Rib Pain or Intercostal Neuritis – A NYC Chiropractor/Applied Kinesiologist/NKT Practitioner Explains

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. A lot of the times, the patient has already been evaluated by their M.D. for these conditions with negative results.

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.

intercostal-nerve

intercostal-muscle

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.

breathing-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?

The Use of Applied Kinesiology in a Chiropractic Examination

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.

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

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

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

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A NYC Chiropractor/Applied Kinesiologist Starts Adding Neuro Kinetic Therapy to the Mix

As some of you know I took the Level 1 seminar of Neuro Kinetic Therapy earlier this September. https://drvittoriarepetto.wordpress.com/2015/09/01/taking-neuro-kinetic-therapy-seminar-sept-12nd-13th/

While Applied Kinesiology looks mainly at balancing individual muscles, NKT works with the theory that that movement is performed in systems or patterns instead of individual muscles.

The human brain also has an affinity toward habits. Repetitive behaviors become patterns and these patterns require reprogramming when they become problematic (Faulty Movement Patterns).

NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating for them.

After an inhibited/weak muscle is found, I would muscle test a synergistic (a helper muscle) or an antagonist muscle (an opposing muscle) https://en.wikipedia.org/wiki/Anatomical_terms_of_muscle which is strong/facilitated that may be affecting the inhibited muscle. That facilitated muscle would be therapy localized (the muscle is either touched or put in motion) and the inhibited muscle retested. If the TL strengthens the inhibited muscle, then I know that the TLed muscle is affecting the inhibited muscle.

One can then use whatever techniques the practitioner knows in order to release the compensating muscle; in my case, I use the following AK techniques. https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2011/02/16/how-an-applied-kinesiologist-uses-neuro-lymphatics-to-improve-health/

https://drvittoriarepetto.wordpress.com/2011/07/29/how-a-nyc-applied-kinesiologist-uses-neurovascular-pts-for-better-physical-and-emotional-wellbeing/

The inhibited muscle is then retested which should test strong now, the retesting causes a “neural lock” which reprograms the motor control center in the brain.

Corrective exercises to restore proper movement patterns and reprogram the motor control center can be given.

Here is an example in which I used a mix of AK & NKT:

A male patient came in with rt. low back/lumbar flank pain after sneezing in the shower; patient said that he was “unprepared for the sneeze.” He touches the area of his quadratus lumborum. https://en.wikipedia.org/wiki/Quadratus_lumborum_muscle

I first test the psoas; an important muscle for the low back which I always test in low back problems and a muscle which connects with the diaphragm muscle.    http://corewalking.com/walking-and-breathing/ 

I find the rt. QL and lt. psoas weak; I ask the patient to touch the sternum which is the neuro-lymphatic point for the diaphragm; the main breathing muscle involved in a sudden sneeze. I then retested the weak QL and psoas while patient is touching  (therapy localizing); they now test strong.

I then rub the neuro lymphatic pt. for the diaphragm and find a place on his rib that is tender and flailing out due to over contraction of the diaphragm and massage to get a release.

I then retest the QL and the psoas, they both test strong; the retesting created a “neural lock.” I then adjust the patient’s spine and pelvis. Corrective exercises are given.

© 2015-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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The Importance of a Proper Chiropractic Examination – A NYC Chiropractor’s/Applied Kinesiologist’s Take

Doing a proper examination with a new patient is of the upmost importance. It not only shows where the patient’s pain/problem is but it shows the location of the origin of the pain/problem and contributing factors.

For example, the patient may be complaining of posterior leg pain but orthopedic and neurological testing will show at what spinal nerve level does that leg pain originates from.

What muscles are weak or in spasm? For example, is the nerve being compressed by a spastic piriformis as the nerve travels down the buttock or is a weak piriformis or gluteus maximus allowing for instability in the lumbo-sacral or sacro-illiac joints.

testing rectus femoris

What is the history of this patient? A proper examination includes the filling out of an intake form which includes history of past injuries and current health problems.

Has this patient had a history of ankle injuries which may have affected their gait and caused compensation in the pelvis, hips or torso of the patient? Did that compensation set the patient up for problems down the road.

Does this patient have problems like acid reflux or breathing problems where the diaphragm is not working properly and therefore causing over-compensation in the abdominal muscles which support the low back or over-compensation in the neck muscles contributing to neck pain.

Does this patient have a history of hypertension; then a taking of the patient’s blood pressure is part of their examination. Are there white spots on their nails or do they bruise easily; patient may need certain supplements to improve oxygen flow/wound healing and cut down on chronic inflammation.

Does the patient have problems with urination or gout; these problems may show up as an energy blockage in the kidney meridian and the psoas muscles which is linked in applied kinesiology to the kidney meridian. Stimulation of acu-points on the kidney meridian may affect the psoas; part of which is located in the front of the lumbar spine and an imbalance can contribute to low back pain.

For more on use of applied kinesiology in a chiropractic examination; please see https://drvittoriarepetto.wordpress.com/2014/08/09/the-use-of-applied-kinesiology-in-a-chiropractic-examination/

Range of motion testing shows not only what movements are painful but it is also important as it gives a clue of what muscles may be involved. Range of motion after treatment is a quick test of how the patient is doing.

A proper examination (and following treatments) also requires that the patient is either wearing an examination gown (women) or down to their underwear (men). This enables me as the doctor to rule out anatomical problems such as a swollen ankle or knee as contributing to the patient’s complaint.

The doctor can also rule out health problems that cause pain that need to be referred out. For example an established patient came in complaining of posterior pelvic pain and since she was in an examination gown, I noted a rash. The rash was herpes zoster and she needed to be referred out as well as needing nutritional advice and an adjustment. If she was still wearing street clothes as in many chiropractic practices, I would have not known the “real” cause of her pain.

The above examination takes time and is geared for a chiropractic and applied kinesiology practice not for a quickie fifteen minute /3x a week practice. . Unfortunately a lot of chiropractors do not do a complete examination which I deduce when new patients who have previously seen another chiropractor ask me when I enter the examination room if they should lay face down. No I say, I need to do an examination first.

If you are interested in a comprehensive examination and treatment, please free to contact me at drvittoriarepett@aol.com or call me at 212-431-3724. 

 

© 2015-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

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The Musculoskeletal Aspects of Asthma

Like most of you, I’ve been watching the Olympics and as I watched, I remembered a previous Summer Olympics and watching the start of the Women’s Marathon. I noticed something in the body language of one of the front runners and said to my friends, “That runner has asthma; look at her neck.”  My friends chuckled and then the announcer talking about the runner I pointed out said that she suffered from asthma.

“How did you know?’ asked my surprised friends. Her SCM (sternocleidomastoid) muscle http://en.wikipedia.org/wiki/Sternocleidomastoid_muscle was very pronounced. Instead of using her primary muscles of inspiration, her diaphragm, the external intercostals and the sternocostalis; she was using an accessory one.  http://skeletalmuscularsystem.suite101.com/article.cfm/muscles_of_inspiration It was causing her rib cage to be higher in position on her torso and more barrel shaped: a classic visual for asthma patients

In  my Applied Kinesiology practice, I see a number of patients with breathing problems. To a person they all have problems using their diaphragm muscle properly, they use small muscles higher up in the chest and shoulders creating  a “barrel-shaped” chest. And many have problems w/ their intercostal muscles and the up of down movement of the ribs; their rib joints don’t move properly therefore not allowing the movement of the chest.

Tightness and/or weakness is also found in the Pectoralis major & minor, SCM, the Anterior & Middle Scalenes and the Serratus anterior as well as other accessory muscles, they tested to find out if they are inhibited or compensating.

breathing muscles

With applied kinesiology, I can use golgi tendon and muscle spindle reflexes to re-set the muscles and use neuro-lymphatic & neuro-vascular points to flush toxics out of the muscles. I restest the inhibited/weak muscles to get a neural lock in the brain’s muscle center.

I use neuro-lymphatic & neuro- vascular pts to help lymph and blood flow to the diaphragm and also give the patient breathing exercises to strengthen the diaphragm.

I also stimulate acu-points for the lung meridian and it’s brother/sister pair- the large intestine meridian which may indicate that the patient needs probiotics.

The cervical & thoracic spine are checked for subluxations/somatic dysfunction as the nerves from these areas  innervate the before mentioned muscles and the lung and are adjusted as needed.  The articulations of the rib joints to both the vertebrae and the sternum are also important to check.

Once the above is done, the patient is given breathing exercises to do daily in order to strengthen the formerly weak muscles

Working on all these aspects causes the bio-mechanics of the chest to work better and breathing is freed up.

Of course causes of both bronchial and lung and general inflammation need to be found and worked on via nutrition and lifestyle changes; but that is another blog.

And by the way, though they usually do not need it, I always warn my patients to no matter how well their breathing feels, to always carry an inhaler, just in case.

Self-taught Breathing Retraining Helps Asthma Patients

©  2010-Dr. Vittoria Repetto

©  Revised 2015/2017 -Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic practice at 230 W. 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials at my web site.

 Want to be in the know on holistic information and postings? Follow me at https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto