The ribs are designed to protect the lungs and heart and assist breathing. Twenty-four ribs start at the shoulders in the thoracic spine region and run down the mid-back covering the front, back, and side of the chest. Almost all ribs are attached in two places, including the spine in the back and the sternum in the front of the chest, by cartilage joints. Trauma, poor posture, intense coughing, sneezing, and heaving are a few factors that can cause mechanical rib dysfunction or rib misalignment.

Rib dysfunction and misalignment are typically caused by unhealthy postures like slumped back and rounded shoulders, weakened posterior muscles, and repetitive stress from work, sports, and intense physical activity. Any ribs can become misaligned, causing dysfunction and stress on the body. A chiropractor can adjust and reset the rib as they do for misaligned and compressed spinal joints.

Rib Cage Design

The ribcage is flexible and expands when inhaling. Each rib is attached to the spine by three joints in the back and the breastbone in the front. Breathing is an involuntary reflex that is impossible to avoid movement in these joints. The joints are small but allow flexing, so the ribs rise and fall with each breath. These rib joints can become inflamed from rib misalignment causing movement problems that can restrict breathing.

Rib Misalignment

Rib misalignment symptoms can include:

• Difficulty breathing.
• Difficulty when trying to sit up.
• Dull, achy, deep pain next to the spine or under the shoulder blade.
• Unexplained back pain.
• Pain when moving or walking.
• Painful sneezing and/or coughing.
• Tenderness and pain in the front of the chest.
• The formation of a lump over the affected rib.
• Swelling and/or bruising in the region.
• Numbness in nearby or surrounding ribs.
• Radiating pain from the back to the front and vice versa.
• Improvement when pressure is applied to the affected rib.

Rib Dysfunction

Up to 50% of emergency room visits for chest pain symptoms result from non-cardiac factors, with the majority being rib misalignment and the muscles and joints around the rib cage becoming irritated/inflamed.

Causes

There can be several reasons for a misaligned rib. The more common causes include:

Unhealthy Postures

• Unhealthy postures stress the body that can place pressure on the posterior portion of the ribcage.
• With time, the ribs can start to shift out of alignment.

Physical Activity, Exercise, and Sports

• Working out intensely can cause the ribs to shift out of position.
• Weight lifting improperly can cause the body to shift along with the muscles involved not being strong enough to handle the added weight and movement, causing rib misalignment.

Pregnancy

• As a woman’s body changes, the weight shifts to the front.
• This can create a downward pull on the rib cage, increasing misalignment risk.

Intense Coughing or Sneezing

• Excessive or severe coughing, associated with asthma, bronchitis, or pneumonia, can significantly strain the ribcage.
• Coughing from a common cold can generate stress to cause a rib to dislocate.
• Sneezing hard can also cause a rib to shift out of place.
• Illnesses associated with constant coughing and sneezing can increase an individual’s susceptibility to rib misalignment because of the weakened state of the muscles.

Intense Vomiting

• Vomiting intensely or heaving can cause the condition.
• Vomiting does not necessarily involve the lungs, but the convulsive action can cause a rib shift/pop out.

Chiropractic Treatment

Chiropractic can diagnose and treat rib misalignment/dysfunction by using various stretching or massage techniques to loosen the area, making the muscles more flexible, then applying firm pressure to realign the rib back. The treatment plan will include specific stretches, postural exercises, diet, and other recommendations to prevent rib problems.

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Spinal Decompression In 90 Seconds

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References

Flodine TE, Thomas M. Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction. [Updated 2021 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK560751/

Jawed, Muzamil. and Bruno Bordoni. “Osteopathic Manipulative Treatment: Muscle Energy Procedure – Exhaled Ribs.” StatPearls, StatPearls Publishing, 19 February 2022.

Rib somatic dysfunction (417242001); Costal somatic dysfunction (417242001); Somatic dysfunction of rib (417242001) www.ncbi.nlm.nih.gov/medgen/736159

Vemuri, Adithi. and Kiyomi K. Goto. “Osteopathic Manipulative Treatment: Counterstrain/FPR Procedure – Thoracic Vertebrae.” StatPearls, StatPearls Publishing, 15 November 2021.