My daughter had chest pain about a year back.The following is her medical history:- A Chronological Profile of Injury Current age (as on Today) ------ 11 years 8 months Date of Injury ------- 10/1/14 Activity causing Injury ------- Rope climbing, time 10 A.M. Pain started ------- 7 P.M. Evening Place of Injury ------- In & around lower sternum area Fever ------- In the intervening Night of 10-11/1/14 Vomiting -------- in morning of 11/1/14 Bowel Movements -------- Painful for a week thereafter Breathing/sneezing/ Coughing -------- Painful for a week thereafter Both exhalation & inhalation Perceptible loss of Appetite------- Till end August/September 2014 a) Pain while sitting, getting up, changing sides, straightening her legs, walking, etc. b) There was no strength in legs (perceptible loss of strength) while she tried to run. On medical examination, following was found:- 1. She was diagnosed “Tender T. & R. abdominus due to strain”, of various degrees by different doctors. 2. Since she had a very pronounced muscular contractions/vibrations (which were so strong that they could be felt in the back) at the same place where the injury manifested (in the Sternum area), she was re-examined in Late June/July by different doctors. 3. It was discovered that She had perceptible dip of 1 cm or more, just below the sternum, in her chest. Diastasis recti suspected but negatived by Ultrasound. 4. There were some adhesions, on the right side of the Central tendon of the diaphragm. 5. She had a pronounced anterior pelvic tilt. 6. It took about 2 months to release/dissolve the said diaphragmatic adhesions, after which she felt better. After this treatment, she never had pain in sternum area or vibration sensations in her upper back. 7. Both ultrasounds and MRI was negative for any injury or anatomical aberrations in either diaphragm or in the injured muscles. The problem was diagnosed as functional which MRI/ultrasounds can’t capture. Phase 2 The Aftermath of Diaphragm Adhesions (treatment) · She was put on TVA activation, diaphragmatic breathing & Mcgill quadrupeds, pelvic clock and other exercises. · She resumed playing tennis gradually. Had bouts of pain, not at the original injury spot but about two inches down towards her navel. It appears that site of her pain had shifted south (new Area). · She felt discomfort and pain whenever her tennis sessions intensity was increased. Recent Examination & conclusion by therapist a) That original dip had disappeared and diaphragm was smooth. b) Some anterior pelvic tilt persisted. c) Problems in Serratus anterior,Right Quadratus Lumborum,Anterior Oblique System. Calf muscles & inner thigh (adductors) were tight. Current Problems She has recurring bouts of pain in the new area. I suspect she was not correctly diagnosed as remnants of pain remains. I suspect that problem area is Xiphoid process and muscular junction which has never been thoroughly investigated. At present she is fully functional. She has no pain in linear sprints. She came first in class 6 to 8 100 m sprints without any pain. The intriguing thing is that She feels mild discomfort of level 2, on a scale of 1-10, whenever she is extremely hungry, in the very same area, i.e. 2 inches below the sternum. This vanishes the moment she eats something.