Hi docs,
It is with a heavy heart and hurty ribs that I return to the Pain and Rehab forum.
SITUATION: 32 year old male, been training for about 1.5 years (not counting time off due to illness & injury). Pain in lower right ribcage, just below the breast but above the bottom of the ribs.
In mid-March I had a pretty bad cold with a gnarly cough, with a lot of violent coughing episodes. By late March/early April, I got over the cough and cold but I had a pain in my ribs, which I assumed was a strain due to too much coughing. It’s somewhat hard to predict when it will flare up, but usually I feel it if I take a deep breath (yawning or bracing for a deadlift), raise/lower my arm (like a front raise), sit up/lie down, cough/sneeze, or get a blunt force to the rib cage. Sometimes it radiates around laterally to the rear (at the same elevation) when doing upper back work e.g. lat pulldowns.
Today while using the ab crunch machine for the ab work AMRAP in my GPP session, I felt a snap on the 8th rep of the set, followed by some pretty bad pain. Not like a 10 on a 1-10 scale, but probably at least 7. I finished the GPP workout in a bit more pain than I was used to and went to the doctor. They listened to my story, palpated my ribs, and said it sounded like the pain was coming from between two ribs and they thus diagnosed me with costochondritis and sent me on my way with a prescription of 600 mg ibuprofen. I’ve got an x-ray scheduled for tomorrow just in case because my track record of recognizing bone pain is not stellar, but I don’t anticipate anything that bad.
QUESTIONS:
Reading some other posts on this & the medical forum, it sounds like the BBM recommendation is business as usual, but lighter and with less pain. I just started the Powerbuilding 1 template and have noticed that the exercises on the third day (namely deadlifts and dumbbell overhead press) really aggravate the sensitive area, so judging from the recommendations made on other posts and the “Pain in training” article I’m planning to lower the weight and up the reps as necessary. However, some movements cause pain even without weight. In the event that e.g., dumbbell overhead press is not possible, do I just strike it from the record until I’m able to do it without wincing?
Also, from what it sounds like in BBM podcast ep 99, NSAIDs slow recovery because the inflammation they suppress is part of the recovery process (I think Derek has alluded to this with ice when I was doing my ankle sprain research). If that’s the case, would the suggested course of action be “work around the pain”? What is a “reasonable” pain level for a given rep/set?
From other posts it sounds like the c-word diagnosis is rather broadly applied to a variety of circumstances united by the “ribs hurt” symptom. That being said, it also sounds like many various rib conditions take weeks to resolve, so I was wondering if there were any particular rehab-like exercises I could do to ease the process along? Or is that all included under the “do your normal routine, but lighter and with bearable pain” recommendation?