Costochondritis – Causes, Symptoms, Treatments


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The good news is costochondritis is not a serious condition and while it can be painful, it will not cause any permanent harm.

Costochondritis is a painful condition of the chest wall. The rib cage is a very tough bony structure that protects your lungs, but in order for your lungs to have the ability to expand when you take a deep breath, your rib cage was created with joints between your ribs. The chest wall is made of ribs, cartilage and joints. Ribs are made of a very hard solid bone and cartilage which is very strong, but a softer and flexible material (like your ears) and is found in the joints throughout your body.

A word of warning is necessary here! You are an IFPA certified personal trainer and should NEVER attempt to diagnose any medical condition. It is very easy for a non-doctor to misdiagnose a medical condition and in this case, misdiagnosing Costochondritis is very easy. Without a doctors’ expertise Costochondritis can present the same as Bornholm Disease which is caused by a viral illness (Coxsackievirus A & B, Echovirus, etc.) Tietze’s Syndrome or a ruptured Alveoli, etc.

Far more serious to the point of DEADLY would be to misdiagnose Costochondritis from heart disease, cardiopulmonary disease (CPD), coronary artery disease (CAD), hypertension (HPB), etc.

Your IFPA Personal Trainer Certification course and textbook “The Book on Personal Training” provided you very specific signs and symptoms of all the very serious and life threatening heart diseases and conditions. As an IFPA certified personal trainer, you are required to review each of the tables and figures provided for you in your text on the chapters concerning safety and exercise. It is expected you will review these chapters on a regular basis and review the signs and symptoms before your personal training sessions. While a young, healthy athlete would not be suspect of having any heart disease, it is better to be safe than sorry, so refer them to a doctor.

Far more serious is a personal training client with any Coronary Artery Disease (CAD) risk factors as depicted in your IFPA textbook “The Book on Personal Training”, for example:

  1. Age: Men over 55, women over 65 or women with premature menopause without estrogen replacement therapy.
  2. Family History: First degree relative with heart disease. 55 (Male-Father/Brother) or 65 (Female- Mother/Sister)
  3. Current cigarette smoker
  4. Hypertension: Blood pressure (BP) over 140/90 on two occasions or is on BP medication.
  5. High cholesterol: Total cholesterol is > 200 mg/dl or HDL < 35 mg/dl
  6. Diabetes Mellitus: Insulin dependent > 30 years old or having insulin dependent diabetes > 15 years old or persons with non-insulin dependent diabetes > 35 years old.
  7. Metabolic Syndrome
  8. Lack of Exercise/Inactivity
  9. Being overweight
  10. High stress level

As an IFPA Certified Personal Trainer you are also required to carefully monitor each of your personal training clients for signs and symptoms of cardiopulmonary difficulty during exercise. The following list should be committed to memory along with all the tables in “The Book on Personal Training” chapter on Safety & Exercise:

  1. Onset of pain or tightness in the chest, shoulders or surrounding areas (Angina or Angina like symptoms which present like Costochondritis
  2. Dizziness, light-headedness, confusion, nausea and fainting
  3. Failure of heart rate to increase with increase in exercise intensity
  4. Noticeable change in heart rhythm and/or abnormal heart activity (palpitations and fluttering)
  5. Physical or verbal evidence of severe fatigue
  6. Profuse sweating (diaphoresis)
  7. Disorientation
  8. Significant drop in systolic blood pressure (20 mm Hg or more) or failure of systolic pressure to increase with increase in exercise intensity.
  9. Excessive rise in blood pressure (systolic > 260mm Hg; diastolic > 15 mm Hg)

Warning!!! There are many causes of chest pain. Chest pain can have very serious and potentially deadly consequences. Any new, severe or persisting chest pain must be discussed with a doctor. In cases of particularly severe chest pain, especially if the pain radiates to your jaw, neck, shoulders, or arms and you feel breathless, sick, sweaty, have difficulty breathing or it feels like a very heavy man is standing on your chest, these may be symptoms of a heart attack and you should call emergency medical response (EMS) immediately!

If the doctor tells you or your personal training client that it is Costochondritis, the doctor will probably recommend treatments such as painkillers and anti-inflammatory medications. One of the most common treatments is Ibuprofen an anti-inflammatory drug.

Ibuprofen is in the NSAID family of drugs, which is a Non-steroidal anti-inflammatory drug. NSAIDS should never be taken on an empty stomach. You can also try contrasting heat pads with ice application, TENS therapy (Transcutaneous Electrical nerve Stimulation), Acupuncture, gentle stretching and rest the area by stopping any activity, exercise or sport that causes pain.

With rest and some of the suggested treatments described above, the pain diminishes fairly quickly, generally no more than 6-8 weeks. It is possible Costochondritis could return, especially if you jump right back into an activity that may have caused it in the first place. Though in many cases Costochondritis has no known cause.

In any regard, it is your responsibility as an IFPA Certified Personal Trainer to design all your programs to maximize both the safety and effectiveness of all your personal training sessions. Your goal should be to retain your personal training clients for many years, to accomplish this goal, you must always strive to do your best. Your goal must be to help every client you have to live a longer, healthier and happier life!

Good luck in all your goals!

Dr. Jim Bell


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