Sunday, November 15, 2009

Costochondritis- Massage vs. Medical Massage

Reading through my blog, you'll see that I'm a fan of medical massage therapy. Many people have asked me, "what's the difference between the 2?" Well, I have no clue. =) But I came across this article that went into great detail about the difference between regular massage therapy and medical massage therapy for Costochondritis. My goal is never to steer anyone to do what I'm doing, but to simply put as much information out there about Costo and the different ways that sufferers handle and heal from this Gag Gag Gag condition. =)

"Simply put, Medical Massage Therapy is the focused use of advanced massage techniques to treat a specific condition and achieve a specific outcome. In some cases the condition treated is first diagnosed by the patient’s physician. In other cases the medical massage therapist simply treats the patient based on the patient’s subjective description of his symptoms following a thorough assessment of the patient’s muscles, posture, etc.

Techniques used during a medical massage often include neuromuscular therapy, myofascial release, and lymphatic drainage massage among many others; however, they can also include more common techniques such as Swedish massage. The major difference between a medical massage and a regular massage is that it is performed by therapists with advanced training and the treatment is structured to obtain a specific outcome.

All massage therapists in Arizona must be licensed by the state to legally practice, however, there is no separate license that recognizes “Medical Massage Therapists” over any other licensed massage therapist (LMT). Any LMT can legally perform any type of massage, including medical massage.

Despite this, it is very helpful to seek out a Medical Massage Therapist if you require massage therapy to treat a specific symptom. Any therapist using this term to describe himself or his practice is clearly advertising that he focuses on medical massage. This will narrow down your search for the proper massage therapist for your needs from among the thousands of therapists who mainly focus on relaxation or general therapeutic massage techniques. You can think of the term Medical Massage Therapist as a specialty among massage therapy. It is similar to a family practice Medical Doctor advertising that she specializes in “medical care for women”. The MD is still just an MD like any other, however, knowing her focus is a great help to the patient when seeking a doctor.

Costochondritis is an inflammation of the cartilage that connects the ribs to the sternum. It causes sharp and often severe pain in the costosternal joint (where the ribs connect to the sternum), sometimes mimicking a heart attack. While the cause of this condition is not know, medical massage therapy focused on the breathing muscles and other muscles that attached to the thoracic cage (rib cage) has been shown to be an effective treatment for the pain associated with costochondritis.

Humans normally have 12 rib bones on each side, ten of which attach to the sternum via costal cartilage. Cartilage is softer and more pliable than bone allowing the ribs to expand during inhalation. Dozens of individual muscles attach to the ribs and many of those muscles are used during inhalation. When these muscles are tight (hypertonic) additional stress is place on the costal cartilage contributing to the painful condition.

Additionally, the pain from the cartilage inflammation sometimes causes patients to breathe more shallowly contributing to muscle tightness that can cause continued pain long after the cartilage inflammation has dissipated.

By assessing the condition of the breathing muscles and other muscles connected to the rib cage, your medical massage therapist can formulate a treatment plan to effectively alleviate your symptoms completely in many circumstances. Your therapist will stretch and release hypertonic muscles in the intercostals (muscles between each rib), diaphragm (your main breathing muscle) as well as the other muscles he or she finds are exerting an abnormal amount of pressure on the costosternal joints.

For the massage therapist:
Be sure to assess all muscles of inhalation as well as any other muscles which attach to the thoracic cage or thoracic spine. While all muscles are important to assess and treat if needed, specific muscles which should not be overlooked are; the sternocleidomastoids, scalenes, obliques, rectus abdominis, internal and external intercostals, pectoral major and minor, diaphragm, serratus anterior, latissimus dorsi, and trapezius. Muscles on the posterior of the body must be addresses even though symptoms may only present themselves at the costosternal joints because of the pressure these muscles exert on the thoracic cage. You may experience difficulty in palpating and releasing deeper muscles until the more superficial muscles are released. According to the Mayo Clinic other treatments for costochondritis include muscle relaxers, NSAIDS, antidepressants, physical therapy, and heat." - written by Steve Ibach with help from the mayo clinic website.


  1. Does anybody know a good message therapist (skilled in Costochondritis) in the Northern Virginia area?


  2. Hi Sumit,

    Unfortunately, I sure don't, but if anyone else does- please post it here. Maybe call around to the rehab centers and physical therapy places? Ask for their medical massage therapist?

    Hugs to everyone!!!

  3. lucy~ i know you are going to laugh when i tell you i cannot for the life of me find the post i left last night :D i want to read your reply LOL! can you tell me where i might find it? this time i made a note of where i left this post so i know where to look tomorrow haha- thanks a million.

    your music teacher anonymous sister.

  4. Hi, Lucy,

    Thank you for your blog. Great links! But you didn't give credit to the guy who wrote the Costochondritis article you quoted: Steve Ibach, Massage Therapy Examiner.

    I'm glad you figured out the link to celiac disease and are on the road to recovery. May you be well and blessed.


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