Every few times during the year, I get a patient with a displaced rib head. (I’ve had one or two myself) The sensation is an intense stabbing pain that “takes your breath away” in either the back or the front of the chest; sometimes the pain goes round the rib and sometimes seems to go from the back to the front like a knife.
When a patient comes in, we evaluate them via examination and a detailed history to rule out things like shingles or referred pain for heart, lung and gastrointestinal problems.
But it’s usually a rib head displactment either at the anterior attachment at the sterum [breastbone] or at the posterior attachment at the transverse process of a thoracic vertebrae. The intercostal nerve runs from the anterior rami of the thoracic spinal nerves from T1 to T11 and runs [along with the artery and vein] between the intercostal muscles to the breastbone.
Of course it’s not surprising that a rib displacement “takes yr breath away” as the ribs (& the clavicle) and a lot of the muscles attached to them are involved in inspiration and expiration. Some of these muscles are the diaphragm, the external & internal intercostals, the serratus anticus, pectoralia minor, scalene & SCM muscles.
Muscles attached to the ribs or thoracic spine which may not be directly involved in breathing but may be compensating for a problem with the breathing muscles. Some of these muscles are the rectus abdominis, the abdominal oblique muscles, the quadratus lumborum, the rhomboids and latissimus dorsi; they may be on the same or contralateral side to the displaced rib.
Before I adjust any displacement of the ribs involved or the breastbone or the clavicle as a doctor of chiropractic; I need to balance the muscle pull on the affected area.
I use the muscle testing used in both Applied Kinesiology and NeuroKinetic therapy.
As a Applied Kinesiologist, I test for the function of individual muscles. The questions to be asked are: why is the muscle weak? Is the muscle on the other side hypertonic or “too stronger.” Is the weakness due to a spinal/nerve problem, a vascular problem, a problem with lymphatic function, a nutritional default, a problem with organ function or an acupoint associated w/ that muscle?
As a NKT practitioner, I ask “Is there a dysfunction in the coordination of muscles working in patterns?” NeuroKinetic Therapy works with that concept that movement is performed in systems or patterns. NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating (facilitating) for them.
Once the above muscle related questions are answered, I can adjust the involved rib, clavicle or spinal segment.
Stretches are given to the previously facilitated (or hypertonic) muscles and exercises given to the previously inhibited (or weak/hypotonic) muscles in order to break the pattern that caused the problem.
For a blog on the effects of the breathing muscles on asthma, please check out: The Musculoskeletal Aspects of Asthma
© 2016-Dr. Vittoria Repetto
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