Hah! Yep - that's what happens. Unlike every other joint in the body, those rib joints on the breastbone never get a rest. As long as the rib joints round the back are immobile, the ones on the front will be straining constantly. I should have used that song as a backing track! Cheers, Steve August.

@@Sjj827 Hi Sophia. No, it's not usual with costochondritis. It may not be a big deal, though - any pain can make you a bit nauseous if it's bad enough, and costo certainly can be. My suggestion would be to simply fix the costo and then see if you still get the nausea. Costochondritis is essentially strain and pain at the joints where your ribs hinge onto your breastbone, caused by immobility of the rib joints round the back under your shoulder blade. (That’s why you get a lesser pain and tightness round the back there as well.) When these rib joints round the back can’t move, then the more delicate rib joints on your breastbone MUST move excessively, every breath you take. So they strain, ‘give’ (usually with clicking and popping and often with sharp, scary, stabbing pain), get irritated and locally inflamed - and there’s your costochondritis. It is NOT a “mysterious inflammation” arriving out of a clear blue sky for no reason. So treating it like it is does NOT fix it. You’ve probably found that out. Put the effort in to understand what’s going on so you can fix your costochondritis yourself. It’s up to you - you are very unlikely to find a doc who can fix it for you. They haven’t so far, right? There is a specific reason for that. Also, no - it usually won’t “just settle down.” That’s just doc reassurance and it’s simply incorrect - the existing research shows most costo lasts for AT LEAST a year. There’s a specific reason for that too. Thoroughly read the costo page of the Backpod’s website, including watching the costo videos linked from it - www.bodystance.co.nz/en/costochondritis/ Understand what’s going on and what actually fixes costo. Our sensible and effective New Zealand manual physiotherapy way to fix costo is based on the actual published medical research. The popular medical explanation of costo as a “mysterious inflammation" is not. Yes, this is nuts. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

So the plan is see a chiro free up the frozen hinges that have been sore after yelling loudly August 2019 and the do the back pod rutine

I am correct on this Steve. Thank you so much for these videos aswell

@@Swigzable Good plan, but DO watch the chiro. The good ones are very good, but I don't have a high opinion of the trad US ones for treating costo generally. (1) They usually use the standard body-slam-onto-the-patient-with-their-fist-in-your-back technique. This is usually a dumb choice with costo, because it just squashes and strains further the already strained rib joints on your breastbone. Every time. (2) In my experience, they have a bias towards manipulating the spinal joints and (often) missing the rib joints - and freeing these up is the irreducible core of fixing most costo. (3) All manipulation does is bang a tight hinge free. It doesn't put anything at all "back in" - that's just a nonsense phrase meaning nothing. I’m speaking as a New Zealand physio - I’ve used manipulation myself for over 30 years. It cannot in a split second stretch out the very tough collagen of the ligaments and joint capsule surrounding the joint which will have stiffened down around the immobile joint. So this just freezes the hinge up again rapidly. That's why we developed the Backpod - to stretch out the collagen so the joints can stay free and you get a lasting improvement. We think the chiro approach of continually banging the same bits free is silly and expensive. Here's what i find works best: Yes, get a Backpod. It's the only thing around that we can find that does an effective stretch on the tight rib joints around the back - and getting these freed up is essential. Do READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi. Don't give up - there really is help. It's not that difficult to fix - if you understand it correctly and to the right things for the problem. Mostly, most docs don't. Cheeringly, you can do most of it at home yourself anyway. Here's a long wordy PDF on what costochondritis actually is and what we find works best to fix it. It is more easily read on a computer, not a phone. The PDF covers using the Backpod for costo, and also the other bits that often need dealing to as well. Cheeringly, these can nearly all be done by yourself at home. It takes a bit of time and effort, but it's not that difficult. Good luck with the work! www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf

Thank you. I do sympathise - I know how confusing and frustrating it can be along with the pain. We were flabbergasted to discover that the rest of the world mostly accepted the "mysterious inflammation" nonsense - against the actual published medical research. Here's a long wordy PDF on what we find works best to fix it. It is more easily read on a computer, not a phone. Good luck with the work! www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf

Thank you very much, Gabriel! I share your frustration, though not these days, your pain - I fixed my own costo over 30 years ago. Look, that was just luck. I had costo for seven years after a climbing fall left part of my rib cage frozen up. I understood what was going on after qualifying as a physiotherapist in New Zealand, where we are very good at practical hands-on treatment of spines. I had no idea that most of the rest of the world saw costo as this "mysterious inflammation" until I put up that first KZfaq video explaining how we'd see it and got completely swamped by patient queries from all round the world. Since I'm lucky enough to have an understanding of costo, it does seem worthwhile passing that NZ view on. If you can find the time to tell your story on any of the costo groups, Amazon and Facebook reviews, etc., I do think it's a worthwhile thing to do. Actually - and this amuses me - on the net you actually have more street cred as a costo sufferer than I do as someone with 30 years' expertise in fixing the thing. Well done on thinking for yourself. Cheers, Steve August.

@Cheezus Sliced Hi. Of course I can't be certain over KZfaq but it sounds like what I've been talking about. You get swelling on your chest if the costochondritis strain is bad enough - like running on a sprained ankle, and it swells up. I'm not sure, but I think this might be fairly common with quads and paras. It makes sense - you can't do the usual full body movements to keep all your spinal and rib joints moving freely, so unsurprisingly the spinal and rib joints can get tight, then freeze. When the rib joints round the back (where the ribs hinge onto your spine) can't move, then the more delicate joints at the other ends of the same ribs (where they hinge onto your breastbone) HAVE to move excessively, just to let you keep breathing. So they strain, 'give' (often with clicking and popping), get irritated, locally inflamed (and often swollen - like continually running on a sprained ankle) - and there's your mysterious costo chest pain. Docs usually don't get this at all - as I've explained in the video. If that sounds like a fit, then I'd say the Backpod would be ideal to free up the tight spinal and rib joints around the back that cause the strain at the front. Essentially, all you have to do is lie on the Backpod, and your own body weight provides the force to quietly stretch the joints free. This is something you can do as a quad, although you can't do a lot of the other exercises and stretches that would help. I think it's well worth a try. I'd be very interested in how it goes - I've been suspecting for sometime that this may be a common problem for quads and paras, as I've said. Any thoughts? Ideally, also, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Re TENS - it's not actually a treatment; just a way of interrupting the pain signals running down the nerves. It doesn't treat whatever problem is causing the pain in the first place. Also there's definitely some controversy about using a TENS on the chest, because the heart runs off electrical signals also, and the TENS is designed to swamp the nerves with electrical impulses so they don't carry so many pain signals; a bit wary of doing that near the heart. Have a good look over the Backpod's Costochondritis page - that'll give you an idea of what we're doing. www.bodystance.co.nz/en/costochondritis/ Cheers, Steve August.

Steve NZ Physio Hi Steve, thanks so much for your work and willingness to advocate for this condition. I have ordered the Backpod to London and can’t wait to use it. I have costo as a nice ending to having coronavirus. All clear now but left with costo! Sorry to ask on KZfaq but I was wondering if you could possibly recommend a Physio in the UK? I have seen you mention SirTedFairySpear2 as someone you recommend and I wondered if there might be a way of finding out who that is? Thanks so much. Lizi

@@elizabethwoodland1350 Hi Lizi. Hope you're going well. I just spotted your comment - sorry about not replying sooner. Frankly, finding someone in the UK who knows about costo is not at all easy. Uniformly, the doctors do not understand it, and also don’t realise that they’re actually missing what’s going on. (I’m basing that statement on many patient contacts, plus also phone calls from some UK doctors who’d had costo themselves for many years with no help from within their profession.) I’m slowly garnering the names of a few useful therapists who are good in the area. The UK expert would definitely be Dr Michael Durtnall who has the Sayer Back and Neck clinics, at 8 Sunningdale Gardens, Kensington, London W8 6PX; also at 80 Coleman Street, Moorgate, London EC2R 5BJ, UK. The phone for both is phone +44 20 7937 8978. Michael’s a chiropractor himself, but has moved far beyond his initial training. He’s superb on costo, and his team reflects that. You might have a wait to see him personally - it’s still the best, though. For the massage side, I’d thoroughly recommend a soft tissue therapist called Sophie Cooke, who is west of London at Lapwing House, Cold Ash Hill, Newbury RG18 9NX, U.K.; phone 07533 756247. Sophie has had costochondritis herself, and there’s nothing like being on the receiving end to concentrate your mind on fixing the problem - also my own case! She’s quite committed to it, has been fixing other patients of hers who have costo, is learning further mobilsations etc. for the joints, and is going to be a real asset in this area. If you can reach either of these two, it should be very worthwhile. Please say hello from me if you do. Cheers, Steve August.

The same story :)

Hi Alexander. Well done! Good on you for thinking for yourself, and also for making the Backpod work. Its aim is to stretch fully free the tight rib and spinal joint movement around the back, which means you do have to use it long enough and hard enough for that to actually happen. (Not everyone does that.) Also, unsurprisingly, you can need some other bits as well as the Backpod to return the whole bundle of rib cage machinery back to normal operation. Now you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Sure, keep adding in the hard roller as well - it's all to get the full movement back. The long cylindrical shape of the roller means it can't get much specific leverage on individual rib joints, but it'll still help with the total spine and rib cage mobility. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the remaining work. And well done. If you feel like telling your story as an Amazon or Backpod review, or on Reddit/r/costochondritis it would be really worthwhile for other people. There's still a huge amount of doom and gloom about costo because it's still usually seen - erroneously, and against the actual published medical research - as a "mysterious inflammation" that you treat with an anti-inflammatory approach. It's not and you don't. Despatches from the front lines like yours are hugely worthwhile. Cheers, Steve August (B.A.,Dip.Physio.).

Thanks for sharing!

Hi Alexander thanks for the insight I also do a lot of weight training and have started to suffer from costochondritis. I just purchased the backpod and will start using it today. Are you still pain free ? has the pain returned, and now that you are costochondritis do you still continue to do the back stretching workouts you spoke of ?

I have had this same problem for years, though it severed for me few months ago.. I also almost always felt pain after training chest, especially doing dips. That what i think made it worse for me, because i started doing really deep dips and kept training through pain.. Now i been diagnosed with costochondritis a month ago, and have been trying to find information myself of how to heal it. I'm currently doing anti inflammatory diet, but it seem to not work. I also started using foam roller for my back which i find extremely painful on left side, but i keep rolling through pain. I am not seeing great results yet, but it's for sure better. ( i couldn't even twist to sides, it was that painful). Also for me, at firat i had experienced pain in my centre and more left side of the chest, but not I'm feeling it more in upper chest(seems to be 2nd rib) and i kind of see some swelling arround the cartilage. I'm working physical job and it might not be helpful for treating it, but I wish so much i can heal it and come back doing training. It is so mentally hard when it's not getting better..

@@stevenzphysio4203 I was diagnosed of costochondritis, but my chest is not tender...the pain doesn't get worse when I apply pressure with my hand. Instead it's a very heavy squeezing pain. It's been getting worse over time (it's about 10 months now). Now, I can hardly sit or stand, and I limp & stoop while walking. I'm wondering if my case is still costochondritis...

Hello. So did it work for you?

How's it going?

Are you feeling better now?

How is it now ?

same

Hi Valerie. Well done on thinking for yourself, gambling I just might know what I’m talking about, and getting a Backpod. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However do it safely with COVID-19 around. At a minimum, you should both wear masks and hand sanitise. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

How long did u use the backpod each day? And how long did it take to clear up?

Same question as the one above...what did u do??

Thank you very much.

Thank you very much, Dwane - I appreciate it! Cheers, Steve August.

Please what is his name of Facebook

What is FB name?i need to ask as well something

Hi Holly. Thanks very much. Yes, it does make sense! And it's supported by the medical research, which the suppress-the-"mysterious-inflammation" approach isn't. Have a good look over the Costochondritis page on the Backpod's website www.bodystance.co.nz/en/costochondritis/ Good luck with the work. Cheers, Steve August.

how are u doing today? :) hope you feel better, im dealing with this right now :/

Hi Karen. I remember your name - I think we corresponded years ago. Well done! I'm very pleased the Backpod solved your costo problem. What I've been trying to get across is that costo is actually not a difficult problem - once you simply understand what it is. Most people including docs don't, even though it's there in the medical research. So you get all this doom and gloom about costo not being fixed - simply because it's not treated correctly. It is a mad situation. Very nice to hear from you. Merry Christmas, and a Happy New Year.

Hi Katie. Thanks, and well done on thinking for yourself. The shortness of breath is easy to understand. Costochondritis is essentially strain and pain at the joints where your ribs hinge onto your breastbone, caused by immobility of the rib joints round the back under your shoulder blade. (That’s why you get a lesser pain and tightness round the back there as well.) When these rib joints round the back can’t move, then the more delicate rib joints on your breastbone MUST move excessively, every breath you take. So they strain, ‘give’ (usually with clicking and popping and often with sharp, scary, stabbing pain), get irritated and locally inflamed - and there’s your costochondritis. It is NOT a “mysterious inflammation” arriving out of a clear blue sky for no reason. So treating it like it is does NOT fix it. You’ve found that out. It's actually more like having the hand brake in the car jammed on - nothing's wrong with the vehicle, it's just that one piece of seized machinery that's the problem. The tight rib machinery round the back that causes the rib joints on your breastbone to strain, also means you can't take a full breath in - it's like wearing a tight corset. So that makes you breathe high and fast, and often that hyperventilation pushes you towards panic attacks, and certainly anxiety. It's all classic costo. The frozen rib joint movement, where the ribs hinge onto your spine, cannot show on X-rays, CAT or MRI scans, because these are all essentially still photos, and simply can't show whether the rib and spinal joints can move fine, or are frozen solid and completely immobile. I have to say that though this explanation is simple and logical and demonstrable, in my experience docs - including respiratory specialists - just do not think of it. They're concentrating on the lungs and missing this simple consideration of rib cage expansion. Stick with the Backpod - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Keep us updated!! Hope you're feeling better.

How are you feeling now?

Hi Jason. Well done on thinking for yourself. Stick with it - it’s very tough stuff you’re stretching and it takes time. READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

How are you ?

@ludstertv has that worked for you?

Well done on thinking for yourself. It is completely nuts. All I'm doing is passing on my bog standard New Zealand manual physio understanding of costo and how to fix it. This is also what the published medical research shows. The "mysterious inflammation" idea is NOT supported by the research, and is simply wrong. So, of course treating it with anti-inflammatory and other meds doesn't fix it. Get a Backpod and start using it - you'll need that after three years of the rib machinery round the back being frozen solid. Stick with it - it’s very tough stuff you’re stretching and it takes time. READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

What did u do to fix it may I ask??

@@stevewilliams7659 used the backpod in line with the instructions in the box and did all the exercises in Steve's other videos

Thank you, Thomas. How are you using the Backpod for deep fascial release? I keep finding applications for it I never thought of.

Hi Damian. Well done on thinking for yourself, deciding I might make sense, and doing the things needed to fix yourself. So, things are getting stronger and freer. All good. Now you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. For you still to be getting sore, even though you're stronger and freer, you might need some extra bits dealt to as well. (1) Shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. (2) As well, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. (3) You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html (4) Lastly, and you may or may not need this, but you certainly could after four years with costo. What you can get with costo and especially Tietze’s is swelling where the ribs join onto your breastbone. (Tietze's is just costo with enough swelling of the joints where the ribs join onto your breastbone to be noticeable.) All it is is intracellular fluid - same sort of fresh fluid swelling that happens if you sprain your ankle. As with a sprained ankle, after a week the fluid selling sets hard. This is just normal inflammatory response to strained joints - there’s no auto-immune component. It’s a normal repair process, with fibrin in the fluid acting as a slow setting glue to hold everything together while the torn fibres and cells are repairing. With costo and Tietze’s, the irritation and strain can continue for months or years, so you get a rock-like build-up of this stuff, often with a bit of fresh swelling on top if the mechanical strain is still happening. It’s a bit like running with tight boots causing a blister and NEVER STOPPING for years. (As the costosternal joints never get a rest as long as you breathe.) So you've still got some hardened swelling there where the ribs join onto the breastbone. It doesn’t just interfere with the normal free glide of the rib hinges, it also binds down the free nerve endings and receptors, tethering them and making them hypersensitive. Break it down. This is like working hard putty or play dough until it becomes malleable. You can do this yourself. Use something to let your fingers slide. Massage wax is better than oil - oil dribbles. Better again is something that will also reduce the irritation of working adhesive fibrosis around, so Voltaren (diclofenac) gel or CBD cream like Penetrex. Penetrex seems to work better. Spend about 10-15 minutes every three days working your fingers through the hardened bits in all directions. Start gently - it’ll get easier as you continue. It will be tender and maybe sore - gets easier as it frees up. The first time is the worst. Just do what it feels like it can handle, and expect to feel it tender, especially to touch, afterwards. It takes time - probably a few or several weeks. But it’s easy enough to do. It’s the main answer to this specific bit of the problem. Try all that. You've done a really good job on most of the problem - I'd be hopeful these will cover the remaining components. If not, please get back to me. Cheers, Steve August.

Well done on thinking for yourself and not giving up. Going to the ER is always the right thing to do when you start to get chest pain. The docs re very good at checking out the heart, lungs and other dire possibilities. They're just (usually) not good on costo - because it's essentially a hands-on physiotherapy type problem, not a medical one responsive to a medication and suppress-the-inflammation approach. Have a look at the Costochondritis page on the Backpod's website www.bodystance.co.nz/en/costochondritis/ That has more specific details of how we'd fix it - which isn't usually difficult. Good luck with the work. Cheers, Steve August.

@@stevenzphysio4203 I actually ordered the back pod right after I watched the videos. :) A doctor diagnosed me with costo in my 20's and it eventually went away. Now 25 years later it's back. Thank you again for the information. I really appreciate it and can't wait to try the back pod!!

Thanks, Anthony. Well done on thinking for yourself, deciding I might know what I'm talking about, getting a Backpod and making it work. It is scary stuff - I've had it myself. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. As well, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. There'll be muscle tightness overlying the joint tightness as well. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Cheers, Steve August.

Hey Anthony, how are you feeling 5 months out?

@@kailuamazon_3523 Hi. Firstly I can now use the backpod without any pillows and it is actually quite comfortable. Any time I get a bit of chest or side rib discomfort, It helps click things back. Secondly, My Bowen consultant pointed out that the nerve feelings were being mostly exacerbated by TMJ, manifested by a slight Jaw tingling. This was fixed in a week by biting on strategically placed lollipop-type sticks. My consultant has bought a backpod after I recommended it and is a huge fan. He has advised some of his clients to buy them for their back issues. It is hardly known about in the UK .

how are u doing today? :) hope you feel better, im dealing with this right now :/

@@gerdwinter2902 A lot better thanks. I still use the backpod most days as it clicks the upper back into shape.

Thank you, Catherine! If you haven't come across them, here are some further suggestions on getting the most out of the Backpod for costo, plus the other common bits that costo can need. Thanks for the approval! We are trying! Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi. Good - that's all completely consistent, and it's getting better. For anyone else reading this I'd like to point out that gernader8's costochondritis is not, repeat not, repeat NOT an inflammation. The PT manipulation which freed up the rib and spinal joints gave near instant relief. You CANNOT get that if costochondritis is a "mysterious inflammation". You DO get that, all the time, if the joints are frozen and you bang them free with manipulation. Sigh. Okay, stick with it and keep using the Backpod. You'll be tightest at your left rib joints 3 and/or 4. The PTs should do a sitting knee-in-the-back manipulation here, to definitively unlock the hinges. Then use the Backpod lots to stretch free the tight material around the joints so they'll stay free. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, and hopefully the PTs are already doing this, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. As well, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so I'm sure the PTs have got you stretching them as well. There’s also a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Hang in there. If you haven't already, have a look at my Part (2) How to fix most costo KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html There's a home twist stretch for costo somewhere about 10.15 minutes in that I find the best for freeing up the rib joints. You may need to free up those tightest rib joints first, though. Incidentally, your doc is wrong about costo just "going away". One bit of published medical research (Disla et al) states that 55% of the costo patients they studies still had costo after a year, ongoing. I did a survey of 100 costo patients on patient.com, and the average time they'd had their costo was 2.2 years SO FAR, ranging from a few days to 35 years plus. They still all had it. Cheers, Steve August.

Hi. Yes, the disconnect between what the research actually says, and the popular medical and medical site view of costo - is pretty mad! I feel like the little kid pointing out the emperor actually has no clothes on. Re further research, we put in a proposal yesterday in Otago University in New Zealand for a preliminary study on costo and how we treat it; RCT to follow. To be honest, one reason it's never been done before in NZ is just that in my area of experienced manual physio, it was never seen as a question or a problem - we just fixed it and never thought twice about it; as I fixed my own costo over 30 years ago. It's easier than the average low back or neck problem. Good luck with the work on your own costo. I assume you've seen my Part (2) video on How to treat most Costo and Tietze's. Cheers, Steve August (B.A.,Dip.Physio.).

Thanks, Miranda. Well done on thinking for yourself. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please carefully READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

How is your pain

😊

Hi Janet. Thank you very much. Well done on doing the work. Actually, it's important - have a look at the Perfect Posture page on the Backpod's website - www.bodystance.co.nz/en/perfect-posture/ When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. As well, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Well done! Cheers, Steve August.

Janet Coker is it disappeared now Mrs Coker?

Mirind A I am still using the back pod once or twice a day. My upper back pain has improved greatly.

Janet Coker ordered mine coming tomorrow. I’m hoping to god it cures me in 1 month

Mirind A best of luck. I hope it helps you too. It has really helped me but I know everyone’s different. Take it slow and follow the directions. I started on three pillows and I am still down to one now after weeks of use but I didn’t want to rush it and hurt myself.

Thank you. I'm trying to find time for a video specifically for ED doctors, cardiologists, rheumatologists, pain clinics and docs generally. I've been giving lectures to these groups in New Zealand, and the response has been quite amazingly enthusiastic. Essentially, there's a simple underlying mechanism which explains costo, Tietze's, precordial catch, slipping ribs and xiphoid process pain. This mechanism is well understood in my own area of New Zealand manual physiotherapy. But worldwide the medical view is skewed away from this understanding simply by the '-itis' ending of the term most commonly used, which implies it's an inflammation, therefore treatable by the usual anti-inflammatory approach. I suspect this would have to come from someone like me in New Zealand or Australia. It's a communication issue, and we're more egalitarian inside medicine over here. I've been very cheered at how receptive everyone's been, especially the ED docs who are swamped with this stuff daily. They're not nitpicking academics - they want practical stuff that works, and that's what we've got in my area. The supporting research is already there - it's just a matter of getting it known. Cheers, Steve August.

Yassssssss

I am suffering with this pain as well. Can we talk on an email to discuss our symptoms, so that we can help each other to cure this pain.

@@colinprr I am fighting up with the pain for the past 6 years. Did heart test, endoscopy, cervical MRI, chiropractor, physiotherapist, psycatrist, and neurologist but didn't help. Now I am advised for shoulder and Thoracic MRI. They never checked for my lungs.

@@colinprr glad to see you found a solution Can you please share the KZfaq links of exercises? Thanks alot

@@samwd5039 here you go. kzfaq.info/get/bejne/a96mpZaD1rrLkqs.html Follow these exercises, specially the one where keeps the hand on the monitor and strech. That exercise made my chest cartilage bone sound which made it go back to its place.

Hi Roseanna. Thanks - it really is logical and evidence supported; the "mysterious inflammation" idea isn't. For practical treatment, I'd suggest you thoroughly read the costo page of the Backpod’s website, including watching the costo videos linked from it - www.bodystance.co.nz/en/costochondritis/ Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Hi Steve, thank you very much for answering! I have consulted my doctor and she finds it to be Tietze's syndrom - affirming my suspicion after having read about symptoms and - luckily! - finding your video. I have now ordered the BackPod and will let you know how it goes. Thanks again!

@@rosannatindbk7511 Hi Rosanna. Well done on the doctor agreeing, you thinking for yourself, deciding I might know what I’m talking about, and getting a Backpod. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Hi Steve. For some reason my answer is not shown here - I wrote two longer ones to you including some questions... Maybe it's youtube deleting it?

@@rosannatindbk7511 Hi Rosanna. That's irritating. I think it's a glitch. I have noticed that comments occasionally disappear off KZfaq, for no reason I've ever been able to work out. You're welcome to try again, or email me at the contact email address on the Backpod's New Zealand website www.backpod.co.nz Cheers, Steve August.

I want to add that, besides those PT exercises, I have not worked out in nearly year thinking I may make the condition worse.

@@trentwhalin9422 Hi Trent. Well done on thinking for yourself. Yes, working out would have made your costo worse. You can't train through costo - it's different from a muscle strain, say. The reason is that any general exercise or stretch just strains further the already strained rib joints on your breastbone, way before you get a benefit to the tight rib machinery around the back. There are KZfaq videos around saying you can fix costo just by exercises - they don't understand the problem. What works is first stopping anything that hurts. Every time it hurts you're simply straining more the already strained rib joints on your breastbone. It's like running on an acutely sprained ankle - it's going to make it worse not better. What you have to do is free up the frozen rib machinery around the back, which is causing the rib joint strain and pain at the front, FIRST. We use the Backpod for that - to stretch free the tight and immobile rib and spinal joints. It usually takes only about three weeks - the same sort of time as stretching hamstrings that are so tight you can't reach your knees, until you can touch your toes. Of course this varies, but you usually have a clear, obvious improvement in the first week to let you know you're on the path. Stick with it - it’s very tough stuff you’re stretching and it takes time. READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but it sounds like it applies. The commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 is it normal to have a little soreness around the costo the next day after using the backpod? Also, my Costco has tended to be felt either in certain positions (really slouching or stretching upward) and movements that engage my chest/rib cage, where you feel either the sternum being pressed in or pulled apart. Is that normal for Costco?

@@trentwhalin9422 Hi Trent. Yep, all normal with costo. You are starting to stretch free rib and spinal joints round the back that may not have moved for months or years. Sure, you can get some treatment tenderness from them for the first few days - just like you would on starting to stretch a really tight hamstring, say. It's normal and not a biggie. It's up to you to use the Backpod correctly so it doesn't hurt. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 32-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. What also helps is massage for the tight muscles overlying the tight rib machinery around the back. If possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go really hard between your shoulder blades especially. Secondly, as the rib machinery starts to free up, you'll automatically sit straighter. This can pull on the also tight and scarred pec muscles on your chest. The rib joints on your breastbone are really irritable anyway, so they can get a bit sorer too. Again, this isn't a biggie, or a reason to stop. Stretch the pecs as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Hang in there. It takes time to stretch the tight stuff, and it can protest, usually just in the first week. You probably will need the extra bits i suggested in my earlier reply. Cheers, Steve August.

@One With Nature basically. Took some time. I mean months. I slowly figured out I needed other things too like stretching my pec minor, scalenes and thoracic mobility in addition to posture. The backpod is invaluable but for me was only one part of it.

Hi. Sounds like you have costo sitting on top of the iHunch. This is really common - there's a lot of costochondritis happening these days because of hunching over computers, especially laptops, tablets and smartphones. As well as the spine getting hunched and then freezing like that, the rib joints at the back also tighten up. When they get tight enough to freeze, the more delicate rib hinges on the breastbone then have to move more just to let you breathe. So they strain, get irritated, then inflamed - and there's your costo. There's a good Wikipedia article on the iHunch - you are not alone! Also have a look at the Backpod's iHunch page www.bodystance.co.nz/en/ihunch/ It's what we built the Backpod for primarily. Because it's built to stretch the rib hinges at the back, as part of sorting out the iHunch, it also has a specific use in fixing costo. You've probably got the dreaded iHunch, with costo on top. Cheeringly, the Backpod and its home programme are designed for both - they’re both part of the same general tightening hunching problem, and not particularly difficult to understand and sort out. Good luck with the work. Stop exercising until you can lie on the Backpod without needing a pillow under your head to make the stretch milder. You'll hate it. It's still quicker in the long run. The core of the problem is that the rib joints round the back can't move at all, so the joints at the other end of the same ribs where they hinge onto your breastbone HAVE to move excessively - every breath you take. So they strain, 'give', get irritated, get locally inflamed - and welcome to costo. So, this means that any general exercise you do, whether in the gym, yoga, stretches, etc. just further strains the already strained rib joints on your breastbone - way before you get a benefit to the tight rib joints round the back. You can't train through costo, and you can't fix it by training. Anyone who thinks you can doesn't understand it. Sure, general muscle support, especially the muscles around the back, and stretching, etc. are helpful, but only, repeat only, after you've freed up the rib machinery around the back first. That's why we use the Backpod. As far as I can tell, it's the only thing commercially available that will give an effective strong localised stretch to the frozen rib and spinal joints around the back causing the problem - for definite technical reasons which are discussed on the Backpod's website www.bodystance.co.nz/en/backpod/. It really is a very precise problem, with a very accurate answer. Also, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. Might as well go straight into tat now - it'll help lots. As well, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Backstrap posture correctors have their place. We don't like them as physios because they replace the muscles down your back that would normally be keeping you upright, so these get even weaker. Good luck with the work. Cheers, Steve August.

Hi. Yes, it's a beaut, isn't it? Been there myself - that's why I'm doing this. Here's a long wordy PDF on what costochondritis actually is and what we find works best to fix it. It is more easily read on a computer, not a phone. The PDF covers using the Backpod for costo, and also the other bits that often need dealing to as well. Cheeringly, these can nearly all be done by yourself at home. It takes a bit of time and effort, but it's not that difficult. Good luck with the work! www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf

You are so kind to respond. I will read it top to bottom. Thank-you again!!@@stevenzphysio4203

Hi Eric. I'd say you've got a combination of things going on. Your particular strain is at the costochondral junction (CCJ) of your rib(s), where the bony curve of the rib changes to cartilage - technically called 'slipping rib syndrome.'. The usual give and strain happens at the rib joints on the sternum, but they're both essentially the same thing - giving and straining and too much movement at the CCJ or sternocostal joints, because there's no movement at the rib joints of the same rib(s) where they hinge ono your spine. The slipping rib problem at the CCJ is less common than sternocostal strain (= "costochondritis"), and trickier to sort out, but you treat it the same way. So stick with using the Backpod, and especially on your worst bit to the left of your spine. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, shout yourself a sports massage - preferably two, with a week off in between. When you've had slipping ribs for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. Plus, I'd expect that you're tight and scarred in your abs, especially up where they attach to the bottom of your rib cage. The massage person should have a good look around that area especially. Lastly, from what you tell me, I'd also be suspicious that you've jammed your lower thoracic spine into extension at one or more levels, which can essentially nip the nerves coming out of the spine and running round to your abdomen, so you get pain referred there. You might need to see an osteopath for that as well. I'm not recommending a trad US chiro as they're likely to do the usual thrust manip onto that part of the spine, which would just bang it further into extension, increasing the problem. You can simply trying hanging between parallel bars, or similar, to traction that bit of the spine. Go gently - it may strain the rib bit as well but probably not. Forget it if it does. Sorry, that's the best I can advise over KZfaq. I'd push the Backpod, massage, and cautiously the hanging for a fortnight or so, then at the osteo if needed. Cheers, Steve August.

@@stevenzphysio4203 Thanks for the reply, Steve. Really appreciate it. I have been reading up on slipping rib syndrome and I wanted to clarify the terminology. Most resources I read suggest that slipping rib syndrome occurs on ribs 8-10 (i.e. the false ribs) because of injury to connective ligaments, whereas my pain is on the costochondral junction of rib 7 (the last true rib). Would you, for example, describe pain at the CCJ of rib 4 as slipping rib syndrome or something else? I also do not feel any kind of slipping sensation. I also see some resources describing costochondritis as pain in the CCJs. I have been going to regular sports massages for about a year now, initially for other injuries and lately have been targeting my back, chest and abdomen. After 7 weeks of weekly to bi-weekly massages and daily Backpod I have improved some but am still struggling. My next step is to see an osteopath or someone else that can perform manipulation on the spine and ribs. I think I may need some additional help getting my back moving properly. When you say my lower thoracic spine is jammed into extension, should I avoid using the Backpod on those areas? If so, any joints in particular to avoid? Your suggestion about the nerves being irritated is interesting and may make sense of what I am feeling. Would entrapment or irritation of the anterior cutaneous nerve at T7 tend to produce similar symptoms to mine? My pain appears to reside more in the cartilage than in the muscles, but as I loosen up my rib machinery without symptom relief up front, I start to wonder about other possibilities.

@@ericwendt8985 Hi Eric. I don't think either slipping rib syndrome (= excessive movement at the costochondral junctions) or costochondritis (= excessive movement at the sternocostal joints) are well understood usually, and the very fuzzy terms for them reflect this. Personally, I just think of them as costosternal strain, or CCJ strain - this can happen at any level, especially from impact. Yes, sounds to me you may be thoroughly locked at some of your levels. There's a limit to how accurate I can be over KZfaq. Ideally, you find a good osteopath who can accurately check out exactly what's there, and bang free specifically the bits that are too tight for even the Backpod to stretch free. But I'd still do more on the Backpod as I suggested to get as much as you can out of the tightest bits. I'd go as low with the Backpod on the rib joints as needed - if you're sore at a particular CCJ then you do need that rib joint on the spine freed up. You can get both - mecahnical strain at the CCJ, plus nerve root irritation adding in referred pain in the same area. But we know there's still mechanical restriction because you can't turn fully to your left. I'd say push hard with the Backod, and use your left turning rotation as an indictor of how it's freeing up.

@@stevenzphysio4203 Thanks for the clarification. Perhaps I am understating my improvement over the last 2 months because I used to need to wear flector anti-inflammatory patches all day to be able to function how am I now with no drugs. You have mentioned dips and other heavy chest exercises as tending to aggravate costosternal joint strains, I was wondering if there are any exercises or movements that would be worst for my condition in the lower CCJs. I generally avoid anything that requires strong activation or extension of my upper abs (won't be doing those damn dragonflies any time soon) and anything that tends to tighten up my back. Do you have any recommendations for how to ease back into a strengthening routine?

@@ericwendt8985 Hi Eric. Generally you're wanting to build muscle cautiously, without straining the hypermobile CCJs too much while it's happening. I can't do that well over KZfaq. Best to talk to the gym people. As a start, I find the cross trainer / elliptical machines are good. You're upright, lots of cardiovascular workout, plus it's a rather good easy rotational workout for the whole rib cage. Best is to start way back at about 15 minutes and do it only daily, and increase about 5 minutes each time. Anything gung ho on those strained CCJs is just going to be like running too much on a sprained ankle. It's injured, and it's not going to just disappear because you want it to. You do have to build back slowly into what it can handle. The tight rib joints around the back are still freeing up. It'll take more time yet.

My whole left side looks like is swollen.

Hey man hang in there with this. My pain is on the left side and have been to the ER 3 times in the past year because I thought it was my heart. I’m a personal trainer and have always been in god shape. Turns out to be Costo, it’s very very painful and consistent but it can go away! I’m not a doctor but his back pod is legit I’d you use it as suggested and take time to put the work in, you can get back to a pain free life

Hi Li. You're definitely not alone. Coughing is a classic trigger of costochondritis - from pneumonia, the flu, just a bad cold - and now COVID-19. It is not, repeat not, the infection itself that brings on the costo, but the coughing. I'm reasonably swamped with queries from people who've had COVID-19 which has left ongoing costochondritis in its wake. Coughing is a surprisingly strong percussive impact on the whole rib cage. I’ve seen cracked ribs from it, and not just in little old ladies. If the rib cage joints around the back are frozen solid and can’t move a little to absorb that shock, then the whole jolt hits the more delicate rib joints on your breastbone. So they strain and give - with every cough. It’s a lot like repeatedly hitting a sprained ankle with a hammer. And welcome to costochondritis. It’s NOT a “mysterious inflammation” appearing for no reason. The costo can stay even after the infection that caused the coughing has settled. The immobile rib joints at the back stay frozen, so the badly strained rib joints on your breastbone just continue straining, with every breath you take. This will usually get missed, by doctors and patients seeing it in terms of a lingering COVID-19 infection, which it isn’t. So there’s an expectation it’ll just settle down, as the infection has. Statistically, most of it doesn’t. It seems that you only start off costo this way if the rib cage machinery around your back is tight before the coughing starts. Unfortunately that’s really common anyway. So many people now have the iHunch from much bending over laptops, tablets and smartphones - see www.bodystance.co.nz/en/ihunch/ The rib joints round the back get tight along with the spinal joints, and that sets you up for straining the rib joints at the front if you start coughing. We fix it, logically enough, by freeing up the tight rib machinery around the back. See the Costochondritis page on the Backpod’s website - www.bodystance.co.nz/en/costochondritis/ There's a home test there which should show the rib cage restriction I'm talking about. And also how we fix that. Cheers, Steve August.

Hi Pedro. Good - well done on thinking for yourself. Stop the chiro now - if they're any good they'll have unlocked any joints that were tight enough to need it. Stick with the Backpod - it’s very tough stuff you’re stretching and it takes time. READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Thank you so much Steve you have clarified the issue I have suffered with for 6 years. Now I have a way forward thank goodness!!!. Thank you from a fellow kiwi in Taupo 💕 Greatest appreciation for all the work you are doing. I hope you get rewarded in so many ways! Warmly, Nicole

@@Stress-relief-insights Thank you, Nicole. Have a thorough look over the Backpod's Costochondritis page for how we fix it - link is www.bodystance.co.nz/en/costochondritis/ Just email me if you'd like me to talk you through it. Cheers, Steve August.

I have pain in my entire rib cage. I have these bumps on the front and side of rib cage. Before all this happened I was told I had costchondritis. Any remarks from you about this whole rib cage pain would help. Touching them is next to impossible. Doctors just dont know what to tell me. I pray I hear from you.

@@stevenzphysio4203 you are amazing Steven a life saver. This is my last hope I am so excited to get this fixed

How long were you using the back pod before you saw an improvement? I have been using it for about a week and it just feels more sore after I use it so far…

@@MaryC33333 it took about 3 weeks of daily use. It does get a bit more sore once you start and pain may develop in other parts of the rib cage, but the pain will subside, relax into it and take deep breaths. Make sure you use it everyday and don't stop. Make sure you don't over exert yourself during the day, refrain from lifting or strenuous activity, your rib cage needs to heal

@@stevesmith7239 thank you for the response Steve, I’m getting very impatient with this condition! 😅

@@MaryC33333 hello, so have you gotten any better?

Hi Bernie. Mm - if you mean you now have less than 45˚ thoracic rotation then that certainly sounds like what I've been describing. Normal total thoracic rotation in sitting would be towards 90˚ usually, with your shoulders getting towards parallel with your thighs. So if you're only half of normal, then some and perhaps most of your thoracic and/or posterior rib joints just aren't moving. There's a description of how to test for this at home on the Costochondritis page of the Backpod's website - www.bodystance.co.nz/en/costochondritis/ You can see if that's a fit with what you've got. Cheers, Steve August.

Hi. I do sympathise. Costo is pretty common after car accidents. If you were restrained by a seat belt, or hit the air bag in front, that can essentially strain the rib joints round the back - it's not just the front impact. Front damage usually heals, but the badly jolted rib joints where your ribs join onto your spine can freeze and stay frozen. That's the likely reason you've been in pain for three years. If you're getting US trad chiro manips every week, and if the chiro's doing that body slam onto the patient with his fist in your back technique, then be aware that it's badly spraining the already strained rib joints on your breastbone every time it's done. That's every time. We think it's a completely nut so approach to costo. Watch my KZfaq video 'How to fix most costo and Tietze's Part (2). I hope that helps and makes sense of it for you, and good luck with the work needed. Cheers, Steve August.

Steve NZ Physio you’re amazing. Thank you SO much for you insight. I’ll be buying the backpod.

Steve NZ Physio I’ve been using the backpod and it’s helped some to where I haven’t had an episode where I’ve felt I’ve needed to go to the ER but I’m still in pain. Is that Chiropractor move where he twists and body slams you okay in conjunction with the Backpod or is just using the gun-type thing that pushes your ribs in from the side okay?

@@idontknowwhattoput1264 Good, pleased the Backpod's helped. It should do. That's why you're better. Re chiropractors - the good ones are very good, but I don't have a high opinion of the US ones for treating costo generally. (1) They usually use the standard body-slam-onto-the-patient-with-their-fist-in-your-back technique. This is simply a dumb choice with costo, because it just squashes and strains further the already strained rib joints on your breastbone. Every time. (2) In my experience, they have a bias towards manipulating the spinal joints and (often) missing the rib joints - and freeing these up is the irreducible core of fixing most costo. (3) All manipulation does is bang a tight hinge free. It doesn't put anything at all "back in" - that's just a nonsense phrase meaning nothing. I’m speaking as a New Zealand physio - I’ve used manipulation myself for over 30 years. It cannot in a split second stretch out the very tough collagen of the ligaments and joint capsule surrounding the joint which will have stiffened down around the immobile joint. So this just freezes the hinge up again rapidly. That's why we developed the Backpod - to stretch out the collagen so the joints can stay free and you get a lasting improvement. We think the chiro approach of continually banging the same bits free is silly and expensive. Steve August.

Hello Muhammed. Yep, that's costo. You were already tight on your rib cage movement. Then when you lifted the dumbell that put a lot of load on all your rib cage joints. The ones round the back were too tight to move to take that load a bit, so the more delicate rib joints where your ribs hinge onto your breastbone gave instead - it's a lot like spraining your ankle. It hurts! It hasn't settled down in two years because the rib machinery round the back is still frozen, so the rib joints round your front are still moving excessively to compensate - every breath you take. Any treatment, including the medical ones, which doesn't deal to the frozen rib joints around the back which are driving the strain and pain at the front is just missing the point and won't fix the problem. You've found that out. Well done on thinking for yourself, deciding I might know what i’m talking about, and getting a Backpod. It's the single best tool for quietly stretching the tight posterior rib joints. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Thank you for replying Sir Steve. I will surely follow the advice you've given. Just one more thing, about 3 weeks (start of 20202) before this injury occured i found out that i was able to crack my sternum ( audible satisfying painfree pops of the costosternal junctions) holding onto the chair or bench on which i was seated and leaning back while firmly holding the base of the chair or bench. And since i used to crack my back i also started cracking my sternum. Do you think this could've contributed to my initial injury of the sternum? I was very active at the time of my injury and before the injury felt no kind of tightness of the ribs, sternum and back. I was active and agile.

@@muhammedahmed9555 Hello Muhammed. You were still tight in the rib cage joints. When a joint is moving perfectly, it'll just slide silently to full range. It won't crack. You get that when the joint's getting tight - like a rusty hinge. My own costosternal joints used to crack when i had my own costo - it's one of the indicators. They don't since I freed up the frozen rib joints around the back and fixed the costo - they just slide silently. They don't hurt either.

@@stevenzphysio4203 Okay. Thank you Sir Steve for clarifying. I feel so relieved and optimistic now. The back pod will come soon. Super excited for it. After reading all the feedback u've received on KZfaq im so hopeful for my recuperation. Hats off to you Sir. Wish you all the best in your endeavors.

Well, that's horrible. Much longer than my own seven years of it, before fixing it. Yet another example that costo doesn't just "settle down soon" - statistically most of it lasts at least a year, and can just be ongoing. Until you fix it. Here's a long wordy PDF on what costochondritis actually is and what we find works best to fix it. It is more easily read on a computer, not a phone. The PDF covers using the Backpod for costo, and also the other bits that often need dealing to as well. After 45 years, you are likely to need most of these as well. Cheeringly, these can nearly all be done by yourself at home. It takes a bit of time and effort, but it's not that difficult. Good luck with the work! www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf

Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Could you somehow dear sir show what you did thru videos or something. Its very hard to have this and not understood by everyone thinking its just panic attack.

Could you somehow dear sir show what you did thru videos or something. Its very hard to have this and not understood by everyone thinking its just panic attack.

Could you somehow dear sir show what you did thru videos or something. Its very hard to have this and not understood by everyone thinking its just panic attack.

May I asked do yo had any swelling on your chest either side as in my case I have swelling on upper left side ? Please advise as I’m thinking to order backpod .

@@ahsanrajput7518 I had like a knot or tie on my upper left side with pain every time I want to get some things from the floor or even tried to squeeze my swimming shorts ;at first it was very bad pain that goes to the back

Hi Adam. Good. Well done on thinking for yourself. Good luck with the chiro - they do vary. The good ones are very good, and you certainly sound tight enough that unlocking the rib and spinal joints is going to help. But watch out for (1) the usual body-slam-onto-the-patient-with-the-chiro's-fist-in-your-back manipulation technique. This will further strain the already strained rib joints on your breastbone. Also, (2), they do have a bias towards just manipulating the spinal joints and missing the rib ones, and these are the crucial ones with costo. I'm just saying. You can pass on those comments from me and note whether your chiro listens to them or not. Good luck. Stick with it. It's clearly what I've been describing, therefore the way out is to free up the rib machinery around the back. Cheers, Steve August.

Hi. If you stretch anything tight in the body too much in one go - it'll get sore. It's not a biggie. All we're trying to do is get people to start off gently, at least for the first week or so. Talk someone into doing this home massage on you. Get them to go hard down between your shoulder blades. That'll ease up the tight muscle overlying the tight joints, and also immediately make using the Backpod easier. You may ned other things for the costo. Here's a long wordy PDF on what costochondritis actually is and what we find works best to fix it. It is more easily read on a computer, not a phone. The PDF covers using the Backpod for costo, and also the other bits that often need dealing to as well. Cheeringly, these can nearly all be done by yourself at home. It takes a bit of time and effort, but it's not that difficult. Good luck with the work! www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf Re the orphenadrine - can't really say if it'll help. But it's not going to fix your costo - it's just not that sort of a problem. It's a muscle relaxant - but costo is primarily a rib joint problem, not a muscle one.

Thanks, Jenny. Yes, it really does. I feel very much like the small boy pointing out the emperor has no clothes on.. Have a look at the Costochondritis page of the Backpod's website for some more practical info on what you're likely to need - www.bodystance.co.nz/en/costochondritis/ Cheers, Steve August.

Hi Jacob. Well done on thinking for yourself, deciding I might know what I’m talking about, and getting a Backpod. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Thanks for the response. :) It’s been about two weeks now of using the backpod and those tight painful spots between my shoulder blades and spine no longer hurt when laying on the backpod! :) I’m actually now using a lacrosse ball on a thick mat in combination with the backpod to REALLY get in there and loosen things up even more which has made me feel even better. And yes, my costochondrosis was VERY likely caused by years of poor posture and sitting on computers/iPads/etc. I am doing the stretches for costo you recommended in another video as well as the neck stretch and neck strengthening exercises in the booklet. I’ve also started intermittent fasting (with a healthy diet + a variety of supplements) in order to get to a healthier weight and an also hour of walking total per day. My only real problem is that I’ve been getting pain in my neck and some slight nerve discomfort throughout my body occasionally, mostly in my arms (which I’ve actually had happen for a while, so the exercises likely aren’t causing it) it gets worse when I accidentally sit with poor posture for a while. I’m hoping that with time that this will resolve itself once my posture starts to improve. I actually felt great (less nerve discomfort, almost none actually) until I accidentally turned my neck abruptly and awkwardly while adjusting a pillow, which caused the nerve discomfort/pain to come back. Do you have any advice for neck pain or anything that I could do on top of what Im already doing? Ive also been doing chin tucks and the stretch where you put a towel around the base of your neck and lean back with good posture as recommended by bob and brad. Thanks again for sharing this information about costochondritis with the world, I really think MANY people could benefit from knowing this information. I only wish I had realized it sooner. But at least now I’m on track for improving my life and feeling better.

@@jacobkoch8322 Hi Jacob. Well done - you're obviously working seriously to get everything sorted out. Necks are really a bit tricky to diagnose and recommend over youTube - the thoracic spine and rib cage are much less complex. Sounds like you're pulling yourself back after a long time getting really tight and a bit hunched. It's very common. I'd follow all the bits in my earlier reply - you will need the massages also. The walking is excellent. As the costo gets better, concentrate on swinging your arms and breathing in deeply down towards your stomach - it's a good gentle mobilisation for the rib cage as well as good cardiovascular work. Do the pec stretches - it's likely you're just a bit tight through the shoulder and arm muscles that the nerves run through. Ideally, do and see a good massage therapist and get them to work all round the chest, shoulder girdle and the muscles down the arms. That’ll loosen the muscles the nerves are running through. As well, you can start stretching the nerves and muscles gently. Lie on your back on a table, knees bent up, with your left shoulder just off the edge of the table. Hold your palm upwards, then bend your hand and fingers back, then drop the straight arm gently down towards the floor (arm out at 90˚ to your body) until you feel a good stretch and even some tingling down the arm. That’s stretching it all. Hold for several seconds, then lift up the arm to take the stretch off, then do again, several times gently. It’s just a stretch. It’ll all disappear when things are loose enough. That you have the sensations down the arms at all does tell me you were pretty tight to begin with. It’ll stretch (and massage) out fine.

Thanks, Norbert, and well done. Actually if you're back doing dips okay, then you've done a really thorough job - those things cause more costo to trigger than anything else in the gym. So it is important to keep the rib machinery around the back really free, because it's a big load on the whole rib cage. I reckon it's best to do a Backpod session every day you're doing dips, and preferably before you do them. Just to keep things all free, you can get some more oomph out of the Backpod by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Cheers, Steve August.

@@stevenzphysio4203 Thank You! I'll make sure to experiment with your additional tips as well. I read the study you mentioned, where the doctors focused on manual therapy with the participants, and it says that the latissimus was tight many times. In your opinion is it just a coincidence or could be connected to costo? I ask because it could be just that these people were tight in the back unrelated to the condition, on the other hand, the lat cover a huge surface of the back.

Hi Norbert. It's not a coincidence. I talk about the frozen spinal and rib joint movement around the back as being the specific driving cause of the costo strain and pain at the front - which it is. But if the hinges hav been tight or not moving for months or years, the all the muscle (including the last) around, between and overlying those hinges will also get tight and scarred - it's all the same patch of frozen rib machinery; can't separate out the specific bits in isolation on the real patient. Well done on going back to the original papers! I wish the popular medical sites on costo had done that! Cheers, Steve August.

Norbert Marko how long did it take for you to begin exercising and lifting again ? Godspeed

Hi. It's obviously what I've been describing, because you got very good very quickly on the Backpod plus osteopath, etc. Also, all the medical tests were clear, and the docs are very good at those. (They're just not good on costo, usually.) You had costo for a year. So that means for at least that time, the rib machinery around your back was tight and frozen. It freed up nicely on the Backpod and osteopath / chiro manips. But - you cannot stretch out fully the very tough collagen of your ligaments, joint capsules, fascia, etc. in just a couple of weeks. Technically it takes six months (though you get way most of it in the first couple of months). So, it's tightened up again. It's not back to Square One. Firstly, talk, bargain or bribe someone into doing this home massage on you - it should help a lot. kzfaq.info/get/bejne/b8t8iLSJlZmtn3k.html Also, you're better seeing your doctor. You are getting whole right-side-of-chest pain now. Nothing says you can't have something else going on as well, unfortunately. I don't know your age or whether there's any chance of osteoporosis. You have been seeing both a chiro and osteopath, and I don't know what they've been doing. If they've been doing that body-slam-onto-the-patient-with-their-fist-in-your-back manipulation technique, that does strain the already strained rib joints on your breastbone further, every time it's used. There are other techniques that don't. I don't think you can overstretch on the Backpod - the floor stops you. However about 4% of thoracic spines are straight and hollowed. The Backpod used in the normal way won't help these - it's covered in the 'Warnings and precautions' section of the full 31-page user guide. I don't think that will be you case, or you wouldn't have got such a good improvement initially. However you could ask your doctor, or chiro or osteo. Here's a long wordy PDF on what costochondritis actually is and what we find works best to fix it. It is more easily read on a computer, not a phone. The PDF covers using the Backpod for costo, and also the other bits that often need dealing to as well. Cheeringly, these can nearly all be done by yourself at home. It takes a bit of time and effort, but it's not that difficult. Good luck with the work! www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf

Hi. Don't get too worried - remember you did get it clear, and it stayed like that over most of the summer of 2019. So it's fixable, even if it's come back recently. It's not back to Square One. Let's just get it clear again, then this time stop it from coming back. There are reasons it's come back. Firstly, you're a dental assistant, so LOTS of bending forward over patients, on top of the usual bending over laptops, tablets and smartphones that almost everyone does these days as well. So what you'll have is costo on top of the iHunch, when the rib joints get tight enough around the back, as part of the spine getting tight and hunched. So that's an ongoing thing, so once we've got everything completely free again this time, you will have to continue with regular use of the Backpod and the other bits of the Backpod's program. It's not a big deal - like putting oil in your car or otherwise the engine would seize. I use my own Backpod now about once every three weeks, for instance. So do do all the bits shown in the user guide or on the iHunch page of the website - stretch, two strengthening exercises, two home massages, and posture as much as you can. Other possible factor as to why it's come back: have you been seeing a chiro regularly? Sorry, but I have become really disillusioned about US chiro treatment of costo. There are of course really good ones, but: (1) They usually use the standard body-slam-onto-the-patient-with-their-fist-in-your-back technique. This is usually a poor choice with costo, because it just squashes and strains further the already strained rib joints on your breastbone. Every time. (2) In my experience, they have a bias towards manipulating the spinal joints and (often) missing the rib joints - and freeing these up is the irreducible core of fixing most costo. (3) All manipulation does is bang a tight hinge free. It doesn't put anything at all "back in" - that's just a nonsense phrase meaning nothing. I’m speaking as a New Zealand physio - I’ve used manipulation myself for over 30 years. It cannot in a split second stretch out the very tough collagen of the ligaments and joint capsule surrounding the joint which will have stiffened down around the immobile joint. So this just freezes the hinge up again rapidly. That's why we developed the Backpod - to stretch out the collagen so the joints can stay free and you get a lasting improvement. We think the chiro approach of continually banging the same bits free is silly and expensive. If you think any of the above apply, then I'd simply stop going to the chiro. You're much better to go to a sports massage therapist. Shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. The pressure on breathing sounds like tight muscles around the rib cage. As well, if you can, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Go back to using the Backpod daily. I'm assuming you no longer need a pillow under your head to use it now. if so, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Yoga is sort of useful generally, but I think you'll get more benefit from what I've just described. When you don't need a pillow under your head on the Backpod (i.e. the joints are all moving pretty well), then start doing the sitting twist exercise I showed 12.54 minutes into the Part (2) How to fix most costo and Tietze's video kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html Try all that, and I think you'll come right fast. Then it's a matter of quietly keeping everything going - doesn't need a lot of effort but will need it 2-3 times a week, for the next six months anyway. Cheers, Steve August.

Steve NZ Physio Awesome thank you for replying. I will do as you instructed & see where that takes me. It’s very comforting to know someone understands what you are going through. I don’t “Look” sick so many people don’t believe me when I’m clutching my chest, frozen in my step, & holding my breath, just hoping that the pain goes away quickly. If I have any questions I will contact you again. Thank you & God bless!

Hello again Steve. It’s been a month since my chest pain Flared up & some weeks since we last discussed the treatment you recommended. Sadly my pain has not gone away even though it has been better than when it started again. Occasionally One out of 2-3 Flare up’s A day will be very horrible & painful but the rest are somewhat tolerable. Anyways I’ve continued the backpod & stretching exercises that you recommended but I started having questions. It’s Normal for the pain to be Worse.. before it gets better right? Bc after using the backpod i sometimes experience flare ups, more so than when I did not use the backpod. Also would you say that a woman’s Menstrual period could cause some flare ups? Sorry to be so frank but I find that when I have my period I experience more pain than when I didn’t have it. So I’m curious if you know if there could be any link between that? Also when I become sick, I experience more flare ups than when I’m not. I had strep throat earlier this month & managed to fight off a Fever but it seems that when I’m sick I also experience more chest pain.. of course I continue the backpod, etc. Just as we discussed last time but I had some questions. I’m praying this goes away soon, I’d like to start the new year being Pain-free & focus on my job without worrying I might fall on my patients.

Hi there, I have the pain in the same area that you do. My pain got a lot better even after a couple days of using backpod, but I still get flare ups here and there. How long did you use backpod for to become completely pain free? Thank you!

It started getting better after 1 use so I persevered. I used it daily for a week. Truthfully, some days I used it twice a day. Once in the morning on a yoga mat on the floor with 2 pillows and once on my bed at night with one pillow. Because I was feeling much better, I changed to 3 times a week for the 2nd week. By the 3rd week, I used it twice and by the 4th week, I didn’t need it! If I had used it daily each week, I might have improved even quicker!! I should be more consistent for maintenance but now I use it only once in a while when I’m feeling a twinge under my left breast or in my back. I swear by the BACKPOD! Seriously my BEST purchase ever for my health!

@@bkfrance2That’s awesome you recovered so fast!🎉🎉🎉

Hi. Yep, the strain at the rib joints on your sternum will settle down after a bit if you do nothing. But that doesn't mean the problem's just gone away. What hasn't changed is that the frozen rib and spinal movement around the back is still completely immobile. So as soon as you twist, lift, strain, spend lots of hours hunched over the computer, etc. those rib joints on the breastbone will just give again. It's not illogical or a mystery. Costochondritis is essentially strain and pain at the joints where your ribs hinge onto your breastbone, caused by immobility of the rib joints round the back under your shoulder blade. (That’s why you get a lesser pain and tightness round the back there as well.) When these rib joints round the back can’t move, then the more delicate rib joints on your breastbone MUST move excessively, every breath you take. So they strain, ‘give’ (usually with clicking and popping and often with sharp, scary, stabbing pain), get irritated and locally inflamed - and there’s your costochondritis. It is NOT a “mysterious inflammation” arriving out of a clear blue sky for no reason. So treating it like it is does NOT fix it. You’ve probably found that out. Put the effort in to understand what’s going on so you can fix your costochondritis yourself. It’s up to you - you are very unlikely to find a doc who can fix it for you. They haven’t so far, right? There is a specific reason for that. Also, no - it usually won’t “just settle down.” That’s just doc reassurance and it’s simply incorrect - the existing research shows most costo lasts for AT LEAST a year. There’s a specific reason for that too. Thoroughly read the costo page of the Backpod’s website, including watching the costo videos linked from it - www.bodystance.co.nz/en/costochondritis/ Understand what’s going on and what actually fixes costo. Our sensible and effective New Zealand manual physiotherapy way to fix costo is based on the actual published medical research. The popular medical explanation of costo as a “mysterious inflammation" is not. Yes, this is nuts. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Steve NZ Physio Thank you so much for taking the time to respond,and the link . Great to know that I can be proactive with this and do something about it .

Hi Marissa. Well done on thinking for yourself. Unfortunately that's a common story. I do sympathise. Okay, if just using a tennis ball between your shoulder blade and the spine gives some relief, then what you've got is the really common bog standard problem of tight rib machinery round the back driving compensatory strain and pain at the rib joints round the front. In that case - sure, it should be fixable. Get a Backpod. It's the single best tool for stretching free tight hunched thoracic spine joints and posterior rib joints. If the problem is a tight nut, then you want a spanner. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades - there'll be a lot of tight, scarred muscle there. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Thank you Steve so much for this detailed response. I did not expect it. I purchased a backpod before reading your response, but when I tried, it was very uncomfortable (rusty hinge ?). I switched back to tennis ball for some relief. Everything you've noted (rusty hinge, hunched back, bending over computers, - iHunch) applied to me. I've tried deep tissue massages and exercises, to strengthen the upper back, it did not solve the problem. I will try the backpod again. When it is safe with COVID-19 I will invest on a more regular sports massage. Thank you!

@@PineNewYorkWorld2024 Hi Marissa. Yes - DO read the full instructions on how to use the Backpod I've referred to. Basically, it's not sore because the Backpod's hard - it's sore because your joints are frozen and can't move. It's just the same as trying to force down to touch your toes with one hit when your hamstrings are so tight you can't reach your knees - it'll hurt. So all you have to do is a bit of gentler stretching daily until you get there. When all the joints are moving freely, then all you feel on the Backpod is a satisfying stretch. That's what your joints used to be like and what you're aiming for again.

That's the mad thing about costochondritis. The existing, already published, peer-reviewed medical research fully supports my New Zealand manual physio view of costochondritis as a straightforward mechanical strain at the rib joints on your breastbone, caused by immobility of the rib rib joints round your back. There is no - repeat no - medical evidence supporting the "mysterious inflammation" idea, and some clear evidence refuting it. I'm involved in costo research with a group of docs and physios here in New Zealand, and I also lecture on it to the docs at various medical conferences here, EDs and physios. So, yes - we're taking it seriously. I can't speak for the rest of the world. Cheers, Steve August.

Well done on thinking for yourself, deciding I might know what I’m talking about, and getting a Backpod. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Thanks for your quick response. Indeed, I've come back in large part to check on things again to make sure I'm doing everything I can, and properly. I'm pretty sure I'm barking up the wrong tree, but why isn't the medical community in New Zealand and/or elsewhere (U. of Jamestown, Fargo) trying motion imaging technology to prove or disprove the theory? I read the Zaruba & Wilson paper and while much of it is 'over my head', it seems like it points in the right direction. (Gosh, I love the internet!) If some common feature of the maladapted rib-collagen-spine junction could be found maybe it could be renamed more appropriately, reliably diagnosed by a simple xray, and treated more effectively. I often say that computers have exponentially sped the rate of learning around the brain through digital manipulation of imaging technology. Why aren't we applying some of this awesome power to the skeleton. Arguably, many of us use the later much more than the former! I also think by the time we figure out how the human brain really works, the computers will have taken over. Ah, but in seriousness, perhaps you could raise this query with some of the physicians you come in contact with. Ask them to bring a Radiologist friend! I suspect those Radiologists are particularly inquisitive types!

@@jibberscrabst1114 Yes, radiologists can see right through you.. There probably is high-tech motion imaging that will show excessive movement at the rib joints on the sternum. Maybe that's the future. Personally, I don't think it's needed. There is already a perfectly clear and consistent set of clinical tests and congruent history indicating costo. It's only confusing and a mystery if you think it's a "mysterious inflammation" - which the existing already published peer-reviewed medical research says it isn't. Sigh. There are plenty of conditions in medicine which are perfectly acceptably diagnosed just by clinical assessment, e.g. a sprained ankle. Except for any suspicion of a fracture, etc. you don't need an X-ray, scan, etc. If it looks like a duck and waddles and quacks, then almost certainly it's a duck. (Nothing's absolutely certain in medicine.) The problem is most busy caring doctors think costo is actually a herring. Their view of it as a "mysterious inflammation" certainly is - a red one.

Hi Martina. Go for it. it's sorest because that's the tightest bit, and needs more on the Backpod. When all the rib and spinal joints are moving fine, then all you get is a satisfying stretch on the Backpod (no pillow). They only hurt when they can't move - just like trying to touch your toes with really tight hamstrings. Stick with it - it’s very tough stuff you’re stretching and it takes time. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. Not until after lockdown, though, unless you're lucky enough to have a massage person in your bubble.. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Cheers, Steve August.

Hi Rafael. Sorry, don't know. I'm just the physio who invented it. There's been a huge run on Backpods worldwide and we've only been able to make new ones in the last weeks as New Zealand eases out of lockdown. So they should be back on most Amazons quite soon - hopefully only days now. I'd keep checking Amzon.com.br Also simply try Amazon.com - maybe they ship to Brazil. Do watch out for rip-off artists out there on Amazon, eBay, etc. who are selling the Backpod for many times our official sellers' price in the hope they'll suck someone into buying it. It's nothing to do with us whatsoever. Don't buy one. It works like this: people spot that a product like the Backpod is in demand. So they copy our guys' ads and put a huge price on. They don't even have a Backpod in stock. Then if someone's desperate enough to buy one from them, they buy one from our guys at their much lower price, and send it to the person who's paid hugely for their one! The record so far is a Backpod on eBay for US$510! Unfortunately it's legal and hard to stop. But don't get sucked in. You're best to go to the Buy page on the Backpod's website and look through the options there - these are all legitimate. Link is www.bodystance.co.nz/buy-now Those are our only official sellers. Just keep checking the link to Amazon.com You could also try emailing Scott Brundell at scott@sprightly.co.nz Scott's business puts the Backpod on Amazon for us. In the meantime, you can use some tightly rolled up socks taped up into a ball about 90mm across. Use that as we'd use the Backpod. The instructions are in the user guide - there's a pdf of it near the bottom of the Costochondritis page on the Backpod's website - www.bodystance.co.nz/en/costochondritis/ That'll start you stretching the tight ribs. Yes, the Backpod is better - it's got much more specific leverage because of its unyielding core, and usually the joints need that oomph. But the socks will start you off okay. Cheers, Steve August (B.A.,Dip.Physio.).

Hi Marcio. I think you should go back to using the Backpod. It's not a magic wand - it's not goiing to disappear all the problems you've got. But what you're describing with the rib pain and things moving on your chest sounds just like the usual rib immobility around the back causing popping and clicking and giving at the other ends of the ribs on your breastbone. That's what the Backpod's the best tool in the world for. But go gently - you can't stretch this stuff out in one hit. It'll just get sore if you try to - it takes time, usually a few weeks or more. It's like having hamstrings so tight that you can't touch your knees. If you try and force down to the floor in one hit then sure it'll hurt. So you don't do that. You just do a bit of stretching daily and you get there in a few weeks. So just follow the instructions, and use enough pillows under your head so that the stretch doesn't actually hurt. It's just a stretch, and after so long, sure you can get some treatment tenderness afterwards for the first few days - that's completely normal as things start to move for the first time in years. It's not a biggie. Also, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. Good luck with the work. Cheers, Steve August.

Please tell me how would you describe the pain: is it more like a pressure or a sharp pain when you twist/bend? Or maybe both? Do you still manage to exercise? I've had this for one and a half years, I'm 30 now. I get both types of pain, but the pressure always scares me, even if I had a cardiology consult. Sometimes the pressure increases after I exercise, sometimes during exercise.

Hi. I don't really think so - not out of nowhere. What's much more likely is that your rib cage has been getting tight anyway. This is really common these days as part of the iHunch from much bending over laptops, tablets and smartphones. When you lie on any bed, you're lying on your rib cage. So if the rib cage joints round the back can't move, the more delicate ones on your breastbone have to. So these can be straining all night long - more on a hard mattress than a soft one. The answer: just free up the rib cage joints round the back. Would normally take only a few weeks on the Backpod. Have a look at the Costochondritis page on the website www.backpod.co.nz. Cheers, Steve August.

Hello Li. Well done on thinking for yourself. I'm pleased the Backpod is helping. Yes, the usual view of doctors is that costochondritis is not common, and will go away with some anti-inflammatories. Both these statements are simply wrong, as the actual medical research shows. Chest pain is the second biggest presentation to EDs (A&E departments) worldwide, and most of it is not the heart or anything else dire, but simply costo. Also, most of it does not just "settle down soon" - that's just reassurance by the docs and is also incorrect. Yes, putting a video on tic tok would be really worthwhile - there are literally millions of people worldwide suffering unnecessarily. I lecture on costo to doctors and physiotherapists in New Zealand. Our sensible and effective New Zealand manual physiotherapy way to fix costo is based on the actual published medical research. The popular medical explanation of costo as a “mysterious inflammation" is not. Yes, this is nuts. I don't think it matters really how you sleep. Sleeping often hurts with costo because you're lying on your rib cage no matter what position you're in. So that pushes on it and it tends to strain and give more at the already strained rib joints on your breastbone. It's like stretching an acutely sprained ankle - it'll hurt! However it'll go when you've freed up the tight rib machinery around the back which is causing the problem in the first place. We use the Backpod for that. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html It sounds like the reason for your costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

​@@stevenzphysio4203 Hello Dr.Steve, do you think going to a chiropractor would help in any kind? I have been working with the backpod for 5 months now, but I do not have much luck with it mainly because that my case is pretty severe and the backpod alone might not be enough to free up my rib hinges. I lie on the backpod every morning and night for about 15 min, and it gives me a temporary relief. However my rib cage tends to jam back together after a duration of 1-2 hours later no matter how good I keep my posture. In terms of massage my mom only knows 1 chiropractor, and before going I would like to hear your opinion about it.

Thank you so much, Diane - I really appreciate it. I did have costo for seven years myself, so I do remember the pain, disability and fear. Since I came through as a manual physiotherapist in New Zealand, with a practical understanding of how you fix the damned thing, and since this understanding is simply not there in most of the rest of the world, it does seem worthwhile putting it out there. Much appreciate your comments. Good luck with the work. Cheers, Steve August.

Hi Dwane. Hang in there - sounds like you're getting there. It does take time to stretch the tight bits. Try staying in one position for 1-3 minutes. You can bounce initially but then just lie - your muscles will relax better that way which means a better stretch on the tight joints. Use the Backpod on the spine and ribs - stay longest in the tightest bits. Just massage your chest every third day. Daily is just too irritable for it, and the nerves there are pretty jumpy anyway. Try using CBD oil or topical anti-inflammatory ointment like Voltaren (diclofenac) which should reduce the soreness. Your muscles will go tight just from reflex spasm triggered by pain. It's a body splinting reflex to protect a damaged part. As well as that, there's a good chance you're simply generally tight on the muscles between and overlying your ribs, including the pecs. Shout yourself a sports massage for the whole rib cage area - preferably two with a week between them. As well, best to stretch your pecs. There's a good pec stretching KZfaq video called something like Third costochondritis stretching video. Stick with it! Does sound like it's loosening up. Cheers, Steve August.

Do you have any kind of chest exercises to recommend?

Hi Meghan. Mm - depends on the chiropractor. The good ones are very good, but I don't have a high opinion of the trad US-trained ones especially for treating costo generally. (1) They usually use the standard body-slam-onto-the-patient-with-their-fist-in-your-back technique. This is simply a dumb choice with costo, because it just squashes and strains further the already strained rib joints on your breastbone. Every time. (2) In my experience, they have a bias towards manipulating the spinal joints and (often) missing the rib joints - and freeing these up is the irreducible core of fixing most costo. (3) All manipulation does is bang a tight hinge free. It doesn't put anything at all "back in" - that's just a nonsense phrase meaning nothing. I’m speaking as a New Zealand physio - I’ve used manipulation myself for over 30 years. It cannot in a split second stretch out the very tough collagen of the ligaments and joint capsule surrounding the joint which will have stiffened down around the immobile joint. So this just freezes the hinge up again rapidly. That's why we developed the Backpod - to stretch out the collagen so the joints can stay free and you get a lasting improvement. We think the chiro approach of continually banging the same bits free is silly and expensive. You've been in pain for seven months, so the joints have been frozen for at least that long, so they're not going to stay free no matter how many times they get banged, unless you actually stretch the tough, tightened collagen around them. Rule of thumb (ho ho) - if you're getting a temporary improvement with chiro (so it is a joint problem) then you should get a permanent freeing up on the Backpod. It’s particularly relevant to costo - the Backpod is the only thing we can find that will actually do an effective stretch on tight rib joints, and this is the crucial thing in fixing costo. My suggestion would be get a Backpod. Just go to the Buy page on the Backpod's website and look through the options there - these are all legitimate and our ONLY official sellers. Link is www.bodystance.co.nz/buy-now I'm pretty sure the BuyBackpod.com site at the top of the list sells to South Africa; if not then just email them. Stick with it - it’s very tough stuff you’re stretching and it takes time. READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi Paul. I'd just get a Backpod, and I'm speaking as a physiotherapist with 30 years of experience. It's a matter of sustained leverage. You've been frozen up on some of your posterior rib joints and machinery for two years. So that means the VERY tough collagen of the ligaments, joint capsules, and fascia surrounding those posterior rib and spinal joints has tightened down around those immobile joints - like a grape turning into a raisin. No PT or physio technique or home or gym exercise can produce the strong, specific, sustained stretch needed to stretch this out again, so the joints can move freely as they used to. General exercises don't have the specificity needed - everything else just moves more, so you don't get the specific leverage needed for the tight bits. No hands-on PT, physio, chiro or osteopath technique does the sustained stretch needed to actually stretch the collagen so it can stay free - like you'd stretch a tight hamstring, for sustained minutes at a time. (Your fingers and thumbs give out if you try!) Manipulation can unlock the specific hinges, but it cannot, repeat cannot, stretch out the surrounding tightened collagen in the same split-second crack - which is why you get that mad chiro cliché of them banging the same hinges free indefinitely; collagen rebound just freezes them up again. We reckon it's daft. Enter the Backpod. It's got the specificity, strength, stability and small size to actually give an effective stretch to those posterior rib joints - that's what it's built for. Stick with it - it’s very tough stuff you’re stretching and it takes time. READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Last bit - here's a carrot. You'll run better when you fix your costo. The tight rib machinery round the back that drives your costo is also stopping you take a full breath in, hence less oxygen to your lungs and muscles. It's like running in a tight corset. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi Abdulaziz. Well, you've had costo for two years. So it's not just going to go away unless you do something to make it go away. Costochondritis is essentially strain and pain at the joints where your ribs hinge onto your breastbone, caused by immobility of the rib joints round the back under your shoulder blade. (That’s why you get a lesser pain and tightness round the back there as well.) When these rib joints round the back can’t move, then the more delicate rib joints on your breastbone MUST move excessively, every breath you take. So they strain, ‘give’ (usually with clicking and popping and often with sharp, scary, stabbing pain), get irritated and locally inflamed - and there’s your costochondritis. It is NOT a “mysterious inflammation” arriving out of a clear blue sky for no reason. So treating it like it is does NOT fix it. You’ve found that out. It's actually more like having the hand brake in the car jammed on - nothing's wrong with the vehicle, it's just that one piece of seized machinery that's the problem. You can't train through costo - it's different from a muscle strain, say. The reason is that any general exercise or stretch just strains further the already strained rib joints on your breastbone, way before you get a benefit to the tight rib machinery around the back. There are KZfaq videos around saying you can fix costo just by exercises - they don't understand the problem. What works is first stopping anything that hurts. Every time it hurts you're simply straining more the already strained rib joints on your breastbone. It's like running on an acutely sprained ankle - it's going to make it worse not better. Contact sports are worse, of course. What you have to do is free up the frozen rib machinery around the back, which is causing the rib joint strain and pain at the front, FIRST. We use the Backpod for that - to stretch free the tight and immobile rib and spinal joints. It usually takes only about three weeks - the same sort of time as stretching hamstrings that are so tight you can't reach your knees, until you can touch your toes. Of course this varies, but you usually have a clear, obvious improvement in the first week to let you know you're on the path. Cheers, Steve August.

Dear Artin, I completely agree. I've been back through pretty much all of the published research and medical letters on costo and Tietze's - there are only several hundred items, and really only a handful of papers with original, pertinent research. It's a bit jaw-dropping! Trying to do something about that. I'm the clinical treatment advisor of an RCT comparing the standard medical suppress-the-inflammation approach to costo treatment with our New Zealand hands-on manual physiotherapy approach. But it takes so much time! In the meantime, I'd suggest you read the costo page of the Backpod’s website, including watching the costo videos linked from it - www.bodystance.co.nz/en/costochondritis/ Our sensible and effective New Zealand manual physiotherapy way to fix costo is based on the actual published medical research. The popular medical explanation of costo as a “mysterious inflammation" is not. Yes, this is nuts. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi Stephanie. Unfortunately that's a common story. We're trying to change it. Well done on thinking for yourself and not giving up. Have a thorough look over www.bodystance.co.nz/en/costochondritis/ That should give you a clear idea of what's needed to fix it. Which is logical and not all that difficult - if you drop that "mysterious inflammation" nonsense. Good luck with the work. Cheers, Steve August.

Hello, Mark. That's good, and thanks - but no he didn't. Your 6th rib was never "out of place" and it's not "back in place" now. That's just a nonsense phrase meaning nothing real. You 6th posterior rib articulation - where your rib hinges onto your spine - was frozen, immobile, couldn't move. So the rib joint at the other end of the same rib - where it hinges onto your breastbone - was moving excessively to compensate, every breath you took and move you made. So it clicked, popped, gave, strained and got painful. That's what costo IS. So you do fix it by freeing up the immobile rib machinery around the back, which takes the strain off the rib joints round the front. You've just had a graphic example of that - and good. Manipulation - from a chiro, osteopath, manipulating physio or doc - CAN do a good fast unlocking of a frozen rib or spinal joint. It's like banging a rusted hinge with a hammer - breaks the rust seal and unlocks the hinge. That's all it does - it doesn't put anything "back in" or "into alignment." But it CANNOT in the same split second crack stretch out the very tough collagen of the ligaments and joint capsule which will have tightened down around the hinge. Collagen is seriously tough - stronger by weight than steel wire. It's what holds your skeleton together - muscles just move it around. So unless you also stretch the tightened collagen around the joint, it'll just freeze the joint up again - often within days. So manipulation is great for a short term unlocking of a joint, but it's not good for a lasting freeing up of the hinge. That's not just my own view as an experienced New Zealand physio - I've used manipulation where appropriate on my patients for over 30 years. It's also what all the research shows. And it's also physiological common sense. We do think the common traditional US chiro approach of just banging the same joints free indefinitely is limited, dumb, expensive and a bit of a racket for the chiros. That's what we built the Backpod for - to give enough of a focused stretch on the collagen around the joints so they can free up fully and stay free. It gets a valid mention with costochondritis especially because its small peaked shape can get between the spine and the inside edge of your scapula to actually stretch the tight rib joints. (A foam roller or large ball hasn't got the specificity for enough leverage - collagen is tough!) Anyway - good that you're feeling good at present. You have had a graphic example of what costo actually is - a "mysterious inflammation" could not respond in the same way. Hopefully it'll stay free. But if not, you will know why. It's not a difficult problem - just usually needs more follow-through than just the miracle manip.

@@stevenzphysio4203 Thanks for that, as it happens I am using the backpod too, as well as some stretching on the length of a foam roller. My thoracic spine is also curved to the left, which doesn't help. I just wanted you to know that if I hadn't found your video I would have just waited endlessly for it to heal by itself. Message received about the initial relief not a lasting solution- but sitting here now it feels good to be taking a step in the right direction.

@@MarkLiversedge Hi Mark. Perfect - the follow-through on the Backpod is ideal. The manipulation is stronger and more precise, but the Backpod has the longer stretching also needed - it's an ideal combination. Sorry - didn't mean to sound cranky. I get so many, many stories of chiros just continually banging the same hinges free ad infinitum that I'm a little raw on the subject. There are of course plenty of really good thinking chiros who don't just do that. But yes - pleased you got the idea from my video that costo isn't a healing problem, but a tethering one. Words do count. The whole medical red herring about costo being a "mysterious inflammation" which you therefore treat with anti-inflammatories, and which needs time to "heal" is driven by the term "costochondritis", implying an inflammation. If it was just called "pain at the rib joints on the chest" then there wouldn't be this incorrect approach to it. Now that your joint's been unlocked definitively, start (or keep) doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. Good luck with the work!

@@stevenzphysio4203 No you were right, I had misunderstood and appreciate your lengthy response. I still have pain at the front and my rib is still not very mobile- it flares out and I have a lumpy inflammation just under my right pec. I haved used the backpod often during the day for the past week and sometimes it helps, sometimes not, I'm staying with it because I am a keen golfer and every day I cannot play is another day of agony for me (aside from the costo pain). Will keep at it.

@@MarkLiversedge Hi Mark. Okay, that gives me a better picture. Golfers often get costo, because driving requires maximal thoracic and rib cage rotation. If you're getting a bit tight (and often a bit hunched too) in your thoracic spine and rib cage - which is enormously common - then when you swing, the rib joints around the back can't move fully, so the more delicate ones on your rib cage strain. And welcome to costo. There's a short video I put up on using the Backpod for golfers - see kzfaq.info/get/bejne/q7CCe6uarrW2Zmw.html S there's a carrot for you! Well done on thinking for yourself, gambling I might know what I’m talking about, and getting a Backpod. Here's the other stuff you'll likely need. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However do it safely with COVID-19 around. At a minimum, you should both wear masks and hand sanitise. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Yes, coincidentally one main original pre-cordial catch paper came out from where I am in Dunedin, New Zealand - Margaret Sparrow's. I have it, and I'm sure from reading it, it's just a quick flick of costo pain - as we would define costo, i.e. from tight ribs at the back. Sharp stabbing pain isn't an inflammatory or heart attack symptom - I think it's clearly just a rib joint or two on the sternum 'giving' and straining briefly, and they do that when they're tight round the back rib joints. And that tightness will show on the sitting twist test I mentioned, which is also described on the Backpod's costo page.

@@stevenzphysio4203 interesting. Coincidentally the pcs also happened while i was in a hunched position in my computer desk. Also common position for my costo pain. thanks for the info!

Did you experience the pcs pain on your left rib cage? Like stabbing pain that would hurt more if you inhale?

Hi Hat Maker. Nice to hear from you. Mm - if it's posture correction you're after, and you're working at a desk job, you probably want to concentrate on the stabilising muscles around the back, i.e. the middle and lower traps, rhomboids and lats. Pecs too, of course, but often the emphasis is on them and not enough on the muscles behind that oppose bending forward all the time. Re the rib joints - the hinges themselves are probably pretty good now after the osteopath and the Backpod. I'd bet what you're getting on running is more likely to be associated intercostal muscle tightness which hasn't fully stretched out. These are the muscles between the ribs - same ones you eat in spare ribs (sorry..). I think they'll probably stretch out okay just with a bit of running, but to be sure I'd just get someone to do the specific side rib stretch i showed with the bucket handles about 10.15 minutes into the Part (2) How to fix costo video. A few stretching sessions like that should be enough for them. Cheers, Steve August.

Hi Les. Yes. What you're describing is the iHunch - now the biggest upper spinal problem in the computer-savvy world. See the iHunch page on the Backpod's New Zealand website - www.bodystance.co.nz/en/ihunch/ Do all of the small programme of exercises, home massage and stretches in the Backpod's 31-page user guide. We designed it specifically to counter the iHunch and pull you back towards perfect posture. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi. Yep, you've worked it out. Use the Backpod more on the tightest joints - in your case they'll be the lower rib joints. Do use it over all the rib cage and thoracic spine, but do more on the tighter lower ribs. Stick with it - it’s very tough stuff you’re stretching and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However NOT until it’s safe with COVID-19. At a minimum, you should both wear masks, hand sanitise, and when you get home take all your clothes off and put them straight into the washing machine and you straight into the shower, including washing your hair. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Hi Gerd. That’s a standard costochondritis story. Dips are the single worst exercise in the gym for triggering it. It’s nothing to do with form. Don’t even think about them for six months. You have costo on top of the iHunch. That's your upper back getting hunched and tight, especially from much bending over computers and phones. This causes costo, because when the rib joints round the back also get tight enough, the rib joints on your breastbone MUST move excessively, every breath you take. So they strain, click, pop, give (like spraining your ankle) - and welcome to costo. Have a look at the iHunch page on the Backpod’s website www.bodystance.co.nz/en/ihunch/ Also, the Perfect Posture page. Cheeringly, the Backpod and its home programme are designed for both the iHunch and costo - they’re both part of the same general tightening hunching problem, and not particularly difficult to understand and sort out. Good luck with the work. You can't train through costo - it's different from a muscle strain, say. The reason is that any general exercise or stretch just strains further the already strained rib joints on your breastbone, way before you get a benefit to the tight rib machinery around the back. There are KZfaq videos around saying you can fix costo just by exercises - they don't understand the problem. What works is first stopping anything that hurts. Every time it hurts you're simply straining more the already strained rib joints on your breastbone. It's like running on an acutely sprained ankle - it's going to make it worse not better. You’ll hate it. What you have to do is free up the frozen rib machinery around the back, which is causing the rib joint strain and pain at the front, FIRST. We use the Backpod for that - to stretch free the tight and immobile rib and spinal joints. It usually takes only about three weeks - the same sort of time as stretching hamstrings that are so tight you can't reach your knees, until you can touch your toes. Of course this varies, but you usually have a clear, obvious improvement in the first week to let you know you're on the path. Well done on thinking for yourself, deciding I might know what i’m talking about, and getting a Backpod. Stick with it - it’s very tough stuff you’re stretching, you’ve had the problem for five years, and it takes time. Do please READ THE INSTRUCTIONS and the 'Warnings and precautions' section in the 31-page user guide. If for some reason you haven’t got one, there is also a pdf copy of the full user guide near the bottom of the iHunch and Costochondritis pages on the Backpod’s website - www.bodystance.co.nz/assets/Uploads/backpod-full-user-guide-feb-2020.pdf. These are the best detailed instructions on how to use the Backpod. We start people off really gently because often they just do too much initially and get sore. You are starting to stretch joints that haven’t moved for months or years and you can get a bit of normal treatment tenderness for a few days. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. However do it safely with COVID-19 around. At a minimum, you should both wear masks and hand sanitise. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. Get them to go hard down between your shoulder blades. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html The commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Thank you, Vicky - go for it. Stick with it - it’s very tough stuff you’re stretching and it takes time. We start people off on the Backpod really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. Not until you're past COVID-19, though. As well, if possible, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

@@stevenzphysio4203 Thanks Steve for replying promptly. I have ordered the backpod and will definitely follow your instructions. Thanks again.

I forgot to mention that i am currently moderate inflamed and I am currently taken Voltaren 50mg. Do you suggest to see a chiropractor now or wait until the inflammation subsides with Backpod?

@@vickylazarevski6994 Wait for the Backpod. You've had costo for years. It's flared up now but it's been that before. Here's your chance to do something different. Do you regularly see a chiropractor? If so, then he or she hasn't fixed you costo, have they? The good ones are very good, but I don't have a high opinion of the US ones for treating costo generally. (1) They usually use the standard body-slam-onto-the-patient-with-their-fist-in-your-back technique. This is simply a dumb choice with costo, because it just squashes and strains further the already strained rib joints on your breastbone. Every time. (2) In my experience, they have a bias towards manipulating the spinal joints and (often) missing the rib joints - and freeing these up is the irreducible core of fixing most costo. (3) All manipulation does is bang a tight hinge free. It doesn't put anything at all "back in" - that's just a nonsense phrase meaning nothing. I’m speaking as a New Zealand physio - I’ve used manipulation myself for over 30 years. It cannot in a split second stretch out the very tough collagen of the ligaments and joint capsule surrounding the joint which will have stiffened down around the immobile joint. So this just freezes the hinge up again rapidly. That's why we developed the Backpod - to stretch out the collagen so the joints can stay free and you get a lasting improvement. We think the chiro approach of continually banging the same bits free is silly and expensive. Rule of thumb (ho ho) - if you're getting a temporary improvement with chiro (so it is a joint problem) then you should get a permanent freeing up on the Backpod. It’s particularly relevant to costo - the Backpod is the only thing we can find that will actually do an effective stretch on tight rib joints, and this is the crucial thing in fixing costo. Cheers, Steve August.

Be my guest! If just the stretches are enough to clear your costo, then great. If not - and this is usually the case - then you do need more specific leverage to free the tight rib joints round the back. See this page on fixing costochondritis - www.bodystance.co.nz/en/costochondritis/ Cheers, Steve August.

@@stevenzphysio4203 I'm curious, can we use Backpod when costo is fixed? Maybe not everyday but sometimes, just in prevention?

@@Voodoo998 Of course. The reason for using it is just to provide a stretch to tight rib joints round the back, and tight and hunched thoracic spine joints - to free these up again to the movement they used to have. To keep that movement once it's there again, using the Backpod maybe once a week is ideal. It's just like stretching a hamstring that has been tight, whenever it feels like it needs it, ongoing.

Hi. Well done on thinking for yourself. No, statistically most Tietze's and costochondritis doesn't "just settle down." It's another thing that the popular medical view unfortunately gets wrong. Stick with it - it’s very tough stuff you’re stretching and it takes time. We start people off really gently because often they just do too much initially and get sore. It’s a lot like stretching hamstring muscles that are so tight you can’t touch your knees - takes a while before you can reach your toes. When you no longer need a pillow under your head when you’re lying on the Backpod, get some more oomph out of it by lifting your buttocks off the ground, using the Backpod crosswise across the upper back (gives more leverage) as well as lengthwise and out to the sides a little (to get the ribs), and/or linking your fingers together and slowly moving your arms up over your head and down to your waist repeatedly; try that with just one arm as well. Chase the tightest bits and spend 1-3 minutes on each. Also, when you get to that point, start doing the sitting twist exercise I showed 12.54 minutes into the ‘How to Fix most Costo and Tietze’s , Part (2)’ KZfaq video - kzfaq.info/get/bejne/qJ2mmJmfs7zIh5c.html This is to work the joints now they’re reasonably unlocked - like working a rusty hinge back and forth after you put some oil on it. Also, ideally, shout yourself a sports massage - preferably two, with a week off in between. When you've had costo for more than a few months, the muscles between and overlying the tight ribs around your back and sides, plus the pec muscles on your chest, also get tight and scarred. Massage is ideal for loosening them up. Not until you're well out of lockdown, though. As well, if you can, talk, bargain or bribe someone into doing the two massages in the Backpod’s user guide, about once a week for at least a few weeks. You’re probably tight on your pecs as part of it all, so best to stretch them as well. There’s a good pec stretching video on KZfaq - link is kzfaq.info/get/bejne/e8yGfrWJzb-6dXU.html I’m guessing this next bit, but the commonest reason these days for costo starting is if you’re getting a bit hunched, usually from much bending over computers, phones, patients or whatever - we call it the iHunch. As part of the spine getting a bit hunched and tight, the rib joints attaching to your spine also stiffen and seize. When they can’t move, then the joints at the other ends of the same ribs MUST work excessively just to let you keep breathing. So they strain, ‘give’, irritate, get locally inflamed - and welcome to costo. It’s not a “mysterious inflammation” arriving for no reason. Have a look at the iHunch page on the Backpod’s website - www.bodystance.co.nz/en/ihunch/ If that looks like a fit with you, then you’d better do all the bits in the Backpod’s home program - we designed it specifically to counter the iHunch and pull you back towards perfect posture. It’s worth looking at the Perfect Posture page also. Good luck with the work. Cheers, Steve August (B.A.,Dip.Physio.).

Thank you so much for your reply. I’ve worked as a programmer for 15 years so I am definitely an ihunch candidate. I will be checking out all your recommendations and hope the lockdown is lifted soon so I can get a sports massage. Thanks again!

Yes - most costo does NOT settle down soon. There's only one actual published piece of medical research on this (Disla et al) and it shows that most costo will still be there a year later. However the abstract (summary) of the paper says it will spontaneously settle inside a year. This is extraordinary - I have never otherwise come across a paper where the abstract disagrees with the full paper. It's part of the misinformation on costo, and why it's so poorly understood and treated in most places. Well done on your DIY Backpod approach. It bears out completely my New Zealand view, and also what the best published piece of research says on costo. That is, forget the "mysterious inflammation" red herring - you fix it by freeing up the frozen rib machinery around the back, which takes the load off the straining and painful rib joints at the front. That's what you did, and that's why it was helped. You've had that patch of posterior rib machinery frozen for 20 years, though. We've fixed costo that's lasted longer than that, but it does take time and effort. If you want to do a full job, not just acute flare alleviation (not that there's anything wrong with that!) have a look over this long PDF I've done on treating costo. It's essentially a treatment plan for what we find works best, with explanations. It is wordy and detailed, and better read on a computer, not a phone. Link is www.bodystance.co.nz/assets/Uploads/Costo-treatment-plan-incl-Costo-and-iHunch-PDFs-19-July-2022.pdf Good luck with the work. Cheers, Steve August.

@@stevenzphysio4203 Wow, Thank you Steve, I am honoured you even respond to these comments🙂..and thanks for the link, I am saving it and will read it, I need to cure this ill if possible!! Can't thank you enough- and I will remember to update you with any progress!! Blessings!!