All posts in Slipped rib

Shoulder Blade Motor Control & Strengthening and Shoulder Strengthening Exercises for Slipped Ribs

Shoulder Blade Motor Control & Strengthening and Shoulder Strengthening Exercises for Slipped Ribs

All these exercises are excellent at assisting with creating endurance, control and strength around the shoulder.  From our experience, these exercises will assist with preventing slipped rib dysfunction.

Multiple scapular motor control exercises

Scapular retraction (sitting)

Scapular retraction with weights (inclined position)

Shoulder abduction (standing)*

Biceps strengthening (standing)*

Alternative shoulder elevation (sitting)*

Pectorals strengthening (supine)*

Shoulder flexion (supine)*

Front raise shoulder flexors strengthening (standing)*

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How to fix a slipped rib?

How to fix a slipped rib?

What is a slipped rib?

Costovertebral Joints

Costovertebral Joints (where slipped rib occurs)

When I first wrote this blog in 2017, this condition was very common.  It continues to be even more common in the post-COVID era.  I recently updated this blog to reflect the current situation in 2024. A slipped rib or in other words slipping rib syndrome occurs when the joint(s) that form between your ribs and spine and/or between your sternum and ribs move out of proper alignment.  The condition is also referred to as tietze’s syndrome or Chostochondritis (usually referring to the joints between the sternum and ribs located in the chest wall). After this injury occurs, the ligaments that hold the joint(s) together get stretched.

This “stretch” creates irritation, pain, discomfort or “pinched nerve feeling” in the upper back (and sometimes down the arm) and the opportunity for the rib to slip out of place again and again. Often times, it can feel as if a dagger or sharp object is digging in between the shoulder blades and can cause shortness of breath (appearing like a heart attack or panic attack).

What causes a slipped rib to become slipped?

Slipping Rib Syndrome or slipped ribs occur frequently in life.  Often slipped ribs go misdiagnosed and thus under-reported. They are caused by various reasons.  Bending, twisting, lifting, reaching, pulling can cause the rib to slip. Furthermore,  they may be caused by trauma to the body such as being tackled from the side in sports, jumping, or getting hit in a car accident, prolonged or forceful coughing, uneven lifting of heavy objects (furniture, heavy backpacks, luggage, lifting winter/summer tires, etc).

How Can I Treat my Slipped Rib(s)? 

There are many approaches to treat a slipped rib: anti-inflammatories, chiropractic care, physical therapy and strengthening, and sometimes prolotherapy (Prolotherapy, also called proliferation therapy or regenerative injection therapy is an alternative medicine treatment of tissue with the injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain).

How does Dr. Luciano Di Loreto (Chiropractor) treat a slipped rib using Chiropractic care?

Slipped ribs can be treated by various techniques.  One technique is to relax the musculature with heat, interferential current (muscle stimulation that assists in pain reduction), acupuncture, and registered massage therapy.  Recently, I have also been exploring the using of shockwave therapy to treat this conditions. These techniques may assist in soothing the pain or realigning the rib(s) and vertebrae.  A second technique and the one preferred is to adjust the rib(s).  This will also assist in realigning the rib and vertebrae into a ‘normal’ or more comfortable position.

What is an adjustment?

The Ontario Chiropractic Association defines an adjustment as a highly skilled and precise movement usually applied by hand to a joint of the body.  Adjustment loosens the joint to restore proper movement and optimize function. When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about. Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor.    

How is a slipped rib adjusted by Dr. Luciano Di Loreto?

One technique is to have the patient lie on his/her stomach on a chiropractic table.  The adjustment is applied by the chiropractor to the area where the slipped rib(s) is/are irritated.  The adjustment to the area is very quick.  Following the adjustment, the patient usually knows whether or not that rib(s) is/are still irritating them.  Most of the time the pain goes away.  Sometimes, the muscles around the slipped rib remain tender to the touch.  Another techniques is to have the patient sit at the end of the chiropractic table.  The patient sits facing away from the table.  The patient is lowered onto the table and will usually feel the pop or click once he/she reaches the table.  A third technique that is is to have the patient lay on their side facing the practitioner.  In this case, Dr. Luciano Di Loreto, will apply his hand along the area of concern.

Next Step: 

While in this position, patient will relax and take a deep breath.  A small and quick amount of pressure/force is applied and the rib should adjust into alignment.  Following these adjustments (only one maybe used), the patient should feel relief and be able to take a deep breath without the sharp dagger like pain in the back.  After the adjustments, it is always good practice to use a heat pack to soothe the muscles in the region. Trained Chiropractors and other trained practitioners can perform these rib adjustment procedures in various ways.  Always consult a trained health practitioner when contemplating treatment.

Please note that I have NOT exhausted and/or discussed all the options for dealing with a slipped rib.  I have only touched on a few that I find work for my patient’s.  Do your  own research and if you have any questions, please send them along and I will do my best to address them.  Look forward to comments.

Hope you found this information on the slipped rib syndrome interesting. If you would like to book a consultation and treatment, please contact us or book online.

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

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About the Author:

 

 

 

 

 

 

 

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada (Fit for Life Wellness and Rehabilitation Centre located at 3865 Major Mackenzie Drive W., Woodbridge, Ontario., L4H 4P4), Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports (tennis, padel and soccer).

 

 

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Shortness of Breath…Can this be caused by a Slipped Rib?

Shortness of Breath…Can this be caused by a Slipped Rib?

Shortness of Breath…Can Shortness of Breath be caused by a Slipped Rib?

The simple answer is YES.  However, shortness of breath can be caused by more serious conditions.  These conditions require immediate medical attention.

Shortness of breath that comes on suddenly (called acute) has a limited number of causes, including:

  1. Asthma (bronchospasm)
  2. Carbon monoxide poisoning
  3. Cardiac tamponade (excess fluid around the heart)
  4. Heart attack
  5. Heart failure
  6. Low blood pressure (hypotension)
  7. Pulmonary embolism (blood clot in an artery in the lung)
  8. Pneumothorax (collapsed lung)
  9. Pneumonia (pulmonary infection)
  10. Sudden blood loss
  11. Upper airway obstruction (blockage in the breathing passage)

In the case of shortness of breath that has lasted for weeks or longer (called chronic), the condition is most often due to:

  1. Asthma
  2. COPD (chronic obstructive pulmonary disease)
  3. Deconditioning
  4. Heart dysfunction
  5. Interstitial lung disease
  6. Obesity

Although very painful, slipped rib syndrome is usually NOT a serious condition.  It does, however, require special attention and treatment(s).  The assessment and treatment should take place as soon as possible to prevent delay in recovery. 

So why slipped rib syndrome cause “shortness of breath” or DECREASE in taking a FULL BREATH?  

In order to understand this, lets discuss some anatomy first. Slipped rib syndrome was first described in the early 1900’s.  Cases have been reported in children as young as 12 years and much higher in females than males.  We have 2 sets of 12 ribs which create the rib cage.  The ribs attach to each thoracic vertebrae in the back.

Slipped rib syndrome location

Costovertebral Joints (Red Circles)

Sometimes the ligament connection (called costovertebral/costotransverse ligaments) linking the vertebrae of the back and the rib can cause symptoms and discomfort.  If this connection is slightly lax or loose, it may cause something known as hypermobility.  Let’s break up this word – hyper – and – mobile.  Hyper meaning excessive or beyond.  Mobile meaning capable of moving or being moved. Hypermobility may result in stretching of the ligament, misplacement of the bones, and thus an irritation in the back over the attachment location.  Sometimes the nerve in the area can become irritated from this stretching and as a result sends a sharp pain around the torso from the back to the front.  Furthermore, the muscles around the area become taut and irritable as well.   Hope I did not lose you!  If I have, think of it this way…your rib and vertebrae bones are connected together by a ligament (in this case, think of the ligament as an elastic band).  If the elastic band stretches too much, it may cause the bones to shift out of there normal alignment.  If the bones shift, they feel out-of-place and thus cause our body discomfort.  Hope this explanation makes things more clearer.  If the rib is not functioning optimally or creates pain due to ligament stretch, breathing patterns can also be altered.  Sometimes this alteration can lead to shortness of breath or the feeling of not being able to take a deep breath without discomfort.  

How do I treat a slipped rib?

Slipped ribs can be treated by various techniques.  One technique is to relax the musculature with heat, interferential current (electromodality that assists in pain reduction), acupuncture, and registered massage therapy.  These techniques will assist in realigning the rib(s) and vertebrae.  A second technique is to adjust the rib(s).  This will also assist in realigning the rib and vertebrae into a ‘normal’ or more comfortable position.

What is an adjustment?

The Ontario Chiropractic Association defines an adjustment as a highly skilled and precise movement usually applied by hand to a joint of the body.  Adjustment loosens the joint to restore proper movement and optimize function. When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about. Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor.    

How is a slipped rib adjusted by a Chiropractor?

One technique is to have the patient lie on his/her stomach on a chiropractic table.  The adjustment is applied by the chiropractor to the area where the slipped rib(s) is/are irritated.  The adjustment to the area is very quick.  Following the adjustment, the patient usually knows whether or not that rib(s) is/are still irritating them.  Most of the time the pain goes away.  Sometimes, the muscles around the slipped rib remain tender to the touch.  Another techniques is to have the patient sit at the end of the chiropractic table.  The patient sits facing away from the table.  The patient is lowered onto the table and will usually feel the pop or click once he/she reaches the table.  Trained Chiropractors and other trained practitioners can perform this rib adjustment procedure in various ways.  Always consult a trained health practitioner when contemplating treatment.

What exercises should I try if I have a Slipped Rib?

From my experience, a combination of techniques, modalities (IFC, Cryotherapy, He

Wall angels for Slipped rib syndrome

Wall angels for Slipped rib syndrome

at Therapy), registered massage therapy and adjustment, work extremely well to help with the discomfort of a slipped rib. Furthermore, I find that adding mid back strengthening exercises (such as wall angel exercises) to the mix, helps to prevent future episodes of slipped rib syndrome.

 

Please note that I have NOT exhausted and discussed all the options for dealing with a slipped rib.  I have only touched on a few that I find work for my patient’s.  Do your  own research and if you have any questions, please send them along and I will do my best to address them.  Look forward to comments.

Hope you found this information on the slipped rib syndrome interesting. To make an appointment to see Dr. Luciano Di Loreto, please contact the office at 647.873.4490. 

Dr. Luciano Di Loreto, HBSc., D.C. & Associates

Chiropractor & Acupuncture Provider

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

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Can a Cough Crack a Rib?

Can a Cough Crack a Rib?

In short, unfortunately, yes, if the cough is prolonged, repetitive and compounding underlying bone density issues. Do not be alarmed.  A rib fracture (one rib) is not life threatening, however, can be extremely painful. They typically occur under the breast and a little off to the side of the torso.

Rib Fracture

Rib Fracture

A patient (age 40) visited us after she had a flu and cough for 8 days week. She said she coughed so much that it make her body hurt.  After one particular coughing spell, she explained that she had pain along the torso and along the rib.  Again in our office, two days after the initial incident, she felt immediate sharpness and pain when she coughed or when we touched the area.  The area was not red, but it was extremely sensitive and tender to the touch.  We advised she see her family doctor for examination and imaging.  She visited her family doctor after our discussion and had x-rays taken. The next day she came by our clinic to share the results. The x-rays confirmed a hairline fracture along the 5th left rib.  The rib was in proper position and would heal naturally on its own. Her doctor also advised a bone density scan. A bone density test enhances the accuracy of calculating your risk of breaking bones.  A bone density test uses X-rays to measure how many grams of calcium and other bone minerals are packed into a segment of bone. The bones that are most commonly tested are in the spine, hip and forearm.  Doctors use bone density testing to: Identify decreases in bone density before you break a bone, determine your risk of broken bones (fractures), confirm a diagnosis of osteoporosis and monitor osteoporosis treatment. Osteoporosis a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D. Our patient asked if there was anything we could do. Her family doctor felt that some pain medication and follow up with us for pain control therapy would be beneficial. 

We explained that ice over the area would help with pain control.  She asked if we could use laser therapy to assist the soft tissue tenderness. We proceeded with laser therapy treatments which helped with healing of the soft tissue in the area along with tenderness.  After 3 treatments within a one week period, her tenderness had decreased 50%. This was exciting for our patient and for us.  After an additional 3 treatments of  laser therapy and ice therapy over 2 weeks, we were able to improve the condition almost 100%. Our patient was extremely happy with the results.  She followed up with us after her bone density test, to advise us that her bone density was in the normal range.

Please note that although one rib fracture is typically not dangerous, the same cannot be said for multiple rib fractures. Multiple ribs fractures can be dangerous as they can lead to flail chest or an open chest wound. They usually occur due to trauma, car accidents or falls. The main goals in the treatment of multiple rib fractures are control of pain, support of respiratory function, and stabilization of the chest wall either through mechanical ventilation or surgical fracture fixation.  Please seek immediate medical attention if you suspect multiple rib breaks/fracture.

Provided by Dr. Luciano Di Loreto, HBSc., D.C. & Associates

 

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