Costochondritis Rehab

I have had issues with chostochondritis since July of 2012. I have successfully rehabilitated from it and can now perform movements pain free that used to be excruciating. Because this is a common GST related injury I thought I would share what worked for me to finally overcome it. 

Please note that this is worked for me. If you are experiencing chostochondritis see a physical therapist to identify what is the cause of your pain. What worked for me might exacerbate the condition in others.

Chostochondritis is a pain and inflammation in the sternum, where the ribs attach to the sternum. For those pursuing GST this will most likely be caused by dips or back lever. For me it was back lever. A full lay back lever was my goal for the summer of 2012 and as such, I set up a program designed around training back lever 3 times a week (M/W/F). I didn't think this would be an issue as I had trained back lever before and had worked up to a pretty solid advanced tuck back lever. I made good progress most of the summer, working up to a solid straddle BL (maybe 10 seconds) and the ability to hold a full lay for a few seconds. I got excited with my progress and during every workout would try to maximize my volume in the hardest variation I was capable of performing. Towards the end of the summer I started experiencing slight pain in my sternum during back lever. I didn't think much of it and trained through it, which was a terrible idea because it left me unable to perform even a tuck BL without extreme pain in my chest and sternum. Since then I have been rehabilitating and have finally eliminated the final traces of pain. Here are the things I tried, and what eventually worked.

1. Rest. If I had not tried to train through this, I would probably have been able to overcome it in a few weeks, rather than 6 months. Most online resources for chostochondritis recommend rest and advise avoiding any range of motion that aggravates it until the conditions have subsided. For all of my fall semester of 2012 I avoided any heavy pressing, dips, or BL that would aggravate it and instead devoted my time to training for a one-arm chin. I thought that with this much time off I would be able to return to BL pain free. Although I no longer experienced pain in my sternum, every time I tried doing BL or even bodyweight dips on PB, the pain returned. Obviously rest alone was not going to work.

2. Visit physical therapist. This should be the first step for any injury but I didn't get around to it until a few months after the onset of symptoms. The physical therapist at my college said that he could feel that my costal cartilage was swollen, but after performing some movement tests he couldn't figure out why. My pecs weren't tight, my lats weren't tight, nor was anything that he would suspect would cause this swelling. He advised that I rest and if pain persisted, visit a specialist.

3. Self myofascial release. Because the PT could not diagnose the cause of my costochondritis, I decided that I would start doing intense foam rolling daily. I thought I would foam roll every part of my body so that if a tight muscle was pulling on my cartilage, I could maybe alleviate the pain with SMR. All this foam rolling definitely felt great and improved my mobility, but it didn't seem to really affect my symptoms. I could now perform simple pressing like pushups or dips pain free, but BL still aggravated my symptoms. 

4. German hang. What ultimately solved my problem was german hang. During december and january I returned to ring work four days a week (following the WODs) and substituted BL variations for GH in warmup and WOD. This did the trick. German hang loosened up something in my chest and shoulders that was causing my chostochondritis. Now whenever I feel the slightest twinge of pain in my sternum, I simply do a set of GH. One set of 30s german hang seems to clear up any pain I have.

I hope that this is helpful to others struggling with pain from BL, muscle ups or dips. My biggest piece of advice is that if you are experiencing pain ( chostochondritis or otherwise) IMMEDIATELY STOP doing whatever aggravates the pain and visit a physical therapist.

And start doing the fullest range of motion that causes no pain past a 4-ish out of 10, with zero resistance. From there you build up to full ROM with a 0-2 out of 10, and then you start adding one or two pounds at a time.

Glad to hear that your condition has cleared up!

GH is a very good exercise. I'm getting back into them now, taking it slow. Probably 4-5 months to build back up to the 4-5 sets of 30s I was doing before.

It's good to hear that you're finally getting back into shoulder work. A shoulder injury can be one of the most frustrating things, especially in a shoulder girdle dominant sport. I look forward to seeing your progress in the coming months and years with foundation and beyond.

adidashred said:

It's good to hear that you're finally getting back into shoulder work. A shoulder injury can be one of the most frustrating things, especially in a shoulder girdle dominant sport. I look forward to seeing your progress in the coming months and years with foundation and beyond.

Thanks, I look forward to yours too!

I am currently floating on air due to happiness I actually feel like I may end up with GOOD shoulders!

Those first 4 mobility exercises in HS1 are just absolutely priceless. So is the rest, but I'm not able to do any of that yet so I have no idea what that part of the journey will feel like!

That's awesome to hear. I am anxiously waiting on my next paycheck so I can get HS1 and get started. 

Joshua Naterman said:

(...) I am currently floating on air due to happiness I actually feel like I may end up with GOOD shoulders! (...)

Very happy for you Joshua, don't go do something stoopid now!

(Talking to myself as well as to you  B) here )

Hahaha,  Coach told me the same thing not that long ago

I have to stop breaking myself

adidashred said:

I have had issues with chostochondritis since July of 2012. I have successfully rehabilitated from it and can now perform movements pain free that used to be excruciating. Because this is a common GST related injury I thought I would share what worked for me to finally overcome it. 

 

Please note that this is worked for me. If you are experiencing chostochondritis see a physical therapist to identify what is the cause of your pain. What worked for me might exacerbate the condition in others.

 

Chostochondritis is a pain and inflammation in the sternum, where the ribs attach to the sternum. For those pursuing GST this will most likely be caused by dips or back lever. For me it was back lever. A full lay back lever was my goal for the summer of 2012 and as such, I set up a program designed around training back lever 3 times a week (M/W/F). I didn't think this would be an issue as I had trained back lever before and had worked up to a pretty solid advanced tuck back lever. I made good progress most of the summer, working up to a solid straddle BL (maybe 10 seconds) and the ability to hold a full lay for a few seconds. I got excited with my progress and during every workout would try to maximize my volume in the hardest variation I was capable of performing. Towards the end of the summer I started experiencing slight pain in my sternum during back lever. I didn't think much of it and trained through it, which was a terrible idea because it left me unable to perform even a tuck BL without extreme pain in my chest and sternum. Since then I have been rehabilitating and have finally eliminated the final traces of pain. Here are the things I tried, and what eventually worked.

 

1. Rest. If I had not tried to train through this, I would probably have been able to overcome it in a few weeks, rather than 6 months. Most online resources for chostochondritis recommend rest and advise avoiding any range of motion that aggravates it until the conditions have subsided. For all of my fall semester of 2012 I avoided any heavy pressing, dips, or BL that would aggravate it and instead devoted my time to training for a one-arm chin. I thought that with this much time off I would be able to return to BL pain free. Although I no longer experienced pain in my sternum, every time I tried doing BL or even bodyweight dips on PB, the pain returned. Obviously rest alone was not going to work.

 

2. Visit physical therapist. This should be the first step for any injury but I didn't get around to it until a few months after the onset of symptoms. The physical therapist at my college said that he could feel that my costal cartilage was swollen, but after performing some movement tests he couldn't figure out why. My pecs weren't tight, my lats weren't tight, nor was anything that he would suspect would cause this swelling. He advised that I rest and if pain persisted, visit a specialist.

 

3. Self myofascial release. Because the PT could not diagnose the cause of my costochondritis, I decided that I would start doing intense foam rolling daily. I thought I would foam roll every part of my body so that if a tight muscle was pulling on my cartilage, I could maybe alleviate the pain with SMR. All this foam rolling definitely felt great and improved my mobility, but it didn't seem to really affect my symptoms. I could now perform simple pressing like pushups or dips pain free, but BL still aggravated my symptoms. 

 

4. German hang. What ultimately solved my problem was german hang. During december and january I returned to ring work four days a week (following the WODs) and substituted BL variations for GH in warmup and WOD. This did the trick. German hang loosened up something in my chest and shoulders that was causing my chostochondritis. Now whenever I feel the slightest twinge of pain in my sternum, I simply do a set of GH. One set of 30s german hang seems to clear up any pain I have.

 

I hope that this is helpful to others struggling with pain from BL, muscle ups or dips. My biggest piece of advice is that if you are experiencing pain ( chostochondritis or otherwise) IMMEDIATELY STOP doing whatever aggravates the pain and visit a physical therapist.

It is heartening to know that you could finally overcome your pain. I know how frustrating it can be to not be able to perform an exercise for months. ( I've had wrist problems last year and tail bone issues also when I was into athletics)

So I can definitely feel how relieved you must have felt that the pain is gone once and for all!

That being said, I am curious to know about your one arm chin up progression. How much did you improve? Were you able to bang out multiple reps in double hand chin ups before venturing into the one arm territory?

Also, I take it that any "pulling" variation could be done relatively pain free? So I take it that you could perform FL movements pain free?

Yeah front levers were fine, the only thing that aggravated in was back lever and dips on rings so I decided to work on pulling for a while. Before I started training specifically for a one arm chin I could do 10-15 two arm pull ups and a weighted chin with maybe 90lbs. I basically did a pulling workout three times a week for two months. Now I can one arm (not from a dead hang though) and my weighted chins shot up to like 120lbs.

adidashred said:

Yeah front levers were fine, the only thing that aggravated in was back lever and dips on rings so I decided to work on pulling for a while. Before I started training specifically for a one arm chin I could do 10-15 two arm pull ups and a weighted chin with maybe 90lbs. I basically did a pulling workout three times a week for two months. Now I can one arm (not from a dead hang though) and my weighted chins shot up to like 120lbs.

Hey many thanks for the prompt reply adidashred!

Wow a 90lbs chin up is strong!!

I haven't tested my pulling strength in ages and it's probably not a good idea to do so given my current condition too. But perhaps, it might not be that big a loss if I can increase my pulling strength while giving the pressing department a little break.

It does seem to me that my condition does share some similarities with what happened with you. My pain was also triggered by back lever and what blew it was the ring support. You of course were a ton more stronger than me(straddle BL & XR Dips vs tuck BL & XR Support)

Maybe all is not lost if I can rehab my injury slowly and steadily while focusing on getting stronger in the pulls.

Yeah an injury is always a good opportunity to focus on another area of your strength that might be lacking. I would take Josh's advice for rehab. For me, rest alone was not enough to get rid of it, I had to ease back into pressing until I was back where I was before, pain free. It would be good to focus on pulling or lower body, but include some sort of light pressing to ease back into it. 

adidashred said:

Yeah an injury is always a good opportunity to focus on another area of your strength that might be lacking. I would take Josh's advice for rehab. For me, rest alone was not enough to get rid of it, I had to ease back into pressing until I was back where I was before, pain free. It would be good to focus on pulling or lower body, but include some sort of light pressing to ease back into it. 

I will definitely keep that in mind. Right now, simple arm awings and arm circles are causing discomfort so it'll be a while before I do any pressing movement.

I hope to finally start doing some pulling movements from tomorrow and I am curious to know how that goes.

Well good luck, I hope you are able to rehab from this injury successfully and get back into full on training.

adidashred said:

Well good luck, I hope you are able to rehab from this injury successfully and get back into full on training.

Thanks adidashred!

I tried moving around a bit and did a few pull ups, lat flys as well as a single set of tuck FL. While I am pleased that the pain isn't soul crushing, it's definitely there and the next couple of months will be interesting.

Thanks again for all your help!

I get this pain sometimes too, from doing dips wait too deeply for a time (when I turned away from the light and stopped doing GST). Would people suggest doing german hangs to help alleviate this pain? I typically do dead hangs as a part of cooldown. Any other comments?

Daniel Taylor-Shaut said:

Would people suggest doing german hangs to help alleviate this pain?

I would imagine that German hangs would cause much the same stresses, due to a similar shoulder position. Can't speak for certain on the subject because Costo is something that I have never really been troubled by.

I could have got rid of the chest pain in a few weeks if i knew what to do, but it took me a year because I was foolish and avoided the chest area entirely. I have now fully recovered.. 

(note this advice is only relevant if the chest pain was like mine: it did not come on suddenly and with extreme pain, but rather came on over the course of a few weeks due to me doing chest workouts through the pain) 

my physio who gave me the following great advice, which was all that I needed to improve:
''Do as much movement/ exercise as you can, but staying below 4/10 on the pain scale''

When following this, the following are important:
- 'exercise' is absolutely anything that gives you chest pain (but still < 4/10)
- the pain gets WORSE for a few days before it gets better: Once you do 'exercise' for one day, the chest is a lot more painful for following 2-3 days. During this time, it is fine to ease off with the 'exercise'. But after this flare up, resume with the 'exercise'. There is therefore a cycle of exercising and subsequent flare up. Improvements in the chest pain will be seen AFTER A FEW WEEKS and will be fairly slow