David R. Beatty and Camilia Makyhoun

David R. Beatty, DO, Professor of Osteopathic Principles and Practice, WVSOM

Camilia Makyhoun, Assistant Editor, WVSOM Class of 2016

Thursday, March 7, 2013

RIB TIPS FOR CHEST WALL PAIN




Rib angles are the prominent posterior parts
(David R. Beatty, drawing by William A. Kuchera, DO, FAAO)


Upper back and chest aches are often caused by rib joint stiffness or muscle spasm. However, it is better to first consider heart and lung causes before assuming what seems like rib pain is really coming from the ribs.










DOCTOR'S NOTE: Seek evaluation by a health professional if rib pain is worse with a deep breath or exertion, or is associated with a blow to the chest, shortness of breath, cough, dizziness, fever, fatigue, or weight loss.







CHEST POSITION OF EASE

Anterior thoracic position of ease (WVSOM)
  1. Lie on your back with 2 pillows under your head;
  2. Roll your head to the side of rib pain;
  3. If pain is not reduced, add another pillow and slide the pillows down to support your upper back as well as head;
  4. When rib pain is reduced, take a few deep breaths and rest in that position for 2-5 minutes;
  5. Slowly straighten the head and proceed to the LATISSIMUS STRETCH, or roll to one side before getting up;
  6. Use this position of ease 2-4 times a day or as needed for pain relief.






Left latissimus stretch
(WVSOM)
LATISSIMUS STRETCH
  1. Stand with your feet shoulder width apart and place one arm behind the head;
  2. Grasp the elbow with the other hand. If you have trouble reaching the elbow, grasp the wrist instead;
  3. Slowly lean your trunk away from the side of the arm behind the head as far as you can comfortably go;
  4. Take a few deep breaths and lean farther to stretch for 10-20 seconds;
  5. If no increase in pain, proceed to the SUPINE THORACIC/RIB MOBILIZATION;
  6. Do this stretch 1-4 times a day.





THORACIC/RIB MOBILIZATION SUPINE


Supine thoracic/rib mobilization (WVSOM)
  1. Lie on your back on a firm surface with the knees bent and fingers interlocked behind your head;
  2. Push your elbows together. For rib treatment, roll the arms to the side of rib ache;
  3. Use your arms to pull the head forward while simultaneously lifting the pelvis until a single vertebra or rib is touching the floor;
  4. Rock the pelvis up and down to roll the vertebra or rib over the floor until a joint mobilization is felt;
  5. Repeat steps 3-5 for other achy vertebrae or ribs;
  6. Do this mobilization up to twice a day.






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