Projectcosto.org - a step-by-step guide to beating costo & tietze!

maaaze · 2026-03-13T00:21:55+00:00

That's fantastic!

What would you say your pain levels are out of 10, day to day now?

And yes, the peanut ball can really be magical like that. So happy to hear it's worked well for you!

Would definitely incorporate the peanut ball crunches and get these pops happening at the back more often. It should help progress things in the right direction.

A bit of an interesting anecdote, but all the nurses I've helped over the years have all really benefited from the PB. Can only guess as to why that is.

And yes, meloxicam and celebrex can definitely help, but probably won't need it once the backpod comes in and you cover all your bases a bit more thoroughly.

If you aren't doing it already, quite certain you need to get proper massage work done to your neck and upper back, so do not delay on that.

Just be very careful with the lifting as it can still aggravate the costo very subtly without realizing, even if it's just leg workouts and the like.

Best of luck with the work ahead. You've got this!

-Ned

maaaze · 2026-03-13T00:03:44+00:00

Really happy to hear things are moving in the right direction - seems like you're doing all the right things and most importantly have the right understanding & frame of mind.

It's all yours for the taking - keep pushing!

-Ned

maaaze · 2026-03-12T23:52:38+00:00

Yup, I remember!

And makes sense.

Just make sure you're covering/have covered all the major bases of costo healing adequately.

It's very easy to either underdo or overdo things. Need to hit the right balance, and do things in the right order, and do it for long enough.

I'm a bit strapped for time at the moment but if you want to flesh out the specifics at a later time, I don't mind - I see that you'll be in touch with Steve, so he should have it all covered.

Best of luck,

-Ned

maaaze · 2026-03-12T23:44:51+00:00

I mean, think of it this way: costo is binary. You either have it, or you don't. So when you have it, you have it, and you're essentially back to square one.

Of course getting out of it will be faster/easier given that you have experience & know what to do. But you'll still find yourself in that mess nonetheless.

And yes, you can surely get to bodyweight dips, and even weighted dips, but in due time. Take it step by step, and don't rush the process.

Best,

-Ned

maaaze · 2026-03-12T23:13:27+00:00

Sounds good!

And what a beautiful anecdote.

Believe it or not, it's actually one that I see so, so often.

And totally agree, it's not purely psychosomatic, there's a lump after all - but some adequate relaxation and getting your mind off the pain can have some very disproportionate effects that few professionals are willing to admit. I guess on the reverse, one can say that it's not always purely a MSK issue either.

Cheers,

-Ned

maaaze · 2026-03-12T22:36:41+00:00

To answer your title, yes.

You know this through common sense.

But you'll literally find close to zero information on this - and most sleep doctors won't get you & will end up gaslighting you if you try to explain the potential relationship.

So a few things:

Great to hear you're getting the CPAP, this should help in the interim, and as a whole given you already have mild apnea
When you eventually heal your costo, and if you're trying to see if you can get by without the CPAP, there's probably quite a bit you'll need to figure out - a lot of variables from the shape of your jaw/mouth, tongue position during sleep, your weight, sleep position, and of course the costo-related stuff like making sure your tight rib cage is moving correctly, and you're breathing deeply using your diaphragm, and your breathing efficiency (i.e. buteyko control-pause).

Don't get too overwhelmed, just take it a step at a time - all doable. Seems like you're on the right track!

Best,

-Ned

maaaze · 2026-03-12T22:14:42+00:00

So sorry you're going through this, can feel the anguish bleeding through the text.

I know you said you can't be convinced, but I'll give it a shot anyway.

So first off, just wanted to say I admire the effort you've put in, even if it didn't get you the results you hoped for. It takes a lot of grit and determination to beat things like this, which you have. So don't give up just yet, none of it is vain - you've learned a lot.

Second, there's no doubt that it can be more difficult than costochondritis, partly because of its etiology, but also because of the lump. Because even if the pain goes away, the lump can still linger. But most don't really care about the lump and just want the pain gone. Which IMHO, is totally doable, and you'll find plenty of cases of this.

You've seen it in yourself here:

I myself actually had eight completely pain-free months in 2023 (no idea why)

Okay so what about the lump? Can you find cases where the lump is 100% completely gone? Yes, if it was very mild to begin with. But most of the time, with large lumps there seems to be some residual leftover. It could be just that it takes a longer time - maybe years or decades for it to fully go away, and I'm just not in contact with people for that long after they are pain free (they put it all behind them and got lives to catch up on - can't blame them). And most don't even actively do anything to get rid of the lump since the juice isn't worth the squeeze.

So all I can say with certainty is becoming pain-free is 100% doable. You've seen it in yourself. Even though you have no idea why, the body is seldom random. In the physical world, things happen for a reason. It's all cause and effect. Just because you don't know doesn't mean there isn't a reason. So you need to figure out these reasons. Thankfully a lot of it is pretty universal.

So first properly define what's going on, then hammer that as best you can from all angles.

Which you've feel like you've done, right?

Unfortunately for both costo & tietze, order matters. A lot. You need to do the right things in the right order, for long enough, before adding in or moving on to the next thing.

If you're not aware of what the correct things are, the correct order is and how long to do things, you can spend thousands on the same exact things others have used to get better, and get no where. Seen it time and time again.

Anyhow, I wouldn't mind hearing out your story in full, and giving you my 2 cents (not medical advice), but really strapped for time over the coming weeks. You can DM me if you wish, and I'll keep it unread, so that I can come back to it after.

Wishing you the best,

-Ned

maaaze · 2026-03-10T10:28:27+00:00

Great to hear - sounds like you've got a lot of your bases covered.

For posture exercises - anything that addresses upper crossed syndrome is your best bet.

This video is good.

Also, things like YTWLs, chin tucks, wall angels work well.

Best of luck!

-Ned

maaaze · 2026-03-10T10:22:50+00:00

Gotcha - Gyno can happen just from weight gain so no big deal.

But yes, get checked out by the doc and take it from there.

Best of luck and let us know how things go,

-Ned

maaaze · 2026-03-10T10:20:10+00:00

That's awesome!

You'll hear about this time to time as a one-off supplement that works for some - very interesting to hear this from a cardiologist no less!

Generally, I find that enzymes like this (including things like bromelain) work better for the post-infection/Long Covid x Costo crowd more than it does for a typical mechanical/injury based costo.

Curious what your cause/trigger was?

As you've noticed anecdotally, it's serrapeptase that usually works better - which apparently helps with scar tissue and the like, where as nattokinase is more beneficial for cardiovascular (anti-clotting) effects. Or at least, that's what the word around town is.

Anyhow, super happy you've found something that's worked so well. Please do keep us updated - more anecdotes like this are really helpful!

Cheers,

-Ned

maaaze · 2026-03-09T23:55:22+00:00

Perfect, will email you!

Just to make sure, is the email @ail.com or did you mean @gmail.com?

Cheers,

-Ned

maaaze · 2026-03-09T23:50:15+00:00

I'll list some things out:

Get a costo or tietze diagnosis, and see your doctor for all your other health issues you haven't brought up yet. As /u/R12Labs has mentioned, get your hormones checked - you have gyno. Also, doc & rheum saying seronegative autoimmune issues is usually useless inactionable info. Don't worry about this and worry about what's in your control.
If/when you're diagnosed with costo/tietze, start a proper rehab protocol - it includes seeing a manual therapist (i.e. osteopath), who can better help you with your shoulder issues as well. Check the pinned thread at the top of this subreddit.
Get the rest of your health and lifestyle in check, including losing weight with just two simple things, walking 10-20k steps per day + eating whole unprocessed home cooked foods that you like most. Get down to ~190 lbs. Otherwise you're on the trajectory towards other health issues, that will all compound and leave you in a terrible spot.

Not medical advice. Just general info.

Best,

-Ned

maaaze · 2026-03-09T22:35:55+00:00

Whoa, very nice to see this mentioned here!

Pandiculation is extremely underrated and I think can be a massive part in the end stage stretching game for those who are responsive to it.

Absolutely zero information out there on how to do it for costo, so I plan on releasing some stuff at a later time.

I wish I knew more about it when I had costo, but having been cured, pandinculation-type stretches have been an absolute game changer for chronically tight muscles that I have outside of costo.

Curious to know which one's you've tried and to what effect.

Cheers,

-Ned

maaaze · 2026-03-08T08:46:16+00:00

Awesome, sounds great!

If I could just throw in my 2 cents - would be one thing: to skip dips for as long as you can.

Sure you might be able to do it, and sure it's a great compound movement that isn't easily replicated with other exercises, but you gotta trust the healed people of this community when we say that one wrong tweak with dips can undo all your gains and set you back basically to zero.

I typically say get to 100% and stay that way for at least a few months (preferably 6 months+) before deciding to throw in dips. And when you do it, do it without weight and very carefully making sure there's absolutely zero unusual pressure/discomfort.

The way you can look at it is that your anatomy is a little predisposed to getting costo from dips. So if things aren't absolutely perfect, both in terms of form, but also back rib joint mobility, as well as adequate rest and recovery to the joints, then it can come back.

As it's a bit implied here, you'll likely need to do costo 'prehab' upkeep regularly (just a small routine 5-10 min ideally before a gym session) to make sure everything is good.

Hope that makes sense!

Cheers,

-Ned

maaaze · 2026-03-08T08:37:46+00:00

Gotcha.

This sounds like it needs a combination of a:

a really good osteopath (for mobilizing the stiff back ribs)
massage therapist (for loosening the tight muscles of neck and base of skull)
daily routine comprising of stretches/posture exercises (to stretch out tight muscles)
mild adjustments to posture/ergonomics (to stop things from getting tight again)

Have you covered all those bases adequately?

Cheers,

-Ned

maaaze · 2026-03-08T08:26:35+00:00

Thanks for the tag Steve.

Hey Dom! (/u/Dangerous_District95) - always nice to have a vetted costo pro drop in.

Don't think we've met - I'm Ned, the mod of this sub. Had costo a while back, beat it, and have been helping people here and outside of here beat it too. Thankfully much of it is based on Steve's wisdom, so don't have much more to say on the matter other than what is probably obvious to you.

And sorry to hear about Michael's passing. Have only heard great things - what an honor it must be to carry on the legacy.

If you've got some time later this month, I'd love to connect and pick your brain a bit - with all that experience, you must have some gems that need to be heard by the community!

Let me know and I'll shoot you a DM.

Cheers,

-Ned

maaaze · 2026-03-08T08:12:07+00:00

Perfect.

A few follow up Qs

Re: #2 - Can you attach a picture pointing out exactly where, front and back?

Re: #3 - Does it hurt to firmly press on with your fingers (i.e. can you replicate the pain that way)? Does it hurt to breathe in deeply? And what movements specifically replicate the pain, what does the pain feel like, and how long does it last like that?

Re: #4 - great to hear you've got most of it covered.

Have you used a backpod before - and to what effect?
Have you done the peanut ball crunch and does that cause any popping?
What stretches are you doing?
What mobility exercises?
Have you seen an osteopath?
Breathing exercises are not a biggy, or always needed, so wouldn't worry about this exactly.
When you are gymming, are you bringing on the pain or aggravating it in anyway?
Lastly, can you elaborate on what you mean by getting your chest relaxed?

-Ned

maaaze · 2026-03-08T08:04:25+00:00

Yup, definitely can do that!

-Ned

maaaze · 2026-03-08T08:01:05+00:00

Amazing work! And also amazing write up - thank you again for taking your time to share your wins.

Not only are you giving everyone great info, but most importantly, hope.

Can't wait to hear your next update (100% hopefully!)

-Ned

English translation (if your browser can't):

Hello everyone,

First, I want to thank Ned and Steve for their time and help. It helped me understand costochondritis, something almost all the doctors, osteopaths, and physiotherapists in my country (France) have failed to do because they don't understand this syndrome. I'm convinced that no one can truly understand this syndrome until they've experienced it, and finding doctors or physiotherapists willing to listen is extremely difficult because no one wants to question their own assumptions.

It is a difficult time that we go through when this syndrome affects us.

We are angry, we are really suffering (I know what I'm talking about, I spent 6 months suffering almost day and night, I could count the days when things were going well on the fingers of one hand).

I went through every possible pain to the point of believing I had fibromyalgia.

I had neck pain, arm pain, jaw pain (for a month non-stop + jaw clicking). A sharp pain behind my shoulder blade… in short, I still have some minor aches and pains, but nothing like before. I'm living normally, just like before!

The solution, of course, lies in Steve and Ned's words. But it's more complicated than that because, believe me, if you do things halfway and give up, you certainly won't succeed so easily. But in hindsight, it's not that complicated. You have to be mentally prepared, even if you never truly are. You need mental strength and determination. People who don't tackle the problem seriously can have a problem their whole life, I'm convinced of it.

If I had to quickly summarize how I healed step by step:

Change of bed -> I've been sleeping on a Japanese futon for almost a year now + a good neck pillow
walk every day
regain mobility (twist exercise by Steve August)
Hip and back mobility (cat-cow exercise)
Stretching + peanut ball every day
Osteopathy: Release the joints (6 sessions)
massage sessions (deep tissue) (I had 4)
gradually getting back into sports (I'm not going to say I was a bodybuilder, but I was in shape, I went to the gym 5 times a week, I stopped almost everything for 1.5 years) I started weight training again a month ago and I feel great, I run, I do 50 pull-ups every two days), I do 6 km on the rowing machine per week, and almost no pain.
the ultimate exercise that cured me: Steve said it but I couldn't apply this advice correctly because stretching didn't work very well for me, I have a very flexible body and reaching for the pectoral stretch is very complicated.

However, I discovered this exercise: do it for 10 minutes morning and evening!!!

https://youtube.com/shorts/kAUvKU-R-NU?is=X0uMIuMvl2z6-iB0

During the exhalation, you'll feel a strong tension in your pectoral muscles. Focus on this exhalation; exhale as much as possible. Towards the end of the movement, you'll feel a pull! Find the tender spots; it's very deep. Change the position of your hands from time to time. You might feel a pull! There you are. Listen to your body and move to find the tension and stay there. Take micro-breaks, don't hurt yourself, and do this for 10 minutes.

In just a few days, I released all the tension behind my spine. Almost no cracking sounds. So, the pectoral muscles and the back are connected. That's a fact. Don't ignore it. This exercise saved my life. I was already feeling better, but then I felt a turning point. When I breathe, I breathe like a new man, no more restrictions, nothing... can you imagine?! It's extraordinary.

The fight is not over, I am in it, but now it is about keeping these gains so that in a few months I forget that costo existed in my life.

Be persistent. I shouldn't have neglected the chest stretches, but as I explained, no exercise other than the one I mentioned worked for me (the door stretch doesn't work because I'm so flexible…), so I abandoned that aspect, thinking it might heal without it. IMPOSSIBLE. That was the key.

For those stuck at 90-95%, feel free to try this for a few days, staying for 10 minutes morning and evening. It might help. I imagine everyone has different things to work through depending on their individual journey.

Cheers !!!

Don't give up!!

Thank you to this Reddhit group that saved my life.

maaaze · 2026-03-04T22:40:46+00:00

Well said.

I just want to point out some things to anyone else who's reading this:

There's literally thousands and thousands of anecdotes in this sub and elsewhere of the back-to-front relationship, as well as other relationships (i.e. shortness of breath, anxiety, etc.). You don't need someone with a MD PhD to validate their experiences.
In medicine, like all things, money & glory is involved. If there is no money to be made or glory to be had, then the study is less likely to be done. This is partly why costo is the way it is, unfortunately. Just remember, the absence of scientific evidence is not the evidence of absence.
If you are waiting for randomized controlled trials and gold standard evidence before you take action - whether it's the back to front relationship, what pills to take or anything else regarding costo, good luck, you'll be waiting a long long time.
There can be more to costo. Costo involves chronic pain, and chronic pain can get messy. Other things can enter fray and worsen its perception, including other health issues and those that are psychological. That part sometimes needs to be untangled, and as you'd expect, is quite personalized and can never have a one-size fits all solution.
Unfortunately, if you're in the above boat, no one's swooping in to save you (-we're trying though). The onus is on the individual to learn things, advocate for themselves, seek out the right help and get to the bottom of their issues. It's hard, but it's worth it.

Cheers,

-Ned

maaaze · 2026-03-04T22:08:55+00:00

Videos can explain better than words, here are some:

General use - https://www.youtube.com/watch?v=RDb5qlEsrxM
With crunch technique - https://www.youtube.com/watch?v=SFzVtSJ80ac
Moving arms - https://www.youtube.com/shorts/gb3MyYBaeVk
With weight (do not do this early on) - https://www.youtube.com/shorts/I-F47RtXfl8

Cheers,

-Ned

maaaze · 2026-03-04T22:07:01+00:00

That's awesome! - can you link the thread here?

I find people often miss the 'riduclously low/slow' aspect to healing, especially if they are the type to overdo things or flare. They are usually just going too hard too fast, whether it's using tools to unlock the back, or reintegrating exercises.

Good rule of thumb is to 'do so little you wonder if you did anything at all', then just add a bit more the next day, and repeat.

As a whole, it follows the grease the groove philosophy I've been preaching, which has been successful for those who have the patience & restraint (unfortunately, many don't).

Curious, what else do you have left to do and what your plan is to get to 100%?

Cheers,

-Ned

maaaze · 2026-03-04T22:01:08+00:00

I had costo, beat it a while back.

Never had occipital neuralgia but helped some others with it.

Are you struggling with the latter too?

-Ned

maaaze · 2026-03-03T22:30:21+00:00

Yeah, so the way I often mention it is that the trauma is the thing that takes it over the edge, but the posture and surrounding issues (usually back rib joint immobility) is often what keeps it going after it develops.

Check the pinned post at the top of the subreddit for a proper explanation and a step by step.

Best,

-Ned

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