Costochondritis and scubadiving ?

[scubamonica]

Hi. I was diagnosed with costochondritis about 10 days ago. The pain was almost gone and I decided to comeback to the water. I did it the day before yesterday. I did a roll back from the boat and everything's was ok. Same day at the evening I did very few repetitions of biceps with my trx. Just trying not exercising andyesterday I drove a scooter for some hours in and around puerto galera, Philippines where the roads are not exactly the best.
Results: terrible pain ! From the morning to night. Today almost back to normal but I didn't go diving.
My question is. Can be the diving the problem ? Consider I haven't lift any of my equipment, I put 2 kilos in the pockets of my BCD and 2 kilos in the weight belt. Removed the gear in the water. Can be the pressure of the water ? I just don't know what to do ?! I'm still have 20 days to go on my holiday ?
Any advice ?
I stopped any exercise with my trx and I'm doubting about the scooter.
Thanks !

 

[DocVikingo]

Hi scubamonica,

By way of opening, be aware that determining the cause of chest pain, especially in the sternal area, can be tricky, and the discomfort can be the result of some quite serious conditions. As such, you'll want to have a relatively confident diagnosis before proceding.

That said, the water pressures per se involved in recreational scuba will have absolutely no effect on costochondritis. However, an improperly fitting BCD or related dive gear might. Check to make sure that nothing is unduly tight/impinging on the rib area. The condition also could be aggrivated by scootering on rough surfaces or other minor trauma.

If you truly have uncomplicated costochondritis, resting/protecting the chest area (e.g., no TRX, riding on bad roads), anti-inflammatory meds, application of local heat/ice, and gentle exits/entires with donning/doffing gear in the water should provide some relief.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[Duke Dive Medicine]

Hi Monica,

Riding on DocV's coattails a little here, but who diagnosed you, and is this indeed uncomplicated costochondritis or is it related to another medical condition? Is this the first time you've suffered from this, or has it happened before and you're only just now being diagnosed?

Even if you took your gear off in the water, diving still involves some physical activity, e.g. climbing up the boat ladder. This, combined with the force of hitting the water backwards, along with the chest strap on the BC, the bicep exercises you did, and steering a scooter on bumpy roads and probably pushing or pulling it a bit, may be what aggravated your condition. To avoid this, it's probably best to wait until you are well and truly healed before you try diving, or any other physical activity, again.

Best regards,
DDM

 

[scubamonica]

Hi scubamonica,

By way of opening, be aware that determing the cause of chest pain, especially in the sternal area, can be tricky, and the discomfort can be the result of some quite serious conditions. As such, you'll want have a relatively confident diagnosis before proceding.

That said, the water presures per se involved in recreational scuba will have absolutely no effect on costochondritis. However, an improperly fitting BCD or related dive gear might. Check to make sure that nothing is unduly tight/impinging on the rib area. The condition also could be aggrivated by scootering on rough surfaces or other minor trauma.

If you truly have uncomplicated costochondritis, resting/protecting the chest area (e.g., no TRX, riding on bad roads), anti-inflammatory meds, application of local heat/ice, and gentle exits/entires with donning/doffing gear in the water should provide some relief.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Thanks for your answer. I was diagnosed first in Dumaguete in a very basic hospital. they took a x ray and ECG. The dr didnt say anything just prescibed me pain killers. This didn't give me much confidence and the pain didnt desapear so we short our stay in Malapascua to go toCebu. I went to ER in Cebu Doctors Hospital and they took another X-ray, another ECG and a blood test. All to check my heart which is working very well and is very healthy one due my healthy life style. Today almost don't feel a pain but I'll wait until next week to see if I can dive. Thanks again for your answer!

---------- Post added January 28th, 2013 at 02:44 PM ----------

Hi Monica,

Riding on DocV's coattails a little here, but who diagnosed you, and is this indeed uncomplicated costochondritis or is it related to another medical condition? Is this the first time you've suffered from this, or has it happened before and you're only just now being diagnosed?

Even if you took your gear off in the water, diving still involves some physical activity, e.g. climbing up the boat ladder. This, combined with the force of hitting the water backwards, along with the chest strap on the BC, the bicep exercises you did, and steering a scooter on bumpy roads and probably pushing or pulling it a bit, may be what aggravated your condition. To avoid this, it's probably best to wait until you are well and truly healed before you try diving, or any other physical activity, again.

Best regards,
DDM

Hi! As I told before, I was diagnosed first in Dumaguete in a very basic hospital. they took a x ray and ECG. The dr didnt say anything just prescibed me pain killers. This didn't give me much confidence and the pain didnt desapear so we short our stay in Malapascua to go toCebu. I went to ER in Cebu Doctors Hospital and they took another X-ray, another ECG and a blood test. Here the drs were much more trustable and they gave me a name/specific diagnosed. my heart is working very well and is very healthy one due my healthy life style. This is the first time i have this. Today almost don't feel a pain but I'll wait until next week to see if I can dive. The problem is that i can feel no pain but i think has not heal yet. Im scared about trying and make a mess .... How can i know ? Should i stay with no activity for a minimun of time ? One month ? Even if doesnt hurt ? Thanks again for your answer!

 

[DocVikingo]

All to check my heart which is working very well and is very healthy one due my healthy life style. Today almost don't feel a pain but I'll wait until next week to see if I can dive.

If you take the recommended actions, I suspect that you'll be much improved by next week.

Best of luck.

Cheers,

DocV

PS: Did you at least get to see the threshers while on Malapascua?

 

[Duke Dive Medicine]

Hi Monica,

If it's uncomplicated costochondritis then it's basically like an injury or ailment in any other joint. There's a minimum recommended recovery time, then there's what your body will tolerate. A lot of it depends on your age and your general health status. It would be a shame to cut diving out of your holiday, but then you may have no choice if you re-injure the joint. DocV made some good general recommendations above; listen to your body, and be mindful of how you're using the muscles around the area. I hope everything works out well!

Best regards,
DDM

 

[scubamonica]

Thanks for your answers. This website is always useful !
Monica

 

[zugbug99]

Hi Monica,
Costochondritis (tietze's syndrome) is quite common. It is a diagnosis of exclusion usually after a normal Chest xray, labs, EKG in a otherwise healthy person. NSAIDS (ibuprofen, naproxyn, aspirin) are the standard treatment medications used if it returns, or flares up again. There are about 40 other NSAIDS a medical provider could prescribe if the over the counter medications do not control the symptoms of pain. THe problem with costochondritis is it continues to recurr and cause problems usually in the worst places (like the dream vacation to Truk Lagoon.
If you had a recent cold or upper respiratory illness when you were evaluated it may also have been pluerisy another common condition of the inner lining of the chest wall and outer lining of the lungs. It also is a well controlled with NSAIDS but would not be expected to return (unless ill again).
I hope this helps. Nothing beats a good physical examination with a medical provider familure with diving and diving medicine.
Best Wishes!

 

[DocVikingo]

Hi Monica, Costochondritis (tietze's syndrome) is quite common. (sic)

Actually, zugbug, costochondritis and Tietze's syndrome are not quite the same.

Both costochondritis and Tietze's syndrome involve localized pain and tenderness in the same area of the front of the chest (sternum), but the former is not commmonly associated with swelling, while in the latter swelling is characteristic.

Regards,

DocVikingo

 

[zugbug99]

Hi DocVikingo,
It would be an astute practitioner that could discerne from tactile palpation the difference between costochondritis and Tietze's. The sternum actually has only a small part to play, it tis the costochondral ligament that is the culprit involved making up the costochondral joint.
With that being said, nsaids (espcially Arylproprionic acids) work especially well.
Best Regards!