You are in the shower and suddenly you feel a twinge in your back. It gets worse, and suddenly you have a hard time breathing and even when you move your head, you get a stabbing sensation in your back. When you reach back, you feel a “knot” at the base of your neck inside your shoulder blade and assume those are muscle knots. They probably are not (a knot). It’s a rib pushing back at you. This is part two of a series on joint derangements, and featuring the villain of the day – the rib subluxation or “rib out”. For a primer on Subluxation, see Part 1.
Not (knot) exactly. Rib subluxations present as pain in the upper back, typically inside of the shoulder blade. Patients often report they feel like they have “knot” in their back muscles, “like a golf ball”. Pressing on the bump is painful. Occasionally there is sharp pain with deep breathing. Often we hear people say it feels like an “ice pick” or a “wooden stake” in the back. Right about this time we start describing this as “having a rib out”. But are the ribs really “out”? Typically, what we are seeing is a “luxation” or “shifting” of the end of the rib where it joins to the spine in back. When the tissues bruise, it’s essentially a sprain. And in the same way that a sprain can involve the joint and the local tissues, the muscles do get involved as well.
In the body, the ribs form a part of the system for breathing. Your diaphragm, for example, essentially attaches to the ribs. As you breathe, your ribcage expands and moves, each rib swinging like a bucket handle, but also flexing like a fishing rod. If you have a rib subluxation, you may feel a sharp pain every time you breathe. Does this mean you have a rib fracture? Well maybe – but this can also happen with a simple rib subluxation – a “rib out”.
The rib joint has become “slightly deranged”. It’s not dislocated – it’s subluxated. In the human body, upper ribs often derange or subluxate slightly outward and upwards. Placing your hand on your back, you feel a slight bump where the rib pushes out and back. It feels like a speed bump. A rib subluxation can become swollen and can persist for an indeterminate period of time. Accordingly, you get them adjusted.
At Blue Heron Chiropractic, the first thing we are going to do is confirm that there is no fracture. Then, what we are typically going to do is to prepare the joint with some pulsed therapeutic ultrasound to soothe and soften the tissues. Often massage or myofascial release is applied to local muscles. Some very gentle force with a very shallow thrust or tug is then applied to either traction or shift the joint into the desired “normal” position. Often there is an audible click or pop as the joint resettles. We are then going to direct therapies to soothe the tissue reactions in the area. The relief from a rib subluxation release is often dramatic and instantly appreciable. Once you are better, and the joint is “holding”, we will give you some exercises to support it not happening again.
Ribs out are a fact of life – it happens. If you have a rib out, let’s correct it as soon as possible. Often, we can settle this problem within one, two, or three sessions – depending on how sprained it is or was. If the issue tends to return, maybe the joint is slack or hypermobilized. Maybe muscular balance is the problem. We will create a treatment plan to address this and get you back to full function. Generally, relief is so direct that you won’t hesitate to ask for this if it happens again.
Blue Heron Chiropractic specializes in understanding and helping control both Old pain and New pain, Vitality, Motor Vehicle Accident Recovery and Work Injuries. Deep, restful sleep supports recovery for all of the above. Finally, if you have questions about how Dr. Dana Sibilla and Chiropractic can help you, or about exercise, optimal function, pain or pain management, schedule an appointment today. .