By Steven Tran –Sydney CBD Chiropractor
First of all Ribs don’t go out… so what is actually going on?
several joints in the spine such as intervertebral joints, costotransverse
joint, etc. In the thoracic spine, the ribs articulate with both the body of
thoracic vertebrae and the transverse processes, the joints that are formed
here are called costovertebral joint and costotransverse joints.
subluxation or ribs “going out” is described as a partial dislocation of a rib
usually occurring at the costovertebral and/or the costotransverese joints. Despite
the lack of any evidence, healthcare providers have regularly proclaim rib
subluxation as a common clinical occurrence found in patients with unilateral
thoracic pain that radiates to the chest wall.
actually be happening is that the supportive ligaments around theses joints
(costotransverse, intertrasnverse and radiate (costovertebral) ligaments) are
sprained and stressed. Following a major or minor trauma (such as over reaching
for an item or sneezing) of a local ligament, local inflammation and local
muscle spasms (such as the erector spinae) occurs in the attempt to stabilise
the costovertebral and costotransverse joints.
What causes costovertebral joint sprain?
- Sudden acceleration / deceleration
- Blunt trauma to chest and spine
- Overuse or misuse – excessive
bending, lifting, arching, reaching or twisting movement.
- Forceful or excessive coughing
- Poor posture (stooped)
The signs and symptoms of costovertebral joint
- Pain on one side of the spine and
rib cage + pain that radiates from mid back around the chest wall
- Mimic pain of cardiopulmonary
origins (chest pains)
- Pain with deep breathing, sneezing
- Tenderness to palpation over the
- Muscle spasms around the injured joint
What you can do right now for costovertebral
- Avoid forward flexion, lateral
flexion and posterior extension of the spine
- Initially, ice treatment should be
tried at home. This will help in reducing pain and swelling. 10 minutes once in
- Exercises: (these exercises should
be performed under the supervision of a health practitioner initially)
- To perform the shoulder blade squeeze exercise, you should sit or stand tall keeping your back in straight line. Then squeeze the shoulder blade (both shoulder blades together) as hard as you can and also to the maximum pain-free limit. Hold this position for at least five seconds and then release it. Start with10 reps and 3 sets, repeat 2-3 times in a day.
- To perform the thoracic rotation exercises, you should lie down on a flat surface on your back and bend both the knees. Then lower the knees slowly to one side making sure that the shoulders and feet are in contact with the surface of the floor. Then repeat the same to other side with of 10 reps and 3 sets, repeat 2-3 times in a day.
What will a health practitioner do to help with
my rib pain:
- Education as to how to protect spine from future injuries
- Education on what needs to be done in case of injuries in future
- Adjustments / Mobilization
- Soft tissue releases
- Dry needling
- Rib taping to compress and stablise the costovertebral joint.
What’s the recovery time of a costovertebral joint sprain?
The recovery time of a costovertebral joint sprain may vary
from patient to patient depending on compliance with treatment plan. With ideal
treatment and rehabilitation, patients typically take two-three weeks to
recover from the injury.
It is important to note, however, that injured tissue takes approximately six weeks to restore the majority of its strength in ideal healing conditions. To prevent injury recurrence, care must be taken when returning to activity during the healing process. Unsure when you can return to activity? Speak to a health professional to find out more.
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