Costochondritis and Exercise

Why exercise can help costochondritis

Costochondritis, or Tietze's Syndrome, is pain and inflammation in the chest, around the cartilage that joins the ribs to the sternum (breast bone). It can be painful even to breath, let alone exercise!

However, studies have shown that many chronic pain and inflammatory conditions, such as back pain, sciatica and even costochondritis improve with exercise, especially when the exercises and stretches are chosen to relieve tension in and around the painful areas.[1]

Gentle chest opening yoga exercises - good for costochondritis
Gentle chest opening yoga exercises - good for costochondritis | Source
  • Exercise causes the release of pain-relieving and relaxing endorphins.
  • When you exercise, blood flow improves, which helps the injured areas to heal.
  • Exercise increases mobility and decreases tension in the muscles and joints, which can block blood flow and healing nutrients from fighting the inflammation.

Of course, you should avoid any strenuous exercise, or those which put too much pressure on the muscles in the inflamed areas.

Sternum and cartilage connecting it to the ribs - where costochondritis causes pain.
Sternum and cartilage connecting it to the ribs - where costochondritis causes pain. | Source

Disclaimer: I am not a doctor or physiotherapist, and take no responsibility for your use of this information.

However, I have suffered from costochondritis on and off for the past 20 years as a secondary symptom of fibromyalgia.

These are the exercises and stretches, given to me by physiotherapists, that have helped me the most.

Lifting weights should be avoided when you have costochondritis - it will make your symptoms worse and delay healing.
Lifting weights should be avoided when you have costochondritis - it will make your symptoms worse and delay healing. | Source

Sports and exercises to avoid when you have costo pain

Any sport or exercise that has you reaching across your chest with your arms, especially if there is any tension or weight load, should be avoided.

Also avoid any movements that require your chest and shoulder muscles to be squashed or strongly used.

Sports to avoid: tennis and other racquet sports, golf, baseball/softball, basketball/netball, kendo, karate, kung fu

Exercises to avoid: push up, pull up, row, any type of press for the upper body, lat raise or pulldown, tricep dip, press and extension, fly, back extension, lateral raise, any fitball or resistence band movements that put pressure or strain on your chest muscles.

Other movements to avoid: pulling heavy doors open across your body, heavy lifting and holding (including of children), turning non-powered steering wheels, gardening and cleaning (reaching and pulling)

One thing I found impossible to do when in a costochondritis flare, was walking my friend's (large) dog. When the strong dog pulled against the leash, especially when my arm was across my body, the pain was so intense!

These should be ok, but be careful!

Be careful with the following sports and exercises - continue with them only if they cause no pain, or worsening of symptoms, and avoid any poses that cause pain (such as hand-supported poses in yoga).

Aerobic exercises: swimming, running, cycling, tai chi, yoga (some poses), cross training machines

Muscle exercises: sit ups, bicep curls, most leg exercises

Other light aerobic movements, such as walking, are encouraged!

Returning to strenuous sports and exercises

When the pain levels have dropped enough, start with gentle movements, common in your sport, to loosen the muscles.

Serving puts a lot of strain on the chest muscles, and can cause excruciating costochondritis pain. Ease back into sport slowly and carefully!
Serving puts a lot of strain on the chest muscles, and can cause excruciating costochondritis pain. Ease back into sport slowly and carefully! | Source

Take tennis for example:

  1. Start with long and fluid ground strokes for a week or two, and make sure your symptoms do not worsen after your practice sessions.
  2. Then add volleys, which are shorter, stronger movements, to your training routine, for another week of two. As always, watch your symptoms and back off if pain starts to return.
  3. Finally add the overhead shots to your training. These are typically the most painful for recovering costochondritis sufferers.

Stretch to relieve costochondritis pain

Stretching the pectoral muscles (pectoralis major and minor) - the muscles in your chest below your shoulders - helps to increase blood flow to the inflamed areas, and decrease tension.

You will be able to breathe easier after these stretches.

Note: As with all stretches take them slowly and gently, breathing evenly. Don't strain against the stretch!

Pectoral muscle stretch

  1. Stand with your side facing the wall or in the doorway.
  2. Raise your arm to the side, and bend your elbow to a 90 degree angle.
  3. Rest your forearm against the wall, with your elbow at shoulder height, and lean a little forward to stretch your chest muscles open gently.
  4. Breathe, relax into the stretch and hold for about 30 seconds, then release.
  5. Repeat on the other side.

A stronger chest stretch using a door frame.
A stronger chest stretch using a door frame. | Source

Double-sided strong pec stretch

By placing both arms on either side of a door frame, with elbows bent, hands raised, you will get a stronger stretch through your chest muscles.

Important: do this stretch carefully and gently. It can hurt too much when the costochondritis pain is severe.

Angle variations

By repeating with a slightly different angle, your pectoral muscles will be stretched more thoroughly.

  • Rest your elbow and forearm on the wall or door higher or lower than your shoulders.
  • Stretch with your arms directly above your shoulders on the top of the door frame.

Stretching when your pain is gone

Don't forget to keep stretching after your costochondritis pain has disappeared!

This is one of the common causes for recurring costo pain, and one that I always fall into when I'm lazy.

A series of stronger stretches in the corner of two walls will relax tight chest muscles.

With active or dynamic stretching, you are moving rhythmically and holding the stretch for a short time. This both strengthens and stretches the muscles around your shoulders, chest and upper arms.

These are good for improving posture and range of motion, and also for preventing the costo from returning.

Tip: I find active stretching very useful for managing fibromyalgia stiffness and pain, both at home and at work.

Yoga poses to relieve costochondritis pain

Many yoga poses will worsen costochondritis symptoms, including any poses where a lot of your body weight is supported on your hands (downward dog, bridge, upward dog).

Restorative yoga poses and sequences are great for costo sufferers for a number of reasons:

  • the resting postures encourage the muscles to relax, with little tension
  • deep breathing relaxes the ribcage muscles and improves blood flow
  • the relaxation helps you release stress, a major component in increasing costo pain.

Important - avoid any poses and movements which cause pain!

Savasana (corpse pose) - lying on your back, deep breathing and relaxation to reduce pain.

Viparita karani (legs up the wall pose) - another restorative lying pose, focusing on breathing.

Bharadvajasana (bharadvaja's twist) - a gentle seated twist with an open, relaxed chest.

Virasana (hero pose) - a kneeling pose with an open chest.

Balasana (child's pose) - a kneeling pose with your arms forward to keep your chest open and stretched.

Tadasana (mountain pose) - the basic standing pose, open chest, focusing on breathing.

Urdhva hastasana (upward salute) - a chest and abdomen opening standing pose.

Virabhadrasana (warrior pose) - a strong standing pose, with open arms, or arms up and chest stretches.

Belt-assisted yoga stretches for opening the chest

Stability ball stretches for costochondritis

Using a fit ball can give you a stronger stretch than the standing wall or doorway stretches, but you can also ease into these swiss ball stretches gently.

You can use an exercise ball to stretch the pectoral muscles instead of the wall.

  1. Kneel with the ball to one side and lean forwards.
  2. Bend your arm to 90 degrees and keep your elbow at shoulder height.
  3. Rest your forearm on the ball.
  4. Bring your upper body down to stretch the pec muscles.

You can also do this stretch with a straight arm, and vary the angle of your arm to shoulder to stretch the muscle fully.

This lying chest stretch is much stronger, but also relaxes your upper back and shoulders.

Note: If I am in a costo 'flare', this stretch is too strong for me. If you feel pain, please stop and stick with the gentle wall stretches.

  1. Sit on the ball, and roll down until your upper back is lying on the ball, and your legs form a bridge.
  2. Lay your arms out to your sides - they will drop below your body and stretch your chest open. Relax them!
  3. Roll back and forth, to massage and relax your back, and keep breathing evenly.

Tip: This is a fantastic stretch for getting rid of tension from too much computer work.

Foam roller stretches for tight chests

These stretches are quite strong, letting your back curve around the foam roller to stretch the chest muscles.

If you feel pain, stop immediately. Instead do the more gentle pectoral stretches as described above, until your symptoms reduce.

Other techniques to reduce costochondritis pain

Physical therapy (stretching, exercise) is one way to treat costo pain and help prevent it from returning. But there are many other ways to help reduce costochondritis pain.

Stress reduction

Stress can greatly increase the amount of pain felt, and is definitely a component of costo. Any and all stress reduction techniques can help manage pain without medication!

Meditation - laying with arms to your side or stretched out, or sitting in a relaxed pose.

Progressive relaxation - relaxing each body part progressively, starting from the toes, and working upwards. You can tense each muscle before relaxing them.

Deep breathing - stretching your chest muscles gently and improving blood flow to the chest area.
mindfulness - living with full awareness, your mind and attention is present in each moment.

Medications and liniments

Menthol based sports rubs like tiger balm, may provide a little relief, especially when used before stretching.

NSAIDs (ibuprofen, etc.) will help to reduce the inflammation, but need to be taken carefully - always take anti-inflammatory tablets on a full stomach!

When the underlying cause is arthritis, cortisone or biologics may be used to limit the inflammation.

Last year, two cases of costochondritis were linked to vitamin D deficiency[2], plus many other studies have linked a deficiency in vitamin D to chronic pain - it might be an idea to get your vitamin D levels checked.

My stock of sports rubs, heat packs, massage cushion, massage oils, and muscle relaxing bath salts - also used to help me manage costo pain.
My stock of sports rubs, heat packs, massage cushion, massage oils, and muscle relaxing bath salts - also used to help me manage costo pain. | Source

Heat or ice

When the costo pain is extremely bad, ice can help numb the area. But after the initial spike of pain is retreated, applying moist heat is useful for encouraging healing blood flow.

You may find it useful to use a microwavable heat pack or apply ice after stretching or exercising.

Mind & Body Whole Body Wrap
Mind & Body Whole Body Wrap

A long heat pack is an essential for me - it helps both with my occasional sciatica, pain from endometriosis, and also with the costochondritis chest pain. These can be placed in the freezer for a non-wet ice pack, or heated in the microwave. The long length is perfect!


Posture correction

Costochondritis pain is worsened by a hunched posture - using a computer, slouched on the sofa.

Therefore exercises to correct posture are useful, both to help a costo flare and to prevent it from returning.

The Alexander Technique or the Feldenkrais Method are two popular and gentle systems for drawing your attention to your posture, and fixing bad habits.

Pilates can also help improve your posture, but may be too strong when you have bad costochondritis pain.


  1. Stretching exercises for costochondritis pain, G. Rovetta,, G Ital Med Lav Ergon. 2009 Apr-Jun;31(2):169-71
  2. Chest pain and costochondritis associated with vitamin d deficiency: a report of two cases, RC Oh,, ePub June 2012

Your experience

What are your favorite stretches and exercises to help costochondritis?

Do you have an exercising with costo horror story?

Let us know in the comments below!

More by this Author

Comments 38 comments

carol7777 profile image

carol7777 3 years ago from Arizona

I have never heard of this before. Interesting and informative. Great job describing and solutions. Voting up++

nifwlseirff profile image

nifwlseirff 3 years ago from Leipzig, Germany Author

Carol - thank you! It's a nasty, painful illness, which I have had to learn to manage without medications, as I can't take NSAIDs!

donnah75 profile image

donnah75 3 years ago from Upstate New York

How awful to have to live with such pain! A great job here, as many will benefit from your advice. Finding natural, healthy solutions is always the best approach.

nifwlseirff profile image

nifwlseirff 3 years ago from Leipzig, Germany Author

Donnah - It is a difficult condition to live with, especially when it's a secondary symptom of fibro! Thanks!

Massageye - thank you!

SidKemp profile image

SidKemp 3 years ago from Boca Raton, Florida (near Miami and Palm Beach)

Excellent - and so detailed. You deserve a hub of the day, and also up, useful, and awesome, and shared. I especially appreciate that you include enjoyable sports and fun movement, not just repetitive (and all too boring) rehabilitative exercises.

People suffering from costcochondritis and fibromyalgia, or any inflammatory disease, might do well by adding an anti-inflammation diet to exercise like this. If interested, please read my hub about the diet that helped my wife eliminate her rheumatoid arthritis: Heal Yourself: The Most Effective Treatments for Rheumatoid Arthritis.

pstraubie48 profile image

pstraubie48 3 years ago from sunny Florida

These suggestions will be of help to those who suffer from Tietze's Syndrome. My daughter has been told to use many of these same suggestions to help give her some relief. She has fibro and MS (along with mulitple cancers) and this new development.

Thanks for sharing. Sending Angels your way. :) ps

KenWu profile image

KenWu 3 years ago from Malaysia

Great resources for people that faced with this type of problem. I think everyone should avoid any exercises should it cause pain or discomfort on his/her body. But, most importantly taking advices from the relevant professional is the best option.

Voted UP, useful and shared!

pinto2011 profile image

pinto2011 3 years ago from New Delhi, India

Being from the medical field gives me the importance of understanding that how delicately you have woven solution for this problem so nicely. Great hub!

RTalloni profile image

RTalloni 3 years ago from the short journey

An interesting read, and glad to see that you highlighted the fact that many conditions can be successfully treated with exercise. Congrats on your Hub of the Day award--well done!

Your Cousins profile image

Your Cousins 3 years ago from Atlanta, GA

Thanks for hipping me to Costochondritis because I'd never heard of it. But if it strikes me, I am armed and ready to deal with it thanks to all the great info that you have provided. Voted Up and Useful!

Escobana profile image

Escobana 3 years ago from Valencia

Wow! This is totally new to me and the whole idea of having to work out with pain...sounds very challenging.

I'm a lover of working out and running and I am blessed to have not one single physical problem. I find that you offer many good tips for those who suffer from costochondritis.

Great job, up, shared and awseome!

bizarrett81 profile image

bizarrett81 3 years ago from Maine

Great Hub! My doctor recently told me this is what the random, terrible chest pains I have probably are...I do yoga and feel great relief when I am practicing. Very informative and helpful, thank you!

Crystal Tatum profile image

Crystal Tatum 3 years ago from Georgia

Great hub. I was diagnosed with costochondritis years ago. I was given meds but they never helped. I have continued to experience problems but gave up because no one seemed to know what to do, or even if that's what was really wrong. I am still in pain nearly every day. I'm just used to it. Unfortunately, I do all the things you list to make it worse. This is a great resource. Voted up and shared.

prasetio30 profile image

prasetio30 3 years ago from malang-indonesia

Very inspiring hub and I learn something new here related with Costochondritis Exercise. I learn much from you. I love the pictures and the video here. Thanks for writing and share with us. Voted up!


Amanda Swiderek 3 years ago

Thank you providing all the information and tips! Finally, a detailed article to help all those sufferers experience some relief:)

CJ Monet profile image

CJ Monet 3 years ago from NYC

I do not have this condition, but I have been experiencing upper back pain and I am yet without a diagnosis. This will help give me some relief.

nifwlseirff profile image

nifwlseirff 3 years ago from Leipzig, Germany Author

SidKemp - Thanks for pointing me to your interesting article. I had made such diet modifications, but didn't find they helped me. Exercise/stretching is still the best for me!

nifwlseirff profile image

nifwlseirff 3 years ago from Leipzig, Germany Author

pstraubie48 - I'm glad these help your daughter, and I wish her lots of strength and healing!

nifwlseirff profile image

nifwlseirff 3 years ago from Leipzig, Germany Author

Escobana - working out with pain is difficult - the hardest thing is to get started! Thanks!

nifwlseirff profile image

nifwlseirff 3 years ago from Leipzig, Germany Author

Crystal - I'm guilty of maintaining poor posture and carrying bags on one shoulder too! Hope you can find some relief with these exercises!

Sarah 2 years ago

I bought a leash that could be tied around my waist, so that I didn't have to use my chest muscles and my dog actually walks way better this way.

nifwlseirff profile image

nifwlseirff 2 years ago from Leipzig, Germany Author

Sarah - Good idea - no more pulling on the arms and chest muscles! Thanks!

Toto38 2 years ago

I'm 75 and I haven't tried your exercises as I just found your site. I have fibromyalgia and costoconderitis ... the latter as a result of the former, I'm guessing. I can't fold towels without costo pain and I finally hired a cleaning woman as I can no longer do my housework. The costo pain along with sciatica pain makes excersizing very uncomfortable. The only pain med. I can take is x-strength Tylenol because of other meds I take. It's very depressing but, I'm hoping for a reprieve for a little bit so I can try your suggestions. Thank you.

nifwlseirff profile image

nifwlseirff 2 years ago from Leipzig, Germany Author

Toto - Fibro is a difficult beast to manage isn't it! I also can't take many medications (mostly due to allergies).

I hope you find some of these suggestions useful - please let me know which ones worked and which didn't!

KateG 2 years ago

I was diagnosed with Costochondritis only a few weeks ago so found this very information helpful and insightful!! Thanks hubpages

Rachel 2 years ago

I was diagnosed with costochondritis this week though I'm sure I've had it for 8 weeks, since gallbladder removal surgery. I'm on an NSAID, an anti-depressant and a muscle relaxant for the pain and anxiety it causes. Thank you for posting this useful information, I'll give the gentle exercises a go to start improving my fitness as I'm finding it difficult to exercise, other than walking, without rib pain. I've had a couple of bad pain attacks, like an intense iron band across my ribs, but more commonly stabbing pain under my right ribs and tenderness in the middle.

stacey 2 years ago

This is great thanks , iv lived with costo for 6yrs now and have struggled with specialists putting me on up to 26 pills a day to try to manage the pain and inflammation also had injections in the joints and been told if I simply gave up breathing for 4 months id get better .I love running so have found as long as I take it slowly im not making it worse this yr im going to attempt my first full marathon slow and steady.

VAIBHAV SALVI 2 years ago

I have been suffering from costochondritis since 2002. I used to lift weights at home. After a few daysi developed severe pain almost like a muscle tear. But i didn't know what was it called. Doctors told me it was a muscle tear and it would be fine in 6 to 8 weeks. But it continued for 8 long years. I started to gain weight as a result of inability to exercise. I was once asked to get my vitamin d test done. And to my surprisei found out that i was vitamin d3 deficient. Hence the pain. I started taking supplements for vitamin d3. I regularly take it. Also, since i have asthma i can't use combiflam, brufen, ibuprofen. So i take tablet with paracetamol called LANOL ER. I recently joined the gym as my weight was increasing. I started light weights and guess what the pain is back. Sharp knife pain in the left arm radiating to the armpit and the centre of the chest. Huh!!!! So depressed to think that I'm going to have to bear this pain again after having bid it goodbye. Which exercises should i do?

nifwlseirff profile image

nifwlseirff 2 years ago from Leipzig, Germany Author

I haven't read in medical studies that vitamin D is linked with costo, but low D levels *are* linked with fibromyalgia and chronic pain.

When I was able to, NSAIDS helped to quickly control a flare, but I can't take them now. No other painkiller has helped, so I stick with my heat packs, sports rubs like Tiger Balm, and stretching. Paracetamol and aspirin have very mild anti-inflammatory actions.

A visit to a physiotherapist might be able to give you some light weight exercises that won't strain your chest. The trick is first decreasing the inflammation, then increasing range of motion, and slowly and carefully introducing weight bearing movements to strengthen chest, shoulder and back muscles. Baby slow steps!

Lower body exercises shouldn't cause much pain, so long as you don't strain or twist your arms/chest during movements.

If you do see a physio/sports therapist and they recommend some upper body exercises, please let us know!

Rob 2 years ago

Most of the things here could help but as an injured athlete with this problem I would avoid cycling and swimming, both put pressure on the chest!

nifwlseirff profile image

nifwlseirff 2 years ago from Leipzig, Germany Author

Thanks Rob! Definitely don't do anything that aggravates the chest wall muscles when just injured!

Cycling is off my list indefinitely, because of chest pressure which can cause a costo flare, plus neck, lower back and wrist pain. :-(

Warm water might help some people - kicking down the pool on my back/sculling, gentle stretches in the deep end and some pool walking (without arm involvement) does help me reduce the severity and length of a costo flare, and keep them away.

Bella 21 months ago

I was diagnosed with costochondritis 12/19/14 after suffering an entire year with pain. I had to drive to a hospital of science 3 hours from my home to be treated because local doctors had no idea. This pain is excruciating and not being able to breathe is uncomfortable and very scary. I was sent to a cardiologist yesterday because of chest pressure, pain & shortness of breathe. He then sent me to the ER because I had rapid breathing, shortness of breathe and a bunch of other heart attack symptoms. I pray for all who suffer I am trying to get a grip on this because you feel you're gonna die that's how bad this is. I started Naproxen I can't do therapy at this time because I am to weak so I am hoping I can mildly start doing some stretches. Your information was very helpful.

Ancia 20 months ago

Really helpful article, have had costochondritus since I was 8..I am now 26 and love exercise..well at least the thought of it and the odd occasion I have been able to do it. Thanks for sharing

Ksimon18 14 months ago

I bookmarked this page! TY! I've had Costo for about 5 years, and have stopped working out because of the pain. 5 years later I'm up 30 pounds and have recently diagnosed with COPD. So, I decided to research how to exercise with Costo. FANTASTIC INFO! Thank you.

PS. My friends joke about getting Costo from going to Costco too much. I never laugh! I feel for EVERY person that has this.

Bru Swan profile image

Bru Swan 12 months ago from Beverly

Some good info thanks, just recently was told that was my problem and starting to do some research. I'm into working out a lot so now I have to learn to do things properly. Your writing was very lucid and incisive and really helped me get a feel for my problem, thanks again.

Skip 6 months ago

Very informative I ahve suffered for several years and feel so alone I do not take any medication but may be I should start as I can get so Down and fed up with being in constant pain

Twolfe 5 months ago

This is so helpful! I'm coming up on one year of having Costo and am ready for some relief other than pain meds! Thank you!!!!

Bradley Michaels profile image

Bradley Michaels 2 months ago

Unknowingly I have been experiencing this for a few years. Pain all day, joints popping out constantly. At first I thought I had a dislocated shoulder, as it was always popping out. My arm was also popping out of socket. I put my arm in a sling for a week and did doorway stretches and that let the shoulder/inflammation heal. after somewhat healed, i noticed my sternum was popping out when bending over or getting out of bed. then i ran across this site when googling "sternum popping out".

These exercises immediately helped.

Tips: if you have this, dont lift anything heavy, even 5 lbs can cause damage. If bending over, get down to knees first. Take ibuprofen and glucosamine to help joint growth, and to add some lubrication for when things do move around. Get lots of rest, and try to be active somedays and take other days off. Be careful getting out of bed, try to roll off from the side.

I used an cold can of soda and pressed against the sternum when it flares. hot shower after it settles works well!

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