Check out this guy's shoulders. He's got massive swelling, possibly caused by the wholesale destruction of his shoulder muscles (if not his lungs). He is one of a population that follows the Summertime matsuri circuit, carrying the mikoshi (portable shrine) bouncing along on bare shoulders. There were a number of men and woman with similar lumps on the shoulders at this one site. Perhaps it was the 80-100 stairs that made this one particularly gruelling.