First rib subluxation or dislocation – What’s wrong with me?
Do I have a first rib subluxation – first rib out of place?
You have a first rib subluxation if you answer yes to any of the questions.
- Do you feel like you have some sort of pain on the shoulder?
- Or do you feel an agonizing pain around your neck with each and every movement?
- How about slight pain or soreness when you turn your head and trunk?
- Do you experience a tingly or numb feeling on your hands?
Then you probably have a dislocated first rib or first rib out of place (also known as first rib subluxation).
Due to the location of the first rib, its dislocation is rare, but that doesn’t rule out the possibility. Frist rib subluxation can cause severe pain at the time of displacement, even more pain after a few days! If you answered yes to any of the above first rib subluxation symptoms, then you should definitely read further to know more.
What is the first rib subluxation – elevated first rib?
A first rib subluxation is a condition that occurs when the first rib, located at the top of the rib cage, becomes partially dislocated from its normal position. This can happen due to a variety of factors, including trauma, muscle tension, and repetitive overhead movements.
The first rib serves as a crucial point of attachment for several muscles in the neck and shoulder, including:
- Scalenes: These muscles are responsible for elevating the first two ribs, which are vital for breathing. When the first rib is subluxated, it can pressure the scalenes, causing pain and discomfort in the neck and shoulder.
- Subclavius: This muscle is responsible for depressing the clavicle, which is the collarbone. When the first rib is subluxated, it can put pressure on the subclavius, causing pain in the shoulder and arm.
- Serratus anterior: This muscle is responsible for pulling the scapula forward and upward, vital for movements such as reaching and lifting. When the first rib is subluxated, it can put pressure on the anterior serratus, causing shoulder and arm pain.
In addition to these muscles, the first rib also serves as an attachment point for several ligaments and nerves. When the first rib is subluxated, it can also pressure these structures, causing further pain and discomfort.
The first rib’s role as a crucial attachment point for these muscles and structures makes it a vital component of the musculoskeletal system. When the first rib is subluxated, it can disrupt the normal functioning of these structures, leading to pain and dysfunction in the neck, shoulder, arm, and even the hand. In some cases, it can also lead to numbness and tingling in the affected area.
Symptoms of the first rib out of place
So, what are the symptoms of first rib subluxation?
Our body posture and use of our neck and shoulders affect the first ribs.
In a case of an improper position of the neck and shoulders, the first rib will bulge out f its place.
The first ribs will suffer and can stay in a permanently elevated position if a rib mobilization exercise isn’t performed or you see your chiropractor (the elevation or bulging out of the rib from its socket is why some people describe this ailment as an elevated first rib.)
In addition, Elevated first ribs usually occur in people who sleep on their stomachs or those who sleep with one arm under their heads.
Another cause is extensive computer use, especially with poor mouse ergonomics, which may strain the upper spine area (medically called cervicothoracic joints or CTJ) and ligament mechanoreceptors.
This will Subsequently exacerbate the painful upper cross-muscle imbalance pattern.
These individuals often complain of persistent dull pain, soreness, and tightness in the upper shoulder girdle.
In addition, many whiplash-type injuries have first rib involvement.
Tennis players, golfers, and weightlifters seem to be the most susceptible to neurovascular compression caused by fixation of the first rib.
So, whatever might be the reason for the displacement of the first rib, the symptoms will be:
- Permanently raised or elevated the first rib.
- pain and tightness on one side of the neck and shoulder.
- a possible limitation of arm movement on the affected side.
- Tingling sensation on hands.
- Neck pain.
- Unexplainable Shoulder pain.
- Patients with elevated first ribs also complain of constant headaches – only at one side.
what is the treatment for a subluxated first rib?
For most sufferers, the subluxated rib can usually be popped back in place following a short trip to a chiropractor.
Most cases of first rib subluxation or dislocation can be managed by applying some conservative treatment alternatives, which may include a change of usual activities, applying ice packs to the affected area, using non-steroidal drugs (anti-inflammatory drugs), and mentioned, physical therapies.
Examples of some changes in activity may include
monitoring, reducing, and possibly restricting overhead movement, change in sleeping position, especially if the patient typically sleeps with his/her arm extended overhead or tucked under his/her body.
That’s why the general knowledge on the universal treatment for subluxated ribs, specifically an elevated first rib, is rest and sometimes coupled with some pain medications. But the case is quite different for a subluxated first rib.
If you think you might have a subluxation of the first rib and experience any of the dislodged first rib symptoms, then you must see your doctor for a thorough checkup.
Visiting an experienced physiotherapist/practitioner is advisable to help you get the first rib back in place.
It might be painful, but you should start seeing a drastic improvement once the rib/ribs have been adjusted back in position.
First rib mobilization – A painful yet rewarding treatment
If a first rib injury is left undiagnosed or the rib is untreated, it will fixate on its newfound position, affecting your posture. At this point, your physiotherapist might guide you while you perform a series of exercise maneuvers called the first rib mobilization.
Here’s a really good video I found on YouTube about the steps for elevated first rib self-mobilization.
You’ll quickly learn how to mobilize your first rib after watching this short bo, educative video; I hope it helps!
Alternatively, you can check out the written techniques for the first rib mobilization here, too.
references:
Hooper, T. L., Denton, J., Mcgalliard, M. K., Brismée, J., & Sizer, P. S. (2010). Thoracic outlet syndrome: A controversial clinical condition. Part 1:
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Peña-Salinas, M., Oliva-Pascual-Vaca, J., Heredia-Rizo, A. M., Rodriguez-Blanco, C., Ricard, F., & Oliva-Pascual-Vaca, Á. (2017). No immediate
changes on neural and muscular mechanosensitivity after first rib manipulation in subjects with cervical whiplash: A randomized controlled
trial. Journal of Back and Musculoskeletal Rehabilitation,30(4), 921-928. doi:10.3233/bmr-160645
Rashia, S., & Zaidi, S. (2017). A Morphological Study of First Rib Anomalies. International Journal of Advanced and Integrated Medical
Sciences,2(2), 70-72. doi:10.5005/jp- journals-10050-10079
Rochlin, D. H., Gilson, M. M., Likes, K. C., Graf, E., Ford, N., Christo, P. J., & Freischlag, J. A. (2013). Quality-of-life scores in neurogenic
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