What is this Rib Pain?
A common cause of rib pain usually involves blunt trauma to the chest, resulting in rib bruising or fractures. In some cases, pain can result from compromised internal structures, such as contusions or pneumothorax.
What causes this condition?
The diaphragm, a dome-like muscle that sits at the base of the ribs and aids in breathing, can is also be injured. Like other muscles, the diaphragm is susceptible to overuse, strains, tears and even rupture. Poor breathing mechanics during movement can also compromise the length-tension relationship of the diaphragm, leading to muscle fatigue and/or pain.
Conditions that may be related to this condition
- Muscle strain, tear or rupture
Common symptoms / signs
- Pain on palpation along base of ribcage
- Difficulty and/or pain with breathing
- Pain with force expiration (i.e. coughing) or with Valsalva manoeuvre
How is Rib Pain Treated?
As with other muscles, strains may occur due to repetitive overload or powerful contractions of an already stretched muscle. One way to help de-load the muscle is to retrain the activation of supporting structures. The diaphragm not only allows us to breathe, it also works in tandem with the core abdominal muscles to create intrabdominal pressure which helps to support our trunk throughout movement and tasks. We can therefore assess and treat physical impairments found with tasks that demand core stability. There may be a deficiency in activation and control of the lower abdominal and deep core stabilizers (i.e. transverse abdominus). Some exercises to help improve lower abdominal and TA activation include:
- Isometric TA holds – using tactile feedback to cue activation. Master this before moving on to more complex abdominal exercises!
- Supine toe taps
- Dead bug
- Bear hold or crawl
Education around breathing technique during exercise may also be helpful in reducing diaphragmatic stress, for example prompting exhale on exertion. If an overuse injury, it may be beneficial to assess an individual’s movement in order to make meaningful changes.
Risk factors of this condition?
- Heavy lifting
- Training overload
Other causes of rib pain?
- Rib fracture
- Rib, chest wall, pulmonary or cardiac contusion
- Pneumothorax
- Slipping rib syndrome – subluxation of costo-cartilage of lower ribs
- Strain to intercostal muscles