First RIb Dysfunction

Forward Head Posture anyone?

First rib dysfunction is an often overlooked positional fault when assessing shoulder and/or cervical dysfunction.  However, with how often I see postural faults on a weekly basis it has become a primary assessment for me in my shoulder and neck cases.  The first rib has attachments to the scalenes, serratus, and subclavius.  It is important in breathing and shoulder movements.  

A few months back I was warming up before one of my weight lifting sessions and did a few shrugs to finish off.  I felt a pop in my neck and immediately had pain and limited ROM.  Naturally I walked right out of the gym.  I couldn't sleep or move my head from the increased stiffness.  Fortunately, I had no neural symptoms.  What remained was stiffness and pain that was excruciating.  The culprit: the first rib. My first rib elevated and put my levators and upper traps on spasm, locking up around it.  However with first rib mobilizations, soft tissue mobility of the upper traps, scalenes, and levators, in three days I was pain free and had full ROM.  I worked on pain free ROM every hour on the hour in addition to my therapy.  The point of this is to remind us of the importance of first rib dysfunction.  I typically see it with my patients with poor posture and it tends to immediately improve patients cervical ROM when they are stiff.  

Next time you see a patient with limited cervical ROM or increased stiffness check out the first rib in addition to the t-spine and c-spine.  

- Brian

Want to know how to treat cervical and first rib problems?  Check out the Insider Access page for manual therapy techniques and assessment techniques!

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Also- check out Brian's recent published posts on Paleohacks.  http://blog.paleohacks.com/why-stretching-isnt-helping/

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