Feel pain in your chest? Reach out to your doctor to make sure it is nothing serious. However, if you’ve gotten a clean bill of cardiac health, it may be your ribs acting up. Ribs form joints where they meet your sternum (breastbone) and spine, and if the joints get strained or involved in an accident, they can misalign or become inflamed. While it’s impossible to completely avoid the risk of rib pathology, an aligned and proportioned posture and well-maintained muscle tone will go a long way in helping you avoid issues.
The rib cage is comprised of twelve pairs of thin rib bones, divided into three types: true ribs, false ribs, and floating ribs. Each pair of ribs attaches to either side of one vertebra in the spine. The top seven ribs, true ribs, attach directly to the sternum. The ribs and sternum are connected with costal cartilage (“costal” is Latin for “rib”). The eighth through tenth ribs are considered false ribs. Instead of attaching directly to the sternum, they attach to the cartilage of the seventh rib. The final two ribs are called floating ribs, and do not attach to the sternum at all. In fact, they don’t even make it all the way around to the front of the body.
Rib pain most frequently derives from a misaligned rib, referred to as a torsioned rib, or from inflammation of the cartilage that joins the rib with the spine or sternum, referred to as costochondritis. Those suffering from a torsioned rib or costochondritis complain of pain in the chest.
If you are feeling chest pain, contact a doctor immediately to determine the source of the pain, as the pain associated with a torsioned rib or costochondritis often feels similar to a heart attack or other heart or lung conditions.
Although everyone experiences pain differently, most people who suffer from rib pain complain of a sharp or aching pain somewhere along their rib cage. Those specifically suffering from costochondritis may experience specific pain on the left side of the sternum. Pain is typically exacerbated with a deep inhale or exhale. Pain can be localized in an area around one rib, cover multiple ribs, or spread from front to back, along the path of the impacted rib. In response to pain, muscle spasms may occur, increasing the intensity of the pain.
If you experience shortness of breath, dizziness, or pain running down your arm, call 911 immediately, as this can be a sign of a serious lung or heart issue.
A torsioned rib is one that has popped out of alignment and is no longer congruent with the joint. This can cause irritation when the rib cage expands during breathing or coughing. A manual therapy physical therapist can manipulate the rib to push it back into place and shorten the healing time.
Costochondritis, also known as chest wall pain, costosternal syndrome or costosternal chondrodynia, is unexplained inflammation of the cartilage that joins the rib with the spine or sternum. Swelling may accompany the inflammation. Inflammation and pain can last several hours, days, or weeks; however, the body corrects the problem on its own. Specific lifestyle adjustments may decrease pain and healing time.
Rib dysfunction occurs for a variety of reasons, but often the root cause is related to body posture.
Optimal posture is achieved when all the bones and joints of the body align in perfect proportion for an effortless upright position. In this position, the forces of gravity and body weight are evenly distributed throughout the body to minimize compression, inflammation, and compensation for movement. In other words, the body is designed with perfect proportion—specific bone alignment and a certain amount of space in each joint. When proportion is compromised and the space between the bones decreases, and/or the joints are out of alignment, friction between the bones, bursas (fluid-filled sacs that act as shock absorbers), muscles, tendons, and ligaments cause pain and potential injury.
In the case of a torsioned rib or costochondritis, awkward twisting or prolonged compromised posture, especially hunched posture where the rib cage is chronically compressed, may cause the condition. Often it is a combination of the two; poor posture leads to structural issues that can ultimately lead to pain as a result of a simple awkward movement.
Costochondritis may also be caused by a blow to the chest, improperly performed heavy lifting, strenuous exercise, or severe coughing.
- Sit tall. Ground your feet on the floor, feeling the bases of your toes and heels on the ground. Equalize your weight on your feet and on your sit bones (those bones you can feel in the middle of your buttocks). Do not allow your body to lean more toward the right or left. Measure the distance between your last rib and the top of your hip with your thumb and pointer finger. Challenge yourself to lengthen that distance by sitting tall—creating more space between your last rib and the top of your hip. Finally, open your sit bones and empty your abdominal by drawing the belly in toward the back and up toward your ribs. Notice how you look and feel taller. Sitting tall keeps your upper body in optimal alignment, reducing any chance for slumping. Hunching compresses the ribs. Over time, this compression can lead to pain or injury.
- Lift and twist with care. When lifting a heavy object, place your body directly in front of the object, bend your knees, and lift slowly. Avoid simultaneously bending and twisting, especially when lifting an item off the ground.
- Eat anti-inflammatory foods. A regular diet of highly processed, inflammation-inducing foods can contribute to the onset of or prolongation of costochondritis, the inflammation of the cartilage surrounding the ribs. To avoid costochondritis, or to treat this condition, make whole foods 95 percent of your daily diet, leaving junk food for special occasions. Learn more about anti-inflammatory foods.
- Ground the feet. Press the bases of all ten toes into the floor and equalize weight distribution on each individual foot. Now, equalize the weight between the right foot and the left foot. Feel the earth supporting you. The feet are the base for support of the entire body. Grounded feet allow for overall optimal body alignment.
- Stabilize the hips. This is a three-part process. First, find your sit bones—those bones you can feel in the middle of your buttocks—and open them away from your tailbone. Second, empty your abdominals by drawing the belly in toward the back and up toward the ribs. Finally, lengthen the side body—the space between the ribs and hips. Stable hips provide proportioned support for the ribs.
- Engage the ribs. Place hands on either side of the ribcage with the fingers facing each other and the thumbs wrapping around the back body. Inhale; expand the ribs east and west toward the palm centers. Notice how the fingers move away from each other. Exhale; contract the ribs toward center. Notice how the fingers move toward each other. Mobility in the ribs decreases chances for rib injury. Practice rib engagement for 3-5 breaths twice a day to enhance rib mobility.
- Rest. Adequate rest is essential to proper healing. The body uses a tremendous amount of energy to heal. Resting gives the body the opportunity to use almost all of its strength to heal.
- Intentional breath. A common complication of rib injuries is the inability to take a deep breath due to pain. Deep breathing is critical during the healing process, as without it, mucous and moisture can build up in the lungs and lead to an infection such as pneumonia. While healing, it is important to take the deepest breath you can bear at least once an hour (3-5 times an hour is optimal).
- Epsom salt and lavender oil baths. Epsom salts soaked in water release magnesium sulfate. During a bath, the magnesium sulfate is absorbed through the skin to help reduce inflammation. Lavender oil promotes the relaxation of muscles. Together, the two create a powerful tonic to aid in healing. Simply add a cup of Epsom salts and two or three drops of lavender oil to a warm—not hot—bath, and enjoy!
- Start standing with feet hip width apart. Notice the movement of the rib cage as you breathe naturally.
- Cross arms around your rib cage with fingertips pointing toward each other on the back of the body.
- Inhale; fill the rib cage with air, and expand the ribs away from center—east and west—toward palm centers. Notice the fingers moving away from each other.
- Exhale; release the air from the rib cage, and contract the ribs toward center. Notice the fingers moving toward each other.
- Continue for 8 breath cycles.
- Start standing with feet slightly wider than hip width apart. Bring Eastern Prayer mudra (hands sealed with finger stems pointing north) to the chest and pull the elbows wide.
- Bend knees and hinge at hips into a squat position. Position knees in line with ankles. Now, stand tall.
- Inhale; lengthen the side body—the space between the ribs and hips. Exhale; squat and empty by drawing the belly in toward the back and up toward the ribs.
- Continue for 12 breath cycles.
- Begin standing with feet together. Ground the feet equally through the bases of the toes and heels.
- Bring Eastern Prayer mudra (hands sealed with finger stems pointing north) to the chest and pull the elbows wide. Lengthen the side body—the space between the ribs and hips—and bend knees slightly.
- Keeping legs and hips stationary, twist to bring the left elbow in-line with the sternum. Set gaze to the right elbow. Equalize weight on feet to align knees; one knee should not poke out farther than the other.
- Release the twist and return to standing. Repeat steps on alternate side.