6 Costochondritis Exercises to Relieve Chest Pain

Costochondritis is one of many possible causes of chest pain. It’s caused by inflammation of the cartilage that connects your ribs to your breastbone (sternum). This condition can be quite painful — and even worrisome if you’re unsure of the cause.

The good news is that chest pain caused by costochondritis usually resolves with at-home treatments in a few weeks. Exercises for costochondritis, including stretches and breathing exercises, can help.

Let’s take a closer look at what causes this condition and what you can do to help relieve the pain.

What causes costochondritis?

Your rib cage is made up of 12 pairs of ribs. This bony cage protects your organs, like your heart and lungs, and aids in breathing. The ribs connect to your sternum by cartilage. Costochondritis causes this cartilage to become inflamed and painful. Symptoms include:

• Pain in the anterior (front) chest wall, which worsens with shoulder movement

• Tenderness where the ribs connect to the sternum

• Increased pain with coughing and deep breathing 

In many cases, costochondritis happens without a known cause. Sometimes it can be linked to:

• An Injury, such as a car accident, fall, or blow to the chest

• Severe bouts of coughing

• Strenuous lifting or vigorous upper body activity, such as rowing

• Inflammatory conditions, like rheumatoid arthritis

• Scoliosis or osteoarthritis of the spine

Costochondritis most often affects people between the ages of 40 and 50, with females having a slightly higher risk than males. 

Because chest pain from costochondritis can mimic serious heart conditions, like a heart attack, it’s always a good idea to see a healthcare professional if you have chest pain of any type. There’s no single test to diagnose costochondritis, so your primary care provider may want to rule out other conditions. 

6 costochondritis exercises

In the early or acute stages of this condition, rest, ice, and nonsteroidal anti-inflammatory drugs (NSAIDs) are beneficial. But once the pain subsides, research suggests that gentle exercises may help. Although more high-quality studies are needed, one small study found that stretching reduced pain in people with costochondritis. A case study found that rib mobilization with specific stretches may be beneficial, along with manual therapy from a physical therapist. 

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Experts tend to agree. To help ease symptoms of costochondritis, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) recommends:

• Gentle stretches

• Active range of motion

• Posture exercises 

Below are six exercises to help relieve pain from costochondritis. Follow these tips for best results:

• Perform these exercises at least once a day for a minimum of 6 weeks. These exercises should be pain-free. If you feel pain during exercise, stop and rest for a few more days before trying again. 

• Apply a heating pad for 10 minutes before exercising. This will help relax the muscles and improve blood flow. 

• Use an ice pack for 5 to 10 minutes after exercise to decrease inflammation.

1. Diaphragmatic breathing

Because deep breathing hurts, you may find yourself taking shallow breaths. But this can actually increase muscle tension and worsen chest infections (if present). 

Diaphragmatic breathing has many benefits. It can improve the function of your respiratory muscles, increase blood flow, reduce muscle pain, and even reduce feelings of anxiety. 

• Step 1: Sit on the edge of a chair with good posture. Avoid slouching.

• Step 2: Place one hand on your stomach below your rib cage and the other hand on your chest.

• Step 3: Take a deep breath in through your nose for 4 seconds. Focus on filling your stomach with air. The hand on your stomach should lift as your stomach expands. The hand on your chest will stay relatively still. 

• Step 4: Exhale or breath out through pursed lips for 4 to 8 seconds. 

• Step 5: Continue diaphragmatic breathing for 5 minutes.

• Step 6: Do this one to three times a day. 

2. Chest stretch

This chest stretch targets the muscles in the front of your chest (pectoralis). This helps improve mobility in your chest wall and ribs. It can also help improve your posture by keeping your shoulders back, decreasing pain and promoting healing. 

• Step 1: Stand facing an open doorway or a wall corner.

• Step 2: Raise your arms to shoulder height and bend your elbows to a 90-degree angle.

• Step 3: Rest your forearms against the wall or door frame with your palms flat.

• Step 4: Lean or step forward until you feel a stretch across your chest and arms. Stay within your pain-free range. 

• Step 5: Hold for 30 seconds.

• Step 6: Repeat five times.

3. Mid-scalene sternocleidomastoid stretch

This neck stretch improves flexibility in the sternocleidomastoid and scalene muscles, which are respiratory support muscles. This helps restore normal rib function, taking stress off your healing chest. 

• Step 1: Sit up straight and hook the fingers of your right hand above your left collarbone.

• Step 2: Bend or tilt your neck to the right. Keep your neck in a neutral position (don’t let it fall forward or backward).

• Step 3: Hold for 10 seconds.

• Step 4: Return your neck to center.

• Step 5: Repeat the stretch three to five times.

• Step 6: Hook the fingers of your left hand above the right collarbone.

• Step 7: Bend or tilt your neck to the left.

• Step 8: Hold for 10 seconds.

• Step 9: Repeat the stretch three to five times.

4. Thoracic self-mobilization (with flexion and extension) 

This self-mobilization exercise increases rib mobility and function. It also improves the range of motion in your trunk. These types of exercises are helpful in decreasing the pain of costochondritis. 

• Step 1: Sit in a low-back chair and interlock your hands behind your head.

• Step 2: Exhale as you bend forward at the waist until your elbows touch your knees.

• Step 3: Keeping your hands interlocked, inhale as you extend back over the chair. Your elbows will fall slightly to the side. Only go as far as you comfortably can.

• Step 4: Repeat this sequence 5 to 10 times.

5. Thoracic self-mobilization with unilateral rotation

Similar to the previous exercise, this one adds rotation to improve rib and trunk mobility, promoting healing.

• Step 1: Sit in a low-back chair and place one hand behind your head. Hold onto the chair seat with your other hand.

• Step 2: Exhale as you rotate your trunk down to touch your elbow to your opposite knee.

• Step 3: Inhale as you straighten and rotate your trunk, extending back over the chair. Stay within your pain-free range.

• Step 4: Repeat this sequence five times.

• Step 5: Switch arms and repeat the sequence on the other side five times.

6. Scapula squeeze

Poor posture, such as slouched or rounded shoulders can affect rib cage mobility and increase costochondritis pain. The scapula squeeze exercise strengthens your back muscles to help improve posture. You can make this exercise more difficult with a resistance band.

• Step 1: Sit in a chair (or stand) with your trunk upright and shoulders back.

• Step 2: Bend your elbows and squeeze your shoulder blades together, holding for 3 to 5 seconds.

• Step 3: Slowly release.

• Step 4: Repeat the scapula squeezes 15 to 20 times, and do 2 to 3 sets.

How do you treat costochondritis?

Even though costochondritis can be very painful, most people (91%) will have complete resolution within 3 weeks with at-home treatment. 

In addition to the exercises above, the following treatments will help heal costochondritis:

• Rest: During the early stages, avoid activities that increase your pain. This may include lifting, housework (like vacuuming), or activities like painting or mowing. Avoid strenuous upper body exercises like push-ups or pull-ups. Slowly progress to the exercises above as tolerated.

• Ice or heat: Apply a moist heat pad a couple of times a day for 10 to 20 minutes. This helps relax tight muscles. You can also use an ice pack for 10 minutes once or twice a day to decrease pain and inflammation.

• Over-the-counter (OTC) pain relievers: Try a short dose of OTC NSAIDs like ibuprofen (Advil) or naproxen (Aleve). This will help decrease pain and inflammation. 

• Topical medications: You can also try topical creams, gels, or lidocaine patches to ease pain.

• Corticosteroid injections: If at-home treatments don’t help, your healthcare team may suggest a corticosteroid injection to help decrease inflammation.

• Acupuncture: Although more high-quality studies are needed, acupuncture may help reduce the pain of costochondritis. 

• Physical therapy: A physical therapist can perform manual (hands-on) techniques that may be helpful in treating costochondritis. They can also help set up an exercise routine and work with you on proper posture. 

• Sleeping position: Avoid sleeping on the affected side or on your stomach. Sleep on the unaffected side, with a thick pillow to hug at your chest. Arrange pillows around you for stability and comfort.

Can costochondritis be prevented?

There are ways you can prevent costochondritis from developing. Examples include:

• Control your cough as much as possible. If you have an existing medical condition or respiratory infection, it’s important to get treatment.

• Maintain proper posture, especially with work or repetitive activities. 

• Perform postural strengthening exercises to help reduce chest wall strain. 

• If you perform a sport or other activity that requires repetitive upper arm motion, balance muscle strength in both the front and back of your body.

• Do breathing exercises to help maintain the mobility and health of your lungs and ribs. 

• If you start feeling pain, avoid repetitive upper body activities and heavy lifting until the pain resolves.

Why trust our experts?

Written by:

Kim Grundy, PT

Kim Grundy, PT, is a licensed physical therapist and an experienced writer and editor. She worked at an outpatient orthopedic facility, where she treated patients with chronic conditions and post-surgical athletes working towards recovery.

Edited by:

Lauren Savage, MA

Lauren Savage, MA, is a health editor at GoodRx, where she focuses on movement, exercise, and healthy aging. She aims to provide readers with the information they need to live healthier, more active lifestyles.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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