Rib Pain

 

Rib pain during pregnancy can occur due to certain postures that we get into while pregnant. Rib pain is often felt during the third trimester. The pain may be mild or it may be pretty severe. Typically, this pain is felt most intensely while sitting, because when you sit your body is being pulled into that forward posture or slump position. It is easy to fall into these poor postures during pregnancy; as your belly grows your shoulder blades get pulled forward along with it. Your upper back also rounds forward due to the excessive weight of breast tissue as well as the baby bump that is hanging out in front.


Anatomy (see images below):

  • The rib cage makes a ring shape. The costcovertebral joints connect each of your ribs to your spine in two places.

    • If your back is rounded, this can cause your ribs to pop up and outward.

  • The pectoralis minor and major attach your shoulder blades to your ribs.

    • When you get into that slumped position, this causes those muscles to become very tight. We need to loosen them up in order to get relief.

  • The muscles in your back (Middle Trapezius, Lower Trapezius, Latissimus Dorsi, Serratus Anterior, Paraspinals, Multifidus) aka your postural muscles, need to be strengthened in order to be able to hold your body in proper postures. Strengthening these muscles will in turn help to decrease pressure on the ribs.

costovertebral jt.jpg
External-and-Internal-Intercostals-of-the-Thoracic-Cage.jpg



How to Fix:

When your back becomes rounded and your ribs to pop up and outward, the goal here is to pull them down and back through movement and exercise. In order to do so, your ribs will first need to start moving, and then we need to loosen up the front or the anterior chest muscles to allow the ribs to sit in their correct position.

Incorporating proper diaphragmatic breathing into your daily routine is a great way to create movement in the costovertebral joints. When joints are stiff, they get stuck and that is what causes pain. On the contrary, when joints are able to move, synovial fluid helps to pump healthy cells into that area, keeping it nice and happy.

And then the most important piece is to strengthen those postural muscles in your back so that they can also do their job. If you are feeling this pain now, I would highly recommend that you start taking action, especially if you are planning on nursing because postpartum life does not become easier!


Step 1: Creating Specific Movement in the Ribs (see IGTV)

  • Chest Opener with Chair

  • Side Lying Thoracic Rotation

  • Cat/Cow

  • Side Lying Rib Opening: also combine with soft tissue mobilization

Step 2: Loosening the pectoralis and anterior chest structures

  • Pectoralis Stretch: perform at 60/90/120* on both sides

Step 3: Diaphragmatic Breathing

  • Proper diaphragmatic breath occurs in the bottom ribs. You should not see movement in your chest. Draw air into the belly but the main goal really is making those bottom ribs to expand forward and backward and side to side.

Step 4: Stabilization Exercises

  • DB Bent Over Reverse Flys

  • DB Bent Over Rows

  • DB Side Lying External Rotation

  • RB Pull Aparts

Other tips to make your ribs feel better:

  • Taking a hot shower and letting the water run along your backside.

  • Avoid sitting for long periods of time.  

    • If you do have to sit for work, take breaks often and try some of the stretches in step one.

  • Avoid hunching over while standing

  • Eat an anti-inflammatory diet- lots of fruits, vegetables, beans, nuts, etc. Try to avoid processed foods, refined grains, sugary drinks, etc.

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Seek immediate medical attention if you are experiencing severe, sudden onset rib pain and have the following symptoms: dizziness, seeing spotting or floaters in your eye, bleeding, headaches, nausea and vomiting. This could be a sign of gallstones, heartburn, or liver failure.