By Dr. Joshua Kiely, DC

Rib out, slipped rib, irritated rib. They are all pretty much the same thing. If you’ve never had it before, count yourself lucky, but if you’ve had the experience of a ticked off upper back rib joint, you know what I’m talking about. 

Today’s blog will go into detail on what really is happening when a “rib is out”, why it hurts so much, and what you can do about it.

What does it feel like when a “rib is out”?

As a chiropractor in Ottawa, “slipped rib” or “rib out” is one of the most common injuries I see. Most times, when a patient tells me their “rib is out”, they mention symptoms including pain with a deep breath, tension in their upper back, sharpness with movement on one side, and pain with raising or lowering their arm.

These types of rib injuries can be excruciatingly painful for several days, and seemingly come out of nowhere. They typically do not show bruising, redness or swelling, and most movements tend to aggravate them.

What is really happening when a “rib is out”?

Describing this injury by saying my “rib is out” makes sense, because it genuinely feels like something has moved out of place and needs to be put back. Despite this feeling, we know from plenty of research that ribs rarely dislocate or move out of place. Instead, it seems that the costovertebral joint (where your rib joins to your spine) becomes irritated or inflamed, then we lock up because it hurts to move. In some ways this injury is similar to a sprain or strain - check out my blog on sprains and strains here if you think that might be what’s slowing you down.

If the rib were dislocated out of its proper position, we could have some serious issues with breathing and lung function. When the rib joint is irritated, we may have pain with a deep breath because this requires the irritated joint to move, but we likely don’t have a life-threatening injury that affects breathing. We can work around an irritated rib, but a rib dislocation is a whole different beast.

Okay so my rib isn’t dislocated, but why does it hurt so much right now?

When a joint is irritated or inflamed, it hurts to move. Because rib movement is essential for breathing, we have no choice but to move the irritated joint 10-20 times a minute all day long. That movement creates pain, and really gets in the way of everything we try to do.

The good news is that movement usually helps with an irritated joint in the long run, it is just quite painful when the injury is fresh. There are chiropractic treatments we can use to get some relief for a “slipped rib” in the short-term. Many of my patients in Ottawa come and see me when their rib hurts even though we both know it is going to improve quickly on its own because it helps them keep doing their normal activities even when there is an injury.

What can you do to avoid the painful “slipped rib”?

The best thing we can do to reduce our risk for pain is to prioritize our health throughout the day. There is no secret recipe for avoiding injuries, but there are some guidelines we can follow to improve how we move and feel.

• Weight train twice a week - strong things aren’t broken as easily.

• Walk daily (or bike or swim or row… just move!)

• If you play a sport that requires rotation (golf, hockey, tennis for example), practice some mobility drills.

  • Thread the needle and side lying thoracic rotations are both simple and effective drills to help with midback rotation (where the ribs are) - check out Spine Ottawa on YouTube for help.

• Practice good sleep hygiene and stress management.

• Take many short movement breaks during the day to get away from your desk or chair.

If you’re struggling to do your normal activities due to a “slipped rib”, it's worth getting checked out to ensure that the injury is not life-threatening (such as a lung issue!). There are also options for getting some personalized treatment and advice to help you get back to your normal activities as fast as possible.