Orthopedic manipulative therapeutic approach of costochondral pain after combined strenuous endurance exercise: a case report

Abstract

The purpose of this case study was to present the effectiveness of physiotherapeutic treatment based on manual orthopedic techniques in an amateur athlete with costochondritis due to physical strenuous exercise. A 31 years old experienced, well-trained, endurance amateur athlete presented chest pain suggesting costochondritis after physical and kinetic examination. Patient reported to present pain after physical effort in the last two weeks (combination of mountain biking, route cycling, running, swimming and yoga). Manual therapy including techniques as resonant oscillation mobilization of the thoracic region, Lewit´s post-isometric relaxation and sliding of the right humeral head, cervico-thoracic high speed technique mobilization, active-assisted mobilization of 7th to 10th ribs during expiratory phase, superficial myofascial induction in lower costal area and, muscle power technique, is effective to relieve pain increase mobility of cervical rotation, increase mobility of glenohumeral joint (e.g., internal rotation), in an amateur athlete with costochondritis due to physical strenuous exercise.