are basically frozen, and it is going to be too hard to do this massage with just my hands,” I said. “I want to try a foam roller.” I got up and went around the corner to a large room where we stored workout equipment. I found the harder of our two foam rollers and brought it back to where he was still lying on his back on the white carpet.
His face betrayed a slight frown, and I could tell that he was getting impatient. I had about two more minutes to get this done before he rebelled.
“I am going to use the foam roller to try to release the entire area a bit more efficiently,” I said.
“What do you want me to do?” he asked with annoyance and trepidation in his voice.
“Nothing,” I said. “I’ve got it. Just lie there.” Foam rollers were great tools to release large muscle groups. I usually used them to roll out my back or gluts, but this would be great to help spread the force more evenly over his chest.
I positioned the foam roller on the right-side of his ribcage just below the injured muscle. Then, I carefully leaned onto the foam roller while rolling it along his ribcage.
He grunted.
What a baby, I thought. He needed to toughen up to work out some of the lactic acid that had built up in these muscles and caused the spasm. I leaned in a touch more and he moaned.
“It might be a little painful, but it will feel better –” I began, but then stopped cold.
I felt something through the foam roller. A small pop.
Something felt wrong, but I couldn’t put my finger on it. I leaned on the roller once more and felt it again. This time there was a clearer crunching noise, and my husband let out a louder moan. The sickening crunch could only mean one thing.
“Ummm…love, I just broke your rib,” I said in a low voice. Merde!
My heart practically dropped into my stomach. A feeling of nausea and panic began to come over me and I let up the pressure on the roller. Swear words directed at myself began to stream through my mind.
He began to sit up slowly, clutching his chest with a scowl and clenched jaw.
Oh, what an idiot I was! Radiation could make the bones weaker and increase the risk of fracture. Why hadn’t they warned us about this? There must be other cancer patients that play golf or sports where they might fracture a bone that was radiated. Had someone told us this – or had I read it in the big binder that they gave us – I would have been more suspicious from the beginning.
“This was the side that you had radiation,” I muttered. “I am so sorry, darling.”
“I think that I am done with massage for now,” he said.
His face was still in a grimace, as he started to get up off the floor. Then, I realized the other reason that breast cancer patients can break a rib.
Metastasis.
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If you are interested in reading more of my stories, I recommend:
1. A Beach Surprise. https://www.afterhesaidcancer.com/p/a-beach-surprise
The Day My Grief Let Go.
That Ribbon.
The Day He Proposed.
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Oh my. I can only imagine how horrible that realization had to have been for you. Your medical knowledge as well as your caregiving knowledge is so enlightening. I appreciate that you are taking the time to write these things down so others of us have more knowledge if we are faced with the same situation. My husband was a golfer, but was not able to golf after his diagnosis. I never would have thought he could injure himself simply from swinging a golf club. Thank you, Kristina!
I'm not a health professional but I am a caregiver. I understand your frustration at not having enough information to deal with an unexpected situation. And for me, there are many. You can find my experiences at Caregiving in the Empty Quarter.