Question
Hello,

My name is Corey, and I'm a healthy 24 year old male. Recently (for the past 4ish months) I have been doing the p90x workout routine. I've been trying to do some major lifestyle changes and get fit and healthy. Everything was/is going fine but the routine involves weight training, plyometrics, yoga, kenpo, and other exercises. Recently I did a long yoga routine. Seemed fine, nothing out of the ordinary. However, when I woke up in the morning I was quite sore/stiff and I couldn't turn my torso to the right without some pain in the chest (mainly the right side going through to the left shoulder blade). Once I got home from work I realized there was a boney bump on the right side of my sternum/near my xiphoid process or whatever. It feels like its right were one of my ribs connects to my sternum. I don't remember anything popping or strange pain or cracking or anything during the yoga workout or pretty much ever (my shoulders/collarbone pop occasionally but nothing in the chest) so I don't know if I did something to it while I was sleeping (maybe slept in a weird position or something, I think I often sleep on my side) I've done some research on it, and I am thinking that a rib head is out of place, or I have torn some cartilage? Does that sound right? A friend at my evening job (I forklift and occasionally lift skids and boards for FedEx Freight for about 2 to 3 hours a night) said he has had similar symptoms before and says it's probably torn cartilage. If its either of those its not drastic like I have read of some cases. I can still do most things. No excruciating pain, but definitely some discomfort. I ran a few block last night with no problems. Its been about 4 or 5 days since and I'm not really sore anymore, but I do feel some minor discomfort in my chest/back left side when I breathe REALLY deeply or yawn and the bump hasn't really subsided at all. I'm trying to be pretty careful at work and such or with lifting of any sort. I have stopped doing most the workout routines, except for some cardio and leg workouts (no upper body or weights obviously). The main thing I'm worried about is the bump. It's pretty noticeable especially from a side angle. Do I need to go to a chiropractor and get it "fixed" or popped back in or something? Or will the bump go away or fall back into place over time? Hopefully it's not a permanent protrusion. Is this something I just need to rest for a while since it doesn't seem to be real bad? I hate to stop the workout routine and loose all the ground I've made. I was just getting in shape too! I just don't want it to heal out of position or something because I know bones can do things like that.

Should I see a chiropractor? I'm pretty strapped for money, and I also don't want to have to go to the chiropractor like every week....nor could I afford it but if it needs done or you would suggest that it'd still be good to know.

Chiropractor? Or ibuprofen and rest? Or both?

P.S. I've read that this can potentially become chronic? Is there any way to prevent that since this is the first time it has happened? (aka, make sure it heals properly or something?)

Hopefully that wasn't too confusing or long winded. Thanks a lot for your help and knowledge.

Answer
Hi Corey,

As you may have discovered, there is not a lot of good clinical data on this, and lots of opinions.   Here's mine:  we don't always know what causes this.   However, often there is some form of physical activity, exertion/overexertion, or overt strain to the rib cage or chest.   There is a chance the joint connection between rib and sternum is simply strained and has thickened up and will recede over the next few weeks;   If you ever caught a basketball and jammed a finger joint, you know how the thick knuckle can take several weeks to go back to normal size.   Be patient.    It is not known if anyone can really "fix" this.   You can't go wrong getting some manual therapy by a chiropractor.   In my opinion, the combination of joint manipulation and instrument assisted soft tissue mobilization (e.g. GrastonTechnique) is best.   First, give it some time.  

Dr. G'