PT on the Net Research

Costochondritis (Tietze's Syndrome)


Question

I am a professional basketball player who plays overseas. I developed costochondritis last October. Basketball only makes it worse. Although I haven’t played since the season ended in April, my chest doesn’t feel any better or more healed. I am supposed to be going back to Europe in August. I have researched my injury and read if I don’t let this heal it will become a chronic injury. Is this going to make me retire? I have already tried a chiropractor, with no success.

Answer

Chest pain in the area of the rib-cartilage junction and the associated inflammation (costochondritis) can be very limiting to an athlete. Costochondritis, also known as Tietze’s Syndrome is a non-specific, inflammatory condition of the upper costochondral junction. When the anatomy of the upper thorax is examined, it is easy to see how much dysfunction this condition can produce. Several large muscle groups attach themselves to the surfaces of the ribs. For example, the external obliques, internal obliques, transverse abdominis, rectus abdominis, intercostals, diaphragm, serratus anterior, pectoralis major, and pectoralis minor all have attachments on the ribs. These muscles are particularly important in allowing the body to stabilize multiple joint segments, and to efficiently produce and reduce forces during functional movement patterns. Basketball is commonly referred to as a “multi-planar” sport, which means that common movements in this sport occur during forward, sideways, and rotational patterns. The greater an athlete’s nervous system can select the right muscles to produce the correct amount of force, at the right joint, at the right speed, at the right time…the greater the performance while lowering the risk of injury. But a painful injury close to your stabilization core ultimately produces dysfunction, and can contribute to other injury patterns.

So how can you improve your condition?

By initiating an Integrated Training program that focuses on core stabilization, optimal neuromuscular efficiency, integrated flexibility, integrated power training, and integrated functional strength training through all planes of motion (forward, sideways, and rotational) within the limits of discomfort. This will allow the body to work together synergistically to stabilize, produce force, and reduce force efficiently. Hopefully these suggestions significantly improve your symptoms. If they do not, refer your case to an orthopedic specialist with professional baseball or hockey experience.

Resources on PtontheNet.com:

  1. Flexibility training (exercise library)
  2. Core stabilization training (exercise library)
  3. Articles on flexibility training and core stabilization – use the keyword search to easily located these articles

Other resources from National Academy of Sports Medicine (www.nasm.org)

  1. Integrated Flexibility Training (video series)
  2. Core Stabilization Training (video)