Dealing with Your Dislocated Rib

It hurts somewhere in the middle of your back, and you can't breathe - dislocated rib. Again, dammit.

Well, it could be any number of other things, including a broken rib. Or pleurisy. Or localized pneumonia. Or cancer. Or... all kinds of things. But when it's your mid-to-upper back, more to one side than the other, and it's a dull ache that gets worse when your chest inflates, keeping you from taking full breaths, chances are it's a popped rib. Sorry, dislocated rib. Sorry, subluxated rib.

It's fairly common. Sometimes it fixes itself. Often it drags on and on until you do something to fix it.

So what exactly IS it?

Funny you should ask. Ever look at a skeleton? Right. Real skeletons are hard to come by. Some doctors and chiropractors have plastic/resin model skeletons in their offices. Sometimes art schools have surprisingly realistic model skeletons for the benefit of their students.

Or you could look online. Some illustrations are available. The good ones are owned by people who want $$ for them. We'll try to sketch up a graphic when we've got time. Remind us...

Anyway, ribs occur in pairs. Most of them are anchored at each end (the spine at the back and the breastbone at the front). Each rib is a (relatively) thin flat bone that curves around the outside of your chest, on one side or the other. At the front, it joins to the breastbone (sternum) by means of gristly bits - the costochondrical joint (basically a cartilage socket). At the back it joins to a thoracic vertebra by means of another gristly bit - the costovertebral joint (basically another socket made of cartilage).

The whole arrangement is meant to allow all the ribs to pivot in tandem at both the front and the back of the rib-cage. Kinda makes breathing possible. Especially for really fat people who have no room below the chest for belly-breathing - all they've got is chest breathing... but we digress. Where were we?

Sometimes the front end or the back end of a rib pops partially out of its socket. That's a dislocated rib.

What causes it?

Very often, the proximate cause (the nearby event on which you or your doctor are most likely to blame the dislocation) is some trauma that contorted a section of your rib-cage.

That could be a fall, a vehicle accident, a heavy blow from a fight or a contact sport, etc.

There'll be an obvious lump at the site, and quite a bit of pain, especially when you breathe.

Another way to dislocate a rib is by letting yourself get weak and flabby, and then exerting yourself, especially in an asymmetrical manner. For example, your correspondent here lives in a northerly climate where we get quite a bit of snow. Since the snow of a previous winter had crushed the little utility shed in our back yard, I was determined that the same fate would not befall the replacement shed. So, when a big dump of snow had the little shed groaning under several feet (a meter, plus) of snow, I set out to remove some of it.

I used a "snow rake". It's basically like a snow pusher, except that it has a long light-weight handle (to reach far up a roof) and you pull the snow down from the roof, rather than push it along a drive or walkway.

So there I was, stretching to get the snow rake to the far side of the roof, then hauling it back toward me, pulling a load of snow. Of course, I couldn't pull that long handle through the middle of my chest, it had to pass to one side of me or the other. Therefore, I was mostly pulling with one arm. Yes, strong torsional motion against a considerable and unaccustomed resistance. (Did I mention that I'd let myself get out of shape?)

Yes, that same side was sore the next morning, and it hurt to take a deep breath.

Another example

We've known people to pop a rib by opening a door.

Yup.

They did it one-handed (don't you?) and it was a heavy door, but that off-balance, asymmetrical pulling motion caused a rib in the back (same side as the pulling arm, usually) to disengage a bit from it's socket. It helps (ok, by that we mean "hurts") to have something awkward in the other arm, or a whinging kid pulling in the opposite direction

Ever see anybody trying to pull-start a reluctant lawn-mower or other two-stroke engine? There's another sore, dislocated rib waiting to happen.... trying to happen. Or maybe apoplexy will get him first. Two words for you man: "electric start". 'Nuff said.

Ever see a strong young kid leap into the air, twisting to look behind him, arms in position to receive a football (American or Australian Rules), when the tackle hits from one side? Yow. If his spine doesn't separate from his lower half, then at least his ribs are yanked brutally out of position. Guess what happens? At least some of those ribs don't resume their proper settings. Being a tough kid, he plays out the rest of the game with a dislocated rib. Makes it worse.

Older guys are so much more sensible. They'll go out on the driving range after a winter of inactivity and whale away at a bucket of balls, with little or no warm-up. All kinds of things can go wrong in that scenario, including a dislocated rib or two. Gosh! Wonder why? Abrupt torsional motion with a long lever in your hand, using muscles that have grown flaccid during the hibernation season. And repeat, aggressively. There goes your season, Bud.

Yeah, yeah, lots of ways to make it go bad. What really happened?

Most likely, in the snow-clearing example, I did some initial damage by repeatedly pulling loads of snow, like rowing, one-armed with my arm high. The footing in the yard was also not the most stable. But I was warm from the work and the muscles were flexible, so I didn't notice much of a problem - it could have gone either way.

Later, during the night, I slept on that side, and my overweight body put a lot of side pressure on the ribs, making the problem worse. If I'd just slept on my back that night, the problem would likely have corrected itself with my straight posture and flattening pressure on the back actually helping the disturbed rib to go back into its rightful place instead of dislodging further. But I didn't, and it didn't (or did or...). So there I was with a dislocated rib.

Similar idea for all the other lucky fellas in the other examples.

How do you FIX it?

A visit to the chiropractor had him manipulate it back in place, and I immediately felt better. Then I took it easy and was exaggeratedly careful with my posture and movement for a few days, and I was as right-as-rain in less than a week.

Compare to a previous time - before I'd discovered chiropractors - and the dislocated rib lasted a month.

The key is to get the rib-end back in position and then keep it there while everything heals.

How do you keep it from coming back?

Ah. Well here comes that dirty word... exercise. The muscles of the back - both the big action muscles and the smaller supporting ones - need to be strengthened and balanced.

So, I started doing some rowing, some pull-downs, and some lightly-weighted rotational motions. That appears to have done the trick. In general, it should work for you, too.

Sometimes, you'll need assistance from a physio-therapist to discover the exact flaw that you are trying to correct, or to help reduce the pain and discomfort enough that you can do the exercises that will eventually prevent another dislocated rib.

Now, let's keep this in perspective. You don't need to be doing maximum strength, reps-to-failure as if you were training for a lifting event or for body-building (for show). That's a helluva lot of work and the results if/when you get them are maintained only by a helluva lot more work, ongoing.

Nope. Instead, we're talking about some relatively gentle exercises. They use small weights to get started, then graduate to bigger-than-sissy weights, but nothing dismaying. After all, the philosophy of this site is to do enough to give the desired result, and not to tie up your life with over-exertions that lead only to more over-exertions... get a life. Give yourself time to have a life. Do enough exercise to be trim, strong and healthy, but leave the "beach-god" muscles to somebody who makes an actual living at being a beach god... yes?

Anything more?

You could have a similar dislocation happen at the front of your rib-cage, with one or more rib-ends popped out of their gristly sockets at the breastbone. That's somewhat less likely than a dislocated rib at the back, but it does happen.

The approach is pretty much the same, so we'll summarize for both front and back.

1. Stop doing whatever is causing the dislocated rib. Sounds simple, but

   a) you might not know what you did, so it could take some thought and observation

   b) you might have received the initial dislocation as part of a major trauma (like a traffic accident where you had other, more important damage (or not)) but the dislocated rib is now being maintained by a body that's bent out of shape and muscles that are trying to protect damaged bits from further harm.

2. Get the rib back in its socket - see a chiro or osteopath or possibly a physiotherapist for that.

3. Allow the problem area to rest in its corrected orientation. Remember, if you've had the dislocated rib for weeks or months, all the surrounding muscles have adapted to the distorted arrangement and might even be trying to pull the rib back to its dislocated position. Those muscles and associated skeletal bits all need some time to subside back into proper aligment. Be as gentle with yourself as possible, while also being hypervigilant about correct posture - standing, sitting, even lying down. If the rib insists on re-dislocating itself, you might need to get taped or braced for several days.

4. Once the rib appears stabilized and comfortable, begin doing some exercises to strengthen all the surrounding muscles in their proper positions.

Anything else to remember?

If you think the injury has just happened, do not warm it . Instead, rest it, apply ice (or a cold-pack) to reduce inflammation around the afflicted area. Try to get to a professional who can diagnose what it really is and - if it's that dislocated rib, which is very likely - pop it back in place.

Ice it some more.

After a couple of days - assuming it hasn't dislocated again! - you can start using heat on it to improve the comfort and to increase blood flow and speed healing. BUT, ensure that you are maintaining very correct posture when you do apply heat. The heat relaxes the muscles, and if you are stretched out on your favorite TV-watching sofa at some odd angle, the torsion could pull the rib-end from its socket again while the muscles are too relaxed and torpid (from the heat) to resist.

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Click here to return to the main backache relief page from this dislocated rib page.

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How did it hit you? How did you fix a dislocated rib?

What did you do that got a rib out-of-whack?
How did you decide that's what it was? Did a doctor, or chiropractor, or physio-therapist tell you?
How did you deal with it?

If you have a tip or trick that we don't know about, it might be just what somebody needs. If you did something that we suggested, and it worked, well everybody will want your extra confirmation that it works.

If you tried what we or others recommend... and it didn't work... well, let us know. Every bit of info helps, one way or another.

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