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It appears he has a broken ribcage and pain is severe because of the interdependence between the nervous system and the skeletal system.
The blood vessels (part of the circulatory system) in the side of the torso where blood is sent are constricting because of exercise. They are sensing that the body is being overly worked.
The bones (part of the skeletal system) are broken. The nervous system sends sensation through the nerves down to the area of problems in which case pain is inflicted.
The bones news to be put in place in order for the bones to heal and have an intact skeletal system.
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