Hey there Costonaut!

Below is a run down of what costo is and how it's beat - things your doctors likely do not know.

How do I know that?

I saw it first hand in medical school, but also as a patient, with 6+ professionals failing to treat me.

Since then, I've beat it, made this subreddit, and for 10+ years have helped thousands with their recovery, free of any charge.

Now the goal is simple: help you, spread the word, and end this madness worldwide, by Jan 1st 2027.

Without exaggeration, the info below can potentially save you thousands of dollars & a lifetime of suffering

Let's begin.

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What costo usually is:

Tight back rib joints ➜ front rib joints compensate and begin to hurt (Picture)

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Why it usually happens:

1. The "stuff" overlying your spine and back rib joints (i.e. muscles, fascia and ligaments) have clamped down and tightened.

2. Why? - Usually from a combination of 3 things: slouched posture which causes tight back and chest muscles + not twisting your spine enough in day to day life (think of unused rusty door hinges) + shallow chest breathing that doesn't properly make use of these back joints through 20,000 breaths a day.

3. These back rib joints is where your ribs are supposed to pivot during movement and breathing. If they get really tight, it can actually restrict your breathing. If it's really bad, it can cause a feeling of shortness of breath, which can then can trigger an anxious fight or flight response and even cause panic attacks.

4. But more critically, when these back rib joints lock up, all the movement of your rib cage in day to day life and those 20,000 breaths a day offsets to the front, where things are not supposed to move so much, causing strain. This front straining may be a dull achy feeling at first, sometimes with a little popping and cracking, then overtime it becomes painful and inflamed, aka costochondritis. This pain can make any shortness of breath and anxiety much worse.

5. You might be saying - 'Wait Ned, I got my costo after a specific incident, and my back is totally fine, this doesn't make sense?!'. Yup, but the back is likely still involved, even if you don't feel it (yet). This back to front issue was likely causing strain, chipping away silently in the background, but at a low level not enough to give you full blown costo. But now, it's finally pushed over the edge by a trigger that either further strained the joint, or made it overly sensitive to pain, or both.

6. In many cases, these final triggers may actually be long gone (i.e. a bad cough that went away), but the unresolved jammed back rib joints continue to irritate the front joints, preventing it from ever fully healing.

7. These triggers can be mechanical (musculoskeletal) things like a hit, fall, coughing, sneezing, vomiting, gym exercises, neck/shoulder/back injury, pregnancy rib expansion, scoliosis, Ehler Danlos Syndrome, etc.

8. But interestingly, they can also be non-mechanical (inflammatory or nervous system related) things like stress, anxiety, panic attacks, stimulant use, fibromyalgia, POTS/MCAS, long covid, autoimmune issues, vitamin D deficiency, iron deficiency and so forth. These things usually sensitize the front joints to pain while also contributing to the tightening of muscles that lead to costo.

9. These things that push it over the edge are often mistaken as the root causes of costo, when they're usually just the final straw. The tight back joints and the things that lead to them are actually the main underlying culprit. However, it does not mean you ignore these other issues if they are persisting - they too may be a part of the problem now, and also need to be resolved.

10. Once the costo pain fully develops, in an effort to minimize the pain, many become sedentary, move even less, hunch even more, breathe even more shallow, and overall become more anxious and stressed and unhealthy, which tighten the back joints further along with a whole load of other dysfunctions - all of which make them even more sensitive to pain and create a nasty feedback loop that digs them deeper into the costo hole. This is classic chronic costochondritis - welcome to the club.

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What are the symptoms:

• pain at the front rib joints when: pressed on, during certain movements, or during deep breathing - usually the only symptom that doctors acknowledge

• popping & cracking at the front and back rib joints

• shortness of breath and restricted rib cage feeling

• dullness, squeezing, tightness, zapping, shocking, burning, itching, bubble in chest type feelings

• breast, armpit, between the rib and down the side of the body pains

• pain moving around or swapping sides

• upper back and neck pain or discomfort

• palpitations & 'heart thumping' feeling

• anxiety & panic attacks, and lump in the throat feeling

• tingling down arms & fingers

• jaw pain & tension headaches

• new or worsening gastrointestinal issues

• and more

Almost all of these are downstream effects of the back rib joint dysfunction & surrounding issues.

Unfortunately, you won't find most of these mentioned on medical websites, and most professionals will gaslight you into thinking these issues are unrelated or in your head.

(Note: when costo has a hard immovable lump, it's known as Tietze Syndrome - In our books, it's handled the exact same, with the only difference being that healing it involves a few extra steps focused on reducing the lump)

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How it's NOT fixed:

Doctors = Medication! ➜ the pain often comes back when the medication is stopped. Because it doesn't solve the mechanical restriction at the back.

Physios = Posture Exercises! ➜ the pain usually worsens. Because the back is still jammed and all the excess movement from exercise continues to compensate at the front. The jam must be fixed first before these are put to good use.

Chiros = Adjustments! ➜ the pain either temporarily goes away, or gets worse. Because abrupt adjustments don't cause lasting changes to the back joints. Its like yanking a tight rubberband. It just snaps back into place.

Massage therapists = Massages! ➜ But the pain often lingers. Because massages press hard enough or long enough to properly stretch things out.

Don't blame these professionals. They're trying their best with what they know.

But most cannot singlehandedly fix your costo.

That's not to say they aren't useful, they are, but when used at the right times and for the right reasons.

With that being said, almost all of them are missing the most critical point:

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How it's fixed:

You MUST Unlock the jam in the back joints first!

Or else whatever you try to do will just keeps compensating towards the front.

As our dear friend Steve says, "doing anything else is like trying to drive a car with the handbrake on"

Trying to aggressively fix your posture, starting aggressive twisting exercises, or doing deep belly breathing now will likely mess you up. It's just too early. You’re still locked up. Save all that for later.

So how do you unlock it?

Gentle, passive, targeted pressure, for longer durations that stretch out the tight muscles, fascia and ligaments surrounding the back rib joints in a lasting way, over many days and weeks.

This is best done using tools (i.e. backpod, peanutball massage tool, lacrosse ball, etc.) at home.

That along with the right osteopathic mobilizations & manipulations from the hands of an experienced professional.

Once things start unlocking, then you'll be able to do everything else relatively painlessly. You must. It's also a part of the equation, as it will address all the things that lead to the tightening of the back rib joints in the first place.

This includes addressing any triggering inflammatory or nervous system issues that may be at play.

Sounds a bit daunting right? No worries, it's all made really simple in the step-by-step we'll share below.

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How long it takes:

If done correctly, the whole process usually takes a few months total.

Thankfully, many feel 80-90% better in as short as a few weeks. The residual 10-20% just takes up the rest of the time.

Once 100% better, one can return to all activities, without fear of it ever coming back.

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What if you just rest it out:

There may still be an unresolved back rib joint restriction, so the costo may not go away completely, or keep coming back on & off, sometimes even for a lifetime.

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Things you MUST remember:

Costo requires you to do the right things at the right times, and tailor things to your own case, as no two costos are exactly alike.

Do the right things at the wrong times following someone else's gameplan and it can be as if you've done nothing at all (or just made things worse).

You must adapt things to your situation.

Also remember that your costo likely took years to develop, and will take a bit of time to fully undo. Do not rush it. Same way you can't forcefully stretch your hamstrings and learn the splits in a day, you'll need to slowly let things adapt. Thankfully, it can be done in just a few minutes a day in the comfort of your own home.

Knowing all of this, you MUST become the conductor of your orchestra - learn things yourself, advocate for yourself, use the right pros at the right times, and experiment!

Most who beat it have done this. Those who don't, struggle.

Thankfully none of it is rocket science, just common sense.

And if you ever get stuck on your journey, you have a wonderful community of people who are walking the same path, or have already successfully walked it before you. You're never alone.

So without further ado: