Costochondritis question

[jnmedrano2004]

Hi everyone,

I am fairly new to massage therapy graduated in Dec 2007, so have not been doing it very long. A client called me that has Costochondritis from an accident she had two years ago from the air bag. She said it's in her ribs and sternum, upon doing research here is what the overview said of this condition....Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum. The condition causes localized chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage. Costochondritis is a relatively harmless condition and usually goes away without treatment. The cause is usually unknown.....she also stated that she has severe lower back pain, I was wondering how would you experienced Massage Therapist approach this, what can I do to help her. Thank you.

Ruthann

 

[hey gemma!]

From any type of auto accident there is going to be some form of whiplash whether front to back, side to side, etc. That will need to be addressed. In my experience working with folks who have had auto accidents w/ and w/o air bag deployment, one of the biggest factors to relieving their symptoms was to work on relieving the whiplash factors [whether or not they've been diagnosed w/ it.] That means releasing fascial tissues from the occiput to the sacrum, working with the entire trapezius muscle and checking to be sure the anterior chest wall muscles are relaxed and not in spasm as well.

Hope that helps you a bit.

 

[J. K]

What Anastasia said is all good. Also, you often need to slowly and gently work the sternum and ribs, compressing and releasing them into the direction of the restriction. Most of the localized pain and tightness from the original conditio can be fairly easily resolved this way.

 

[luv2help]

What Anastasia said is all good. Also, you often need to slowly and gently work the sternum and ribs, compressing and releasing them into the direction of the restriction. Most of the localized pain and tightness from the original conditio can be fairly easily resolved this way.

My experiences have been completely different, and I disagree with your suggestion regarding "often" using compression as a means to "resolve" the condition, as each client has his/own particular experience with their condition. I have a client with intermittently acute costochondritis, and when it's in flare-up mode, even the most gentle non-invasive touch has reacted in him recoiling in pain. He may be an extreme case, but, IMO, it is always better to be safe than sorry. Perhaps, just perhaps, when the condition is not active, I could see attempting very very very gentle work to that area...but my experience with him is that any level of touch is aggravating.

 

[Stuart H]

Of course if your touch is too much you back off or even wait. For the general population who suffers from this condition, gentle but sustained pressure, when tolerated, is quite helpful.

 

[Pompal 09.]

Maybe you need to take a different look at your touch, if when they are not flared it still is aggravating to them. Perhaps your pressure is too extreme? Trying to generalize treatment suggestions on a forum site is difficult at best. Of course if your touch is too much you back off or even wait. But for the general population who suffers from this condition, gentle but sustained pressure, when tolerated, is quite helpful.

Mr. Fritz, perhaps you ought to reread my post, and perhaps then you will note that I refer to approaching this client with an EXTREMELY GENTLE touch. This I mentioned in contrast to your statement regarding "always" using repeated compressions on the ribcage area, which I disagree with. Each client is different, and no singular treatment plan will suit everyone.

I think you hit the nail on the head when you said "trying to generalize treatment suggestions on a forum site is difficult at best." As such, when posting on a forum, it often is best for one to respect the experiences shared by other Massage Therapists on this board.

 

[midwestboi]

Chondroitin sulfate...

Hi there. You might wanna consider recommending chondroitin sulfate for your client. Chondroitin sulfate comes from the bovine trachea and is much safer and more effective than gloucosamine sulfate. It aids in cartilage repair and is a good anti-inflammatory. Just make sure your client isn't on any blood thinners or has allergies to sulfer. Everyone hears about gloucosamine sulfate but you have to be careful about where it comes from. If the source is either India or China, beware. It will contain high amounts of lead and tin and cadmium. Seven tenths of the rivers in China presently do not harbour any life. Gloucosamine comes from sea life crustacean shells so you see my point.

Hope this info is helpful to you.

 

[chelsea.divine]

From any type of auto accident there is going to be some form of whiplash whether front to back, side to side, etc. That will need to be addressed. In my experience working with folks who have had auto accidents w/ and w/o air bag deployment, one of the biggest factors to relieving their symptoms was to work on relieving the whiplash factors [whether or not they've been diagnosed w/ it.] That means releasing fascial tissues from the occiput to the sacrum, working with the entire trapezius muscle and checking to be sure the anterior chest wall muscles are relaxed and not in spasm as well.

Anastastia is right on with that, On top of releasing fascia around the spine and rib cage you could add some pectoral work to aid in your cl's healing. Pin and stretching the pec minor would probably do wonders for helping her take deeper breathes, thus stretching our her diagram and rib cage, and striping over the pec major could help release her sternum as well as help her shoulders roll back and balance out her spine and chest.

 

[Angel M]

Chondroitin sulfate...

Hi there. You might wanna consider recommending chondroitin sulfate for your client. Chondroitin sulfate comes from the bovine trachea and is much safer and more effective than gloucosamine sulfate. It aids in cartilage repair and is a good anti-inflammatory. Just make sure your client isn't on any blood thinners or has allergies to sulfer. Everyone hears about gloucosamine sulfate but you have to be careful about where it comes from. If the source is either India or China, beware. It will contain high amounts of lead and tin and cadmium. Seven tenths of the rivers in China presently do not harbour any life. Gloucosamine comes from sea life crustacean shells so you see my point.

Hope this info is helpful to you.

This is outside our scope of practice, and should be avoided. We have no ability to effectively assess how a supplement may work for a client, let alone how that supplement may be affected by (or interact with) the client's diet, medications, or other supplements they may already be taking.

If you think a client may benefit from some form of nutritional supplementation or dietary change, refer them to the appropriate professional. Do NOT start recommending specific products for ingestion.