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Chronic Costochondritis

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  • Chronic Costochondritis

    Hello docs, my friend has been troubled with this bad chest pain that was diagnosed as above mentioned. Its been troubling for about a year now.
    He says that it used to hurt whenever he would breathe very deeply, or run out of breath when playing basketball, even just get tight for a deadlift.
    In other words, it was very easy to trigger the pain that he described as pretty bad and uncomfortable. Because of it he quit training a year ago.
    Its worth mentioning that year later, its still there but it hurts very little.

    Now, i am very much familiar with your basic recommendations for treating pain and injury and training around it, (Been following you for years, great work) finding the proper intensity / volume / movement that would allow us to train pain free, or at least with minimal pain without noceboing ourselves with demonizing the condition.

    I tried many times to convince him to get back to training, isolation movements, hell, deadlifting an empty bar, whatever, just to get back to the gym. He is very much afraid to do that, and i suppose i am not credible enough for him to trust me blindly that, if nothing else, attempting to get back to training wont give him cancer. That properly designed programming could only be helpful.

    My question at the end is - Do you have any specific recommendations for this condition, any interesting experiences worth sharing or just good ole, whachu gonna do, not train? Thank you for your time, all help is appreciated.

  • #2
    Hi there,

    We discussed this a bit here:

    I am not a fan of this diagnostic label, to be honest. This is primarily used to describe non-specific chest wall pain, rather than a genuine "inflammatory" issue. It does not require special management outside of our usual recommendations. His fear, avoidance of activity, and interpretation of the meaning of his symptoms are likely playing a big part in his experience - these will likely represent bigger challenges to overcome than the actual training side, if / when he does decide to initiate some activity.

    Often it is useful to get our foot in the door via "expectancy violation" - basically finding a task that he expects will be painful / problematic, finding a way to engage with that activity and observe that a low dose of stimulus can be tolerated without issues. For example, maybe he can bench press a pair of very light dumbbells for a set of 5 as a starting point. But the general training management, as I mentioned, is basically the same as it is for everything else.
    IG / YT