Rib Hypomobility and Shoulder Pain
Something I have been assessing more lately is rib mobility for my upper quarter patients. In the past, unless there were signs indicative of rib dysfunction, I typically only checked the 1st rib's mobility. Lately, I have been assessing ribs 2-4 (and further down if significant restriction noted) for many of my upper quarter patients and seen some interesting effects.
Several patients I've seen recently with scapular and/or posterior shoulder pain have presented with restricted rib 2-4 mobility (or some variation). They didn't have any pain with breathing, however, had significant reduction in pain and improved mobility following simply grade IV mobilizations to the restricted ribs. Even greater improvement was noted in the following day. Now the mechanism is not fully understood as manual therapy can have quite a few different effects. It's possible the patient would have had just as effective or more effective response to other treatments. Nonetheless, with the excellent response by my patient, I plan on regularly incorporating upper rib assessment to determine if there are some patterns for application.
-Dr. Chris Fox, PT, DPT, OCS
Looking for advanced sports and orthopedic content? Take a look at our BRAND NEW Insider Access pages! New video and lecture content added monthly.
12/24/2017 02:39:37 pm
For as far as I know, the first 4 thoracic vertebrae are part of the shouldergirdle through their connection with their paired ribs. Clavicle is attached with the first rib through ligaments which in its turn is connected with the 2nd one and so on...
Leave a Reply.
Dr. Brian Schwabe's NEW Book in partner with PaleoHacks!
Learn residency-level content on our
Insider Access pages
We value quality PT education & CEU's. Click the MedBridge logo below for TSPT savings!