Question
I started work as a postman four months ago and have developed a peculiar set of problems since - some actions that are performed on a regular daily basis are causing a sharp pain in the top of my right chest,  underneath the pectoral muscle.  I can reproduce the pain by holding hands close to my chest and pulling.  The action at work that is painful is when a bundle of mail is held in the right hand and an elastic band is pulled around the bundle with the left hand.

Any ideas? - a doctor thinks it may be a muscle tear or strain,  and a physitherapist thinks that it might be a rib and cartilage issue.

Answer
Sounds like they're both close -- muscular spasms, either the muscles on top of the ribs (pectorals) or between the ribs (intercostals).  Those muscles would be hard and contracted to the touch.

If you were my client, I would be examining for that and then give you some training in relaxing the involved muscles.

Manipulations, anti-inflammatory drugs, and strengthening are not likely to get the job done.  Sounds like you need training in relaxation of those muscles and control of them.

Please see the articles on pain and movement education at somatics.com/page4.htm.

Not a complicated problem with the right approach.

with regard,
Lawrence Gold