are you suffering from chest or rib pain that's made worse with compression or certain movements great hey everyone this is Dr Zach Griffin here performance Sport and spine in today's video discussing costochondritis or irritation of the cartilage in the front of your chest if you look at the anatomy our rib cages comprised of 12 ribs cartilage and then the sternum which is in the middle and the two joints that are affected are the costochondral and the cost of sternum so what does this condition feel like well the pain is often described as sharp achy or pressure-like and is exacerbated with external activities deep breathing or upper body movements and we greatly appreciate if you like our video subscribe to our Channel and don't forget to turn on notifications and then palpation or pressure over the affected area should reproduce the pain this condition most often affects the second through fifth rib there's no swelling and it should get better with rest and with people suffering from chest wall pain or pain somewhere in their rib cage about 14 of this were costochondritis patients what causes this condition well there's a few culprits severe coughing or sneezing some sort of chest injury blunt trauma or falling it's training with exercise or exertion heavy lifting and then lastly infections such as pneumonia when we hear the term costochondritis it implies that the main driver is inflammation or inflammatory process but it turns out the main culprit is probably more mechanical irritation or overuse so a more correct term would be called as chest wall pain probably the best way to treat this is just to irritate it less so bring over some posture activity modifications next now with this Condition it's really painful but you can't see anything but I want you to think of it as like a metaphorical scab and every time you pick that scab it takes longer to heal so our job to try to reduce the times in the day that you feel the pain or pick that metaphorical scab with sleeping it's best to lay on your back and you should avoid positions that way in your stomach on the affected side with sitting try to not lean to the side of pain and then it's also best to avoid any heavy lifting or fast lifting with either arm other treatments that people may find beneficial are hot or cold packs over-the-counter medications as long as there's no contraindications cough suppressants avoiding movements that irritate this and then topical NSAIDs for exercise and Rehab we're going to focus on isometrics we're not moving that joint at all and then some mobility of the thoracic or upper back spine now especially for the acute setting you do not want to irritate that anymore so if you start these exercises and they cause more pain just rest the area and don't add these in for the more chronic conditions you're going to have to poke into it a little bit more the wall plank starting with an easy version we're going to put our feet a little bit away from the wall in a plank position hold the tolerance again this exercise should cause no pain to increase the difficulty that we're going to walk our feet farther back and then hold the tolerance to further increase the difficulty you can do this on your knees an anti-rotation isometric so standing with your feet staggered against the wall we're going to put our hands together and then pushing into the wall to tolerance we're going to hold as long as we can again the pain should not increase in acute setting and then you repeat on the opposite side banded row with an anchor band we're going to pull towards our body at about mid chest height hold the tolerance again this exercise should cause no pain in the acute setting you may need to relax your resistance a little bit initially external rotation isometric so the lightweight resistance band anchored we're going to put our hand into a 90 90 position and then push our hand outwards and hold the tolerance again it should cause no pain in the acute setting and we can adjust how harp we pull on the resistance band for the correct dosage so the increase over time as your symptoms allow 90 90 rotation so place your arm at a 90 degree angle against a pole or a door slowly rotate your body at a 45 degree angle into the stretch and hold the tolerance some people may benefit from a deep breath in hold and exhale again an acute setting this should not increase your pain the floor Angel so laying on your back with your knees bent bring both arms up into a 90 90 position so we Press Your Hands overhead to tolerance again an acute setting that should not increase any pain training modifications and exercise modifications are huge remember this is irritation rarely damaged so often by changing the type of exercise the Intensive exercise the frequency or the duration you can still train and let this condition heal and we'll give you some examples now type of exercise so let's say you're having pain with running in the short term modify that to a stair stepper or stationary bike will be helpful intensity this is just making the exercise your activity less hard so the easiest thing is just to do less so take some weight off the bar and continue the same exercise frequency so just doing the same exercise that less often throughout the week so three times is too much in the short term just reduce it to two times and then build up over time and then lasting duration so maybe there's some threshold of time where if you exceed that the joint gets irritated so maybe it's running again at 20 minutes or more it starts to get irritated for a couple weeks stay at 15 to 18 minutes and then gradually increase as your symptoms decrease right another condition that can present somewhat similar to costochondritis is titsa syndrome however this condition is more rare it affects people under the age of 40. it usually affects only rib 2 or 3 and only one rib seconds at the time where in cosmicondritis it's two to five and nine to the time multiple ribs are affected and with this titsa syndrome swelling is present where it's absent in costochondritis and whenever we have chest pain we want to make sure that we've ruled out the heart so this should be done for all patients but especially anyone over the age of 35 a family history of heart disease or any sort of shortness of breath or left arm symptoms thank you for watching my video on costochondritis we hope you found it beneficial if you did please like our video And subscribe to our Channel and don't forget to check out our other videos