Dr Ozello's Sports Medicine Report: Rib Subluxation AKA "Rib Out"

***Disclaimer: Viewing this video does not take the place of seeing a medical professional or working with a certified fitness professional. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Always perform all exercises through a symptom free range of motion. Begin your training at your current health, fitness and strength levels. Increase intensity in small gradual calculated increments.

Serious pathology must be ruled out first in all chest and ribcage pain.

Rib Subluxation
Lack of proper motion. “Rib Out.”

Serratus Anterior Stretching Part 1    • Serratus Anterior Stretching Part 1  
Serratus Anterior Stretching Part 2    • Serratus Anterior Stretching Part 2  

Symptoms
Pain (can be intense), tightness, spams, hypertonicity, limited painfree range of motion and point tenderness.
Inability to take a deep breath.
Aggravated by coughing, sneezing, lifting, twisting, overstretching, rotation, lateral flexion, throwing, movements involving torque (baseball swing, racquet swing) and exercises such as pullovers and dips.

Pain may be located anterior, posterior or along entire bone.
Can be recurring.

Source may be traumatic or nontraumatic.
Improper technique while training.

Contributing Factors
May be linked to hypertonicity of serratus anterior muscles.

Origin can be either posterior at the costovertebral joints and or anterior at the anterior costochondral joints.

Prevention: Stretch serratus anterior muscles and strengthen scapular retractor muscles. Normal breathing exercise.

Chiropractic care is a catalyst for improving a person’s health, fitness, function and recuperation. Chiropractic care is drugfree, surgeryfree functional medicine. The primary objectives of chiropractic treatment are the optimization of nerve flow and the reestablishment of correct skeletal biomechanics. Chiropractic treatment works for preventive and maintenance care. Chiropractic care is effective for a large number of sportsrelated injuries. Chiropractic care restores correct skeletal joint motion, optimizes nerve flow, decreases muscle tension, increases range of motion and decreases symptoms.

Rehabilitation: Selfmuscle work on serratus anterior and anterior, lateral and posterior intercostals muscles.Stretch serratus anterior muscles and strengthen scapular retractor muscles. Practice normal breathing exercise.

Normal Breathing: Practice normal breathing until it’s second nature.
Supine: Relax abdominal muscles to allow greater diaphragm motion.
Place one hand or both hands on stomach.
Inhale slowly through nose.
Focus on diaphragm movement.
Feel the abdominal cavity rise.
Exhalation should be twice as long as inhalation.
Start in the supine position, advance to kneeling, seated, standing and quadruped.

Chest Muscle Stretching in Supine Position
Supine on floor, bench or table. Hips flexed, knees flex and feet flat on floor. Keep lower thoracic spine and lumbar spine contacting floor.
Retract scapulae.
Hold a mild comfortable stretch in chest muscles for five to one hundred and twenty seconds.
Use numerous arm positions:
1) Shoulders abducted ninety degrees and externally rotated. Elbows extended.
2) Shoulders abducted ninety degrees and externally rotated. Elbows flexed ninety degrees.
3) Fingers interlaced behind head. Let elbows gradually fall toward floor.
4) Shoulders flexed one hundred and eighty degrees. Stretch superior.
5) Shoulders flexed one hundred and eighty degrees. Stretch posterior.

Isometric Scapular Retraction
Hold your thoracic spine straight.
Keep your cervical spine in line with thoracic spine.
Pinch the inner borders of your scapulae together.
Hold an isometric contraction for two to six seconds. Begin with a two second hold and build to six seconds.
Release the contraction and slowly return to the starting position.
Build to fifteen reps.
Use a variety of arm positions to target the muscles from numerous angles.

Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV
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