Are My Ribs Out Of Place?

As chiropractors, we are asked all the time about rib injuries, if they pop out of place, and what they should do about it. There are a lot of misconceptions, so I want you to have the best information and approach so you don’t waste time and money spinning in circles and frustrated.

A rib could be out of place, also known as a rib subluxation or a Slipping Rib Syndrome (SRS). This can cause pain and discomfort, and may be accompanied by symptoms like popping or clicking sensations, difficulty breathing, back pain, or abdominal pain. This could also be caused by intercostal nerve impingement as a result of abnormal movement of false ribs (8-12) related to unstable costal cartilaginous attachments. You may also have heard this syndrome named clicking rib syndrome, displaced ribs, floating rib syndrome, twelfth rib syndrome, etc.

Common Symptoms of Slipping Rib Syndrome

• Sharp pain: Often localized to the chest or back, and may worsen with movement, coughing, or breathing
• Tenderness: Soreness when pressing on the affected rib or surrounding area
• Popping or clicking: You might feel a popping or clicking sensation when the rib moves
• Pain with breathing: Difficulty or pain when taking deep breaths or coughing
• Limited mobility: Difficulty twisting, bending, or lifting
• Muscle spasms: Tightness or cramping in the back or chest muscle

1. What causes Slipping Rib Syndrome?

Typically, SRS is caused by a combination of overuse, direct trauma, and/or sudden extension or flexion, repeated one-sided weight bearing or exercise such as throwing a ball, vigorous swimming, or swinging a bat.

2. Are my ribs out of place?

It is rare that a rib becomes partially dislocated, also called a subluxation. Even more so that it becomes dislocated. That is why it is important to get a thorough evaluation and determine the right diagnosis. It can FEEL like it is out of place, which is more because of the destruction of the fibrous articulation of the rib or the associated inflammation of their cartilage portion. There is also instability associated with the cartilage of the false ribs.

3. How do I treat this and be confident it doesn’t come back?

I think we, as providers, need to do a better job of addressing what will actually provide benefit to this condition, both short and long term. Traditional chiropractors might just want to adjust you countless times, hoping to “realign” the rib. However, it is most likely not a realignment issue. In the case of Slipping Rib Syndrome, the affected area is inflamed and hypermobile. A chiropractic adjustment will provide more motion to something that is already moving too much, which could make the pain symptoms worse. However, a traditional physical therapist might not touch you at all and just give you a few exercises that they hope help over a few months.

In this case, the best approach is one in which we can use a combined approach of manual therapy techniques of chiropractic treatment and rehabilitative techniques of physical therapy. We use world class equipment and soft tissue techniques early on in treatment to get your pain and inflammation down. One of the things that have been most effective for us is the Class IV laser. Instead of waiting weeks for relief you can achieve similar results in hours or days.

We can then use our NeuX Unit which requires the Interactive Neuromuscular Stimulation (INS) stimulus to be applied to the dysfunctional tissue sites as the patient simultaneously performs the appropriate movement pattern, using the proper mechanics. The patient benefits from the traditional outcomes of physical therapy, which include muscle strengthening, increased range of motion, and motor learning; however, with Interactive Neuromuscular Stimulation, better results are achieved exponentially faster and with longer-lasting effects.

If you have questions about your rib pain and want world class treatment, schedule a Discovery Visit at strengthchiro.com to see how we can help you achieve your goals