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Get cracking!

Dear Lucy: I’m a 22-year-old male. A few years ago, I got a pain in my middle chest from doing too many deep push-ups. I don’t know if the pain was in my bones or muscles. In any case, the pain came and went, lasting for a few minutes each time, once or twice a week for a few weeks. I haven’t had any pain for a long time, but now, when I spread my arms, I can crack my chest the same way people crack their fingers. It even makes the same sound. It doesn’t hurt when I do it. Is this related to my previous injury? Should I be concerned or get it checked out? —All I’m Cracked Up To Be
 

Illustration of a man's chest and blue t-shirt as he opens his button-down shirt


Dear Cracked Up: First Lucy heard from a reader who could burp on cue. Now she has one who can crack his chest? Lucy’s imagination is running wild as she ponders the other exceptional talents her readers may possess. 
 
But when it came to answering your question, Lucy didn’t ponder long. She knew just where to turn for answers—the man with just the right anatomical model for every occasion, MIT Medical Orthopedic Nurse Practitioner Anthony Pasqualone.
 
According to Pasqualone, the push-up-related pain you experienced some years back was mostly likely musculoskeletal in origin—as is 80 percent of all chest pain seen in primary care settings. “The middle of the chest has a lot of muscles and nerves,” he notes, ticking off just a few. “The pectoral muscles, the intercostal muscles that run in between the ribs, and several abdominal muscles that attach near the rib cage. So, it’s easy to tweak them in a way that can cause pain in the center of the chest.”
 
There’s also the possibility that you had a type of cartilage inflammation known as costochondritis, Pasqualone explains, which tends to occur most often in younger people. “That’s inflammation of the costal cartilage, which is the connective tissue between the ribs. That cartilage gives your ribs their elasticity, but it’s vulnerable to repetitive injury from overuse. And since it runs from the breast bone outward, it can cause central chest pain when it becomes inflamed.”
 
As for your chest cracking, Pasqualone was less impressed with this skill than Lucy. “Though we tend to think of joints as hinged body parts that move—such as the knuckles of our fingers—there’s a joint wherever any two bones come together. Like where your sternum meets your ribs. 
 
“When you crack your knuckles,” he continues, “a sound occurs because of a pressure gradient in the joint capsule. That’s the reason you hear a sound—the same sound—when you crack your chest.” 
 
Pasqualone says that there’s no way to know whether your chest-cracking ability is at all related to your previous injury, but he tells Lucy that “it’s normal to hear the sound with no pain, and as long as there is no pain, your reader should not be concerned.”
 
And there you have it. Lucy hopes it helped to get this off your chest, so to speak, but she will add that if you ever begin to experience pain associated with your chest cracking, you should see a clinician for a thorough evaluation. —Lucy

Back to Ask Lucy Information contained in Ask Lucy is intended solely for general educational purposes and is not intended as professional medical advice related to individual situations. Always obtain the advice of a qualified healthcare professional if you need medical diagnosis, advice, or treatment. Never disregard medical advice you have received, nor delay getting such advice, because of something you read in this column.