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Do I have a Rib Out? Is it a Subluxation?
April 9, 2019
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Subluxations and Dislocations

Joints can become slightly deranged during activity, creating a "subluxation", or fully disengaged, as in "dislocated". In this pic, we are applying some cold spray onto the injury as it swells.

Understanding Subluxations and Dislocations

At Blue Heron Chiropractic, we treat a lot of subluxations. One of the most common presentations of a subluxation is when a patient arrives saying one of their ribs is “out”. In order to understand what it might mean to have a rib out, we first need an understanding of Subluxations and Dislocations. This will be Part 1 of a 2 part series and we will move onto the actual ribs in Part 2.

First of all, let’s discuss some terminology. Joints are where two or more bones come together and they function to provide flexibility and in some cases the mechanics of motion. A “luxation” is the shifting of a bone within a joint.  If a bone in a joint were to shift out of the joint completely, we would have a “dislocation” (disluxation). Dislocations are rather dramatic, and they can be visibly deformed, swollen and discolored, intensely painful, and immovable. A “subluxation” (sort of like saying sub-location) is then much less than a dislocation and represents a change in the attitude of a joint. For example, when someone has a “rib out”, what they are probably  experiencing is a rib subluxation. A subluxated rib joint, can also be painful and swollen.

Visualizing a Joint Model

As an example, let’s make a model joint by putting your fist into your palm. If you would like, rotate and move your fist around in the bowl of your palm, simulating a moving joint. Inside a body, there would be slippery surfaces and fluid helping the surfaces slide on eachother and avoiding friction.

Injury to our joint – Dislocation

Now, along comes an injury, for example – something pulling the elbow with the fist, separating it from the palm. Set the palm and the fist next to eachother in your lap. Now you will probably agree that this joint is no longer functional. This would represent a dislocation, complete with tearing of tissues and disrupted joint capsules, stretched muscles, spasm and pain. This bone is really “out of place”.  

Injury to our joint – Subluxation

Now put the fist back into the palm, re-establishing the joint. Take the fist and turn it on its side in the palm. Now, this joint can still do some of its regular moves, but it’s still deranged. There has been a “luxation”. We can call this a “subluxation”. The ends of the joint still reside together, but they are not sitting properly. For a variation, twist the fist inside the palm. This is also not your average situation, and might also qualify as a subluxation.  There is going to be pain, stretched muscles, and maybe some deformity. While this joint is “slightly out”, there are typically less torn tissues here.

Opinions Vary about Subluxations

Like Chefs discussing a recipe, Clinicians will vary on the details of a subluxation. Some will suggest that the two elements of the joint have to be “partially dislocated” to qualify as a subluxation. Others will suggest that any deviation or derangement of the normal status of the joint, especially if it is painful and creating dysfunction, qualifies as a subluxation. At Blue Heron Chiropractic, our definition of a subluxation is as follows: “Subluxation: a physical derangement within the joint structure with functional, nerve, blood supply or organ effects, often from a trauma. A subluxation is often correctable with a chiropractic joint manipulation.”

Subluxation Treatment at Blue Heron Chiropractic

At Blue Heron Chiropractic, the first thing we will do is determine the extent of the injury and confirm that there is no fracture. We will evaluate joint motion, position and function. What we are typically going to do is to prepare the joint with some pulsed therapeutic ultrasound to soothe and soften the joint. Often massage or myofascial release is applied to local muscles. An adjustment involving 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. The next step is to discuss the cause of this problem so that it does not happen again.

If you have a subluxation, let’s start getting it corrected as soon as possible. Often if there is not a lot of tissue damage, we can settle this problem within a few sessions. If the issue tends to return, maybe the joint is slack or hypermobilized. Maybe muscular imbalance is the problem. We will create a treatment plan to address this and get you back to full function.

Blue Heron Chiropractic specializes in understanding and helping control both Old pain and New pain, supports Vitality, Motor Vehicle Accident Recovery and Work Injuries. Chiropractic has benefits 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. .

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