How Physical Therapy Can Help With Costochondritis Pain

Costochondritis, an inflammation of the cartilage that connects the breastbone to the ribs, can be treated with physical therapy (PT). PT exercises can help ease the pain and inflammation caused by this condition and help you return to normal activity and function.

How Costochondritis Is Evaluated

During your first physical therapy visit for costochondritis, you’ll undergo an evaluation. Your therapist may ask:

• How your chest pain started and what it feels like
• Whether your symptoms are changing
• What makes your pain better or worse
• How the pain impacts your ability to do daily activities like breathing or getting up from a chair

Through this discussion, your therapist will assess the severity of your costochondritis. Severe cases may restrict breathing and movement, while milder cases can cause pain with less impact on mobility.

A Word From Verywell

Costochondritis is a painful but self-limiting condition that can be made worse by poor posture and decreased trunk mobility. Working with a physical therapist to increase your strength and range of motion can improve your symptoms and prevent recurrence.

Common Assessment Tests

After gathering your medical history, your physical therapist will conduct tests to identify issues contributing to your costochondritis. These may include:

• Palpation
• Range of motion assessments
• Strength evaluations
• Flexibility assessments
• Rib mobility tests
• Spinal mobility checks in the neck, mid-back, and lower back
• Pulmonary function and breathing evaluations

After your therapist performs an examination, they should have enough information to determine the root cause of your costochondritis and can start treatment. A plan of care will be discussed with you, and goals for rehab for your chest pain will be set.

How Physical Therapy Can Help

Physical therapy helps manage pain and reduce inflammation from costochondritis by improving movement and relieving pressure on inflamed rib cartilage. An orthopedic physical therapist, specializing in musculoskeletal conditions, is often the best choice.

Several strategies can enhance movement:

• Rib mobilizations to improve rib movement during normal breathing
• Spinal joint mobilizations to help thoracic spinal joints move smoothly
• Range of motion and stretching exercises to relieve pressure on inflamed cartilage and enhance flexibility
• Postural strengthening exercises to support positions that reduce pressure on rib cartilage
• Breathing exercises for better rib movement with deep breaths

  Other treatments, such as heat to increase circulation and ice to decrease pain and swelling, can also help. However, avoid ultrasound or electrical stimulation near the chest, as these may affect nearby cardiac tissues.

Active participation in therapy is essential. Your therapist will likely give exercises to improve movement in your ribs and chest area.

Exercises to Relieve Costochondritis

Exercises for costochondritis are designed to improve overall chest wall and rib mobility. This can help decrease pain and improve the way your ribs and thorax move. Postural exercises can relieve the pressure of inflamed cartilage.

Before starting any exercise program for costochondritis, check in with your healthcare provider to ensure that exercise is safe for you to do.

Pectoral Corner Stretch

The pectoral corner stretch is meant to improve the flexibility of your pectoral or chest muscles. To perform the stretch:

1. Stand facing a corner about 2 feet away from the wall.
2. Place both arms up, with your forearms resting against the wall on each side of the corner. Your hands, forearms, and elbows should be in contact with the wall.
3. Slowly lean into the corner, stretching the muscles in the front of your chest.
4. Hold the stretch for 15 to 30 seconds, and then relax.
5. Repeat the stretch three to five times.

Pectoral Doorway Stretch

You can stretch your pecs using a doorway opening, too. To perform this stretch:

1. Stand in a doorway, and place both elbows and forearms up against the doorjamb on either side of you.
2. While keeping your elbows against the doorjamb, slowly lean forward, stretching the muscles in the front of your chest.
3. Hold the stretch for 15 to 30 seconds.
4. Repeat three to five times.

Scapula Squeeze

The scapula squeeze can be done to improve posture and muscular control of your thorax. To perform this exercise:

1. Sit comfortably in a chair, and gently squeeze your shoulder blades together in the back.
2. Pretend that you are trying to squeeze a pencil between your shoulder blades, and hold the position for three seconds.
3. Slowly release, and return to the starting position.
4. Repeat 10 to 15 times.

The scapula squeeze exercise can be more challenging with a resistance band:

1. Loop the band around something stable, and hold each end.
2. Bend your elbows back, as if rowing a boat, while pinching your scapulae together.
3. Then slowly release.
4. Repeat the exercise 10 to 15 times.

Stability Ball Lying Chest Stretch

Another great way to open up your chest wall and stretch your pectorals and chest muscles is to use a stability ball. To do this stretch:

1. Lie on your back over a 25-inch stability ball.
2. Hold both arms up in front of you, and then slowly open up your arms as if you were going to give someone a big hug.
3. Relax your back as you open your arms, and allow your arms to move toward the floor, opening up your chest.
4. You should feel a slight pulling sensation in your chest when you do the exercise.
5. Hold the stretch for 15 to 30 seconds, and then bring your arms back to the midline.
6. Repeat three to five times.

If an exercise causes lasting chest or rib pain, stop and consult your physical therapist. They can often adjust the exercise for comfort.

Practical Ways to Prevent Costochondritis

An important part of physical therapy is preventing future issues. To prevent costochondritis, consider:

• Maintaining proper posture
• Stretching regularly each week
• Strengthening back and abdominal muscles
• Engaging in regular physical activity

If you start to feel your symptoms of costochondritis creeping on again, performing your home exercise program for stretching, breathing, and postural exercises may help keep symptoms under control.

Long-Term Outlook

Costochondritis is often a self-limiting condition. That means that symptoms and the pain may subside without any treatment at all.

Physical therapy, however, can be an effective management strategy to speed the process along and to ensure that you are moving correctly while your rib cartilage is healing.

If your symptoms persist for longer than six weeks, check back in with your healthcare provider. A referral to an orthopedic specialist may be in order; occasionally, steroid injections are given to relieve inflammation in the costochondral joints.

Keep in mind that the pain from costochondritis usually abates within a few weeks, but some severe cases last for up to one year.