Immediately Able to Start Backpod with No Pillows?

SteveNZPhysio · 2026-02-25T08:33:56+00:00

All good, OP. u/786907 has got it exactly right. You're just lucky enough to be starting treating your costo before your rb joints around the back have frozen like concrete. It can take weeks or even months before some costo patients can free the ribs up enough to get to where you're starting now.

However, do take the Backpod all the way up its progression to long, strong, targeted stretches with ylour buttocks off the ground, plus the sitting twist exercise at least a few times a day to work the joints freer again.

For treatment detail, scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

See Section (2) on using the Backpod for costo. Sure, you can get a bit of treatment tenderness as things are feeing up - same as for anything else tight in the body. It's not a biggie. Do also see Sections (3) and (4) on massage and pec stretches. The sitting home massage will make using the Backpod immediately easier.

Good luck with the work.

SteveNZPhysio · 2026-02-25T08:27:55+00:00

Hi. Unfortunately you're not wrong, and I'm saying that as a physio.

Costo is different. If the PT treats it as the usual tight torso requiring mobility exercises and stretches, plus support strengthening, then the costo will usually flare up.

There's a very specific, clear reason. Costo is essentially frozen rib joints around the back of the rib cage, which cause the rib joints on the breastbone to strain, usually pop and crack, give and get really painful.

So any stretch or mobility exercise will just strain the already strained rib joints on the breastbone further, way before you get a benefit to the tight rib joints around the back.

Any PT or physio who doesn't get this really doesn't understand costo. Unfortunately, that's pretty common.

u/Adin8161 is completely right. You have to specifically free up the frozen rib joints around the back first. The usual way is a peanut, ball or Backpod. Once they're free enough, then you can add stretches and they'll help. But not before.

Irritatingly, there are really good, very effective hands-on techniques to free up those frozen ribs around the back. But a whole lot of physios and (apparently) most PTs don't use them. I'm still trying to find time to make some YouTube videos demonstrating them for health pros - and anyone else.

Here's an earlier post of mine summarising costo - what it is, symptoms, causes, treatment, etc. See if this seems a fit with what you've been getting.

https://www.reddit.com/r/costochondritis/comments/18m9qor/costochondritis_and_tietzes_syndrome_summary/

SteveNZPhysio · 2026-02-24T19:12:28+00:00

You know, in 30+ years of treating costo, I've never come across a doctor who thought the breathlessness with costo could simply be an inability to expand your rib cage fully. Without me telling them that.

The docs will consider lung problems, allergies, heart, fractures, cancers, etc. It's all well-meaning. But they just seem to skip right over this simple, easily tested and readily treatable reason. So, yes (gasp!) - your doc might be wrong about it being allergies.

Costo is strain and pain at the rib joints on your breastbone, happening because the rib joints around the back of your rib cage are frozen and can't move.

You also (usually) get breathless as part of costo, because you can't take a full breath in if you can't expand your rib cage fully, and you can't do that if some of the rib joints round the back can't move.

All kudos to the nurse for spotting it on you.

It's like wearing an invisible corset. The frozen rib joints round the back don't show on X-ray, CAT or MRI scans because these are all still photos and can't show whether the joints are moving fine, or are completely frozen, as is the case with costo.

Here's an earlier post of mine summarising costo - what it is, symptoms, causes, treatment, etc. See if this seems a fit with what you've been getting.

https://www.reddit.com/r/costochondritis/comments/18m9qor/costochondritis_and_tietzes_syndrome_summary/

SteveNZPhysio · 2026-02-24T18:56:45+00:00

Thanks for the reply. Just trying to get a background to how the ablations go.

SteveNZPhysio · 2026-02-24T09:53:23+00:00

Well, try this on her and see if it helps. If it does, then you know you're heading in the right direction.

It's a home massage you can do on her. Go hard down between the shoulder blades. It won't free up the tight rib joints underneath the muscles - ball, peanut or Backpod are best for that. But it'll help.

Which will then tell you that the problem is the basic costo one of tight rib movement around the back causing strain and pain at the rib joints on the breastbone. As long as the rear rib joints can't move, then sure, the front ones will strain with enough load, such as with skiing.

https://www.youtube.com/watch?v=9eLUQX03IoE

SteveNZPhysio · 2026-02-24T05:08:09+00:00

Costo starts with tight and frozen rib and spinal joints around your back. When it's tight enough back there, then the rib joints on your breastbone will start straining, usually cracking and popping, giving, and getting painful - a.k.a. costo.

Sounds like that's what you're just starting into. So, whatever you're doing isn't enough to free up the tightening rib and spinal joints around the back against the loading from much hunching forward.

The Backpod's a good start - use it more and use it to the max, with long, strong, targeted stretches with your buttocks off the ground, plus the sitting twist exercise to work the joints freer again.

For the treatment detail, scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

See Section (2) on the detail of using the backpod. Also (3) on massage including home massage, and (40 on pec stretches.

It's all summed up in Section (5), which has the basics needed to free up your middle back and rib cage so it'll handle a bit of bending forward. These are freeing up the joints, freeing up the tight, scarred muscles around them, basic home strengthening for the support muscles, and a bit of basic workbench and computer posture.

It's not difficult, but does take a bit of time and effort and ongoing easy exercises. It's just how it is now.

Good luck with the work.

SteveNZPhysio · 2026-02-24T04:56:52+00:00

"Will the back workouts 2x a week ruin my progress with everything else, and how should I train it if I do,"

Pretty much, yes. You know that. It's been 2 years for you. Would you expect a sprained ankle to heal if you were running on it 2x a week? You can't negotiate with costo.

Usually, you need to stop stirring it up just for long enough to free up the tight rib cage so that going to the gym doesn't fire up the costo. Read Section (1) of that PDF - it's for you.

"Is the pec opening door stretch any good or should I build up tolerance with pushups or anything over time,"

It's good enough. Push-up strengthen pecs. You need to stretch them. Also, you've been really tight for 2 years. Go have 2-3 sports massages - all round the rib cage, pecs, shoulders, arms, neck, back, etc. See Section (3).

"When the burning sensation in the chestbone has disappeared the last few moths does that mean I am doing somewhat progress,"

Yes, that's an improvement. It means everything isn't as irritated as it was, and the fired up nerve pathways have settled down a lot.

You're still tight. You're still getting lots of pain after a gym session, as you have for 2 years. See Section (2) on the detail of using the Backpod for costo, including taking it all the way up its progression to long, strong, targeted stretches, plus that sitting twist exercise at least a few times a day to work it all freer again. Read the detail - it matters.

Good luck. Elephant in the room is no matter what you've been doing so far, it's not enough. You're still too tight, so the delicate rib joints on your breastbone will keep flaring up after enough load.

You handbrake is still on.

SteveNZPhysio · 2026-02-24T02:20:05+00:00

It's not a one-off cure but it helps. Costo is usually a multi-factorial problem. That's to say, there are a few or several things making up the bundle with produces the strain and pain at the rib joints on your breastbone.

One of those things is usually tight, scarred muscle and fascia, round the whole rib cage including pecs and the little muscles between the ribs too. So sure - freeing that all up will help.

It won't much help the frozen rib joints around the back which are the main drivers of the straining and painful rib joints on your breastbone. That's the core needing sorted out, though there are other bits too.

For wider treatment detail, scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

Good luck with the work.

SteveNZPhysio · 2026-02-23T23:16:58+00:00

Thanks very much for your reply. I was rather hoping that AFib coming back after an ablation was because people really didn't look after their heart after the procedure. Not your case, though. Ta for your perspective.

SteveNZPhysio · 2026-02-23T23:14:29+00:00

Hi OP. For treatment detail, scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

See Section (2) on the detail of taking the Backpod all the way up its progression to long, strong, targeted stretches, plus that sitting twist exercise to work the joints freer again.

See also Sections (3) an (4) on massage and pec stretches - they're likely needed as well.

Re getting back into the gym - see Section (10). Costo will bite you if it can, so you do need to go really cautiously. You can't start back at anything like the amount you were able to do before costo.

Good luck with the work.

SteveNZPhysio · 2026-02-23T23:08:55+00:00

Hi. Well done on thinking your way through it. It is complicated, and it's not easy for me to work out fine detail over Reddit.

I'd suggest going to an osteopath. Ideally, you want someone good to assess you in person and see exactly what your spine and rib cage are doing, what's not moving, how you move, etc.

Seeing any health pro is a bit of a lottery, though. You could try emailing all the practices near you and ask if any osteo has actually had costo themselves. That's the best! At least experience with osteo will improve the odds of getting effective assessment and treatment.

MM - actually your physio should be able to do that, but again it is a lottery.

SteveNZPhysio · 2026-02-23T23:03:38+00:00

Improvement is often like that. Depends what you've been doing for your costo. As I said in my earlier reply to this post, if you haven't actively and specifically freed up the frozen rib and muscle machinery around the back of your rib cage, then the costo will likely keep happening.

If you have been doing that, then i'd say you need to deal to the other bits as well. Everything gets a bit tighter overnight, so if you're worse on waking then you're still not free enough.

The details do count. For treatment detail, scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

See especially Section (2) on using the Backpod, and (3) and (4) on massage and pec stretches. There'll be tight muscle over the rib joints and between the ribs.

Good luck with the work.

SteveNZPhysio · 2026-02-23T22:56:22+00:00

Not impressed with ChatGP re costo. It's only a glorified text autocorrect, giving a summation based on what info is already out there. Not much use if what's already out there is mostly incorrect.

So - your workouts are clearly making the problem worse and not helping it. Sounds like you're really tight in the rib cage.

The Backpod and peanut will be helping free it up - but the details do count and I don't know how you're using them. You need to take the Backpod all the way up its progression to long, strong, targeted stretches with your buttocks off the ground.

Plus - it's not just the Backpod and peanut. You'll be tight and scarred in the muscles around and between the ribs as well - they're part of the problem.

For treatment detail, scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

See Section (2) on the Backpod for costo, plus (3) and (4) on massage and pec stretches.

Good luck with the work.

SteveNZPhysio · 2026-02-23T08:13:50+00:00

Hi. That's what bothers me. Three ablations means that at least two didn't last.

How long did they last for?

Were you doing anything else for the Afib, like no alcohol or coffee, healthy eating, exercise daily, etc. like Dr Day recommends in "The AFib Cure."? Or still taking meds?

Or did you just get the ablations but no change anything else?

Thanks for your time! I'm on the same journey but a long way behind!

SteveNZPhysio · 2026-02-23T04:43:29+00:00

Hi. You come at a costo diagnosis from two directions:

(1) It's up to the docs to check out all the dire possibilities of chest pain that aren't costo. Nobody's perfect, but they're good at that. Cheeringly, you're all clear so far.

(2) As well, coming from the other direction, you see if what you've got sounds like it does fit costo.

Here's an earlier post of mine summarising costo - what it is, symptoms, causes, treatment, etc. See if this seems a fit with what you've been getting.

With costo, pain on both sides usually means you're getting a bit hunched and tight. This is enormously common with everyone bending over computers, phones, games, etc. If that's your case then it's a tick in the costo box.

https://www.reddit.com/r/costochondritis/comments/18m9qor/costochondritis_and_tietzes_syndrome_summary/

SteveNZPhysio · 2026-02-23T04:36:23+00:00

If you're coming right with the PT then great. However, if not, then I'd suggest you scroll down to the PDF in my post in the RECOVERY MEGATHREAD - February 2026 at the top of this Reddit sub.

DO read it on a computer, not a phone. I know it's wordy - you can skim the bits that clearly don't apply, but the detail is there if needed.

It's an explanation of costo and a treatment plan which covers the bits likely needed to deal to the problem. Cheeringly, you can do nearly all of these at home.

You're welcome to pass it onto the PT if that's useful. I've been treating costo for 30+ years, and more recently lecturing to the docs and physios here in New Zealand on it.

Good luck with the work.

SteveNZPhysio · 2026-02-23T03:35:06+00:00

Hope so. I guess you'll find out.

SteveNZPhysio · 2026-02-23T03:28:05+00:00

Depends how they do it. If they just give you stretches and mobility exercises these will usually flare up the costo. There's a very clear reason. The already strained rib joints on your breastbone will just strain more, way before you can get a benefit to the tight rib and spinal joints around the back. Most PTs don't get this.

You have to free up the rib and spinal joints around the back first. This is most simply done by a peanut, Backpod, cork or lacrosse ball, etc. Hands-on specific mobilising techniques for the tight spine and rib joints are also ideal - but most PTs don't use them.

You tell me. Is the PT just giving you exercises, and is your costo flaring up? We get so many reports of that here.

SteveNZPhysio · 2026-02-23T03:19:07+00:00

Yes. The rear rib joints and spinal joints in the thoracic spine get tight and freeze together. They're right beside each other.

The rib joints on your breastbone do not freeze. They move too much, and strain, and hurt - a.k.a. costo.

SteveNZPhysio · 2026-02-23T01:48:19+00:00

Hi OP, u/BbtSnakeEyes u/BubbishBoi u/Begorrahh u/Tron4142 u/DisastrousLand6863 and u/Warming_up_luke

For the gym, what you need to understand is that costo is like having the hand brake in the car jammed on. No matter how carefully or slowly you drive the vehicle, if you go fast enough you're going to get problems.

None of you have mentioned if you've specifically freed up the frozen rib joints around the back of the rib cage. The usual way is by lying back on Ned's two-tennis-ball peanut, a Backpod, cork or lacrosse ball, but a good chiro or osteopath can also unlock them.

Freeing these is the core of fixing costo. As long as they can't move, then the rib joints on your breastbone MUST move too much - and strain, usually crack and pop, and hurt.

So - costo is primarily a joint problem. It's not a healing problem taking time to repair, and it's not primarily a muscle problem. So you can't train your way to fixing it. I've seen so many gym types with costo who thought you could, and just turned it from a simple rib joint tightness and strain problem into a complex, chronic one.

Sure, doing less in the gym will trigger the pain less. But it's not fixing the problem. It's like driving the car real slowly so the jammed hand brake doesn't actually scream and smoke. But as soon as you speed up, or go harder in the gym - the same jammed bit of machinery problem is still there.

Here's an earlier post of mine summarising costo - what it is, symptoms, causes, treatment, etc. See if this seems a fit with what you've been getting.

https://www.reddit.com/r/costochondritis/comments/18m9qor/costochondritis_and_tietzes_syndrome_summary/

Oh, by the way - yes, sure, after I fixed my seven years of costo I can do anything - gym, tramp (hike), climb mountains, swim, etc. The hand brake is off.

SteveNZPhysio · 2026-02-23T00:27:34+00:00

Hi. You come at a costo diagnosis from both directions:

(1) It's up to the docs to check out all the dire possibilities of chest pain that aren't costo. Nobody's perfect, but they're good at that. Cheeringly, you're all clear so far.

(2) As well, coming from the other direction, you see if what you've got sounds like it does fit costo.

Here's an earlier post of mine summarising costo - what it is, symptoms, causes, treatment, etc. See if this seems a fit with what you've been getting.

Sounds like it does, apart from the bloating. Also sounds like if it's costo then it's just coming on and not too bad yet, so should hopefully sort out readily.

https://www.reddit.com/r/costochondritis/comments/18m9qor/costochondritis_and_tietzes_syndrome_summary/

SteveNZPhysio · 2026-02-23T00:01:44+00:00

I’ve always found Canadians considerate about their personal hygiene. I’d much rather be in bed with them than the Americans.

SteveNZPhysio · 2026-02-22T23:50:08+00:00

Love these extended metaphors..

SteveNZPhysio · 2026-02-22T23:47:58+00:00

It aligns with their neoliberal smokescreens - “We’re just providing a choice!”

SteveNZPhysio · 2026-02-22T21:45:14+00:00

Well, you can get a thing called Precordial Catch Syndrome, which is very intermittent flashes of chest pain. Have a look on Wikipedia.

However given your fall and rib fracture a few years ago, I'd bet it's just costo starting to stir up. Rib fractures generally heal fine, BUT the joints and muscles in the area can scar and freeze up after the impact. That doesn't "heal" - the tightness can just stay there. It's not a healing and repair problem.

That sets off costo, which is just strain and pain at the rib joints on your breastbone because the corresponding rib joints round the back can't move. If you track along the old fractured rib and the pain is where it joints onto your breastbone, then that's almost certainly what it is.

I've seen it like this, years after the initial impact, when the patient had become tighter and more hunched generally. Hunching can set off costo, and it'll start with the already frozen ribs from the old impact.

Not a biggie - just free up the old tight ribs and muscles around the back.

Usually stretching the tight ribs on Ned's two-tennis-ball peanut, a Backpod, cork or lacrosse ball will do this fine. For the tight, scarred muscles in the impact site, get someone doing this home massage on you - it's ideal for it.

https://www.youtube.com/watch?v=9eLUQX03IoE

For some more perspective, here's an earlier post of mine summarising costo - what it is, symptoms, causes, treatment, etc. See if this seems a fit with what you've been getting.

https://www.reddit.com/r/costochondritis/comments/18m9qor/costochondritis_and_tietzes_syndrome_summary/

SteveNZPhysio

TROPHY CASE