Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

June 2000

Back Pain - Part 7: Subluxated Ribs

By Rick Allen, DC

"Better health leads to better dancing."

Let's move on to the next cause of back pain as outlined by Michael Gazdar, D.C., C.C.S.P. in his book, Taking Your Back to the Future: Subluxated Ribs. Dr. Gazdar gives a good example of a common scenario for subluxating ribs: "Roger was lifting a heavy computer monitor when he felt something "pop" in his mid-back. He was lifting correctly from the floor to his waist by using his legs and not straining his back. Unfortunately, he forgot to exhale as he lifted, and the force of his full lungs and the increased pressure as he lifted caused one of his ribs to displace slightly. The pain was sharp, immediate, slightly to the side of the spine, and radiated around to the front of his chest." Several years ago, I treated a fellow attending a conference whose subluxated rib was so painful that he could barely breath. In fact, the pain was so bad that he wondered if he was having a heart attack! My colleague, Chuck Goldberg, MD and I took him to a room where we were able to improvise a chiropractic table with a blanket over a countertop and I was able to adjust his rib back into place. As Chuck told him, "You were lucky that Dr. Allen was able to help you so quickly. He saved you several weeks of pain had the rib been left out of place." Dr. Gazdar's case was similar. "It took two adjustments to fix this problem. It probably would have been worse had Roger not come in right away because scar tissue would have formed around the joint and caused many painful adhesions. Usually the longer the rib is out of its natural alignment, the longer it takes to stabilize." In the back, the rib heads connect to the body of the vertebrae as they cross the transverse process (see anatomical illustrations). They connect with the vertebra above, the vertebra below, and the disc between them. Subluxations of the ribs can cause many problems because of compression on adjacent nerves. Subluxation of the upper ribs can cause referred pain and numbness down the arm. The pain may be so severe that you can hardly breathe and sleeping may be next to impossible. Any extreme motion that pulls the arm back behind the body in a sudden jerking motion can also cause ribs to subluxate. I am currently treating a young lady whose upper ribs were subluxated by the force of an automobile accident ten months ago. She is still in agony because the rib, whose joint capsule and ligaments were badly strained, continues to subluxate with even minor activity. It is a challenge that I am jointly treating with an orthopedist and acupuncturist. In dance, improperly turning the lady is a situation that can lead to rib subluxation. The man needs to be certain to keep the lady's turning arm bent at the elbow and in front of her face. Weight lifting can cause the ribs to subluxate if the weight is too great or the breathing is improper. Wrestling and tackle football are more direct causes of knocking ribs out of place. Even coughing or breathing too deeply may cause ribs to subluxate. As Dr. Gazdar explains: The corrective adjustment is fairly simple. The chiropractor will use a drop table, activator (a hand-held instrument), or some efficient lever to quickly "pop" the rib back into its proper position. The adjustment must be made precisely and quickly. Total relaxation on the part of the patient is absolutely essential.

In closing, remember these simple guidelines:

• Be aware of your posture - Avoid forward head posture - Get professional help if necessary, as I have explained in previous articles on proper posture.
• Keep your back fit - A strong back with good posture is less likely to have problems.
• Use good lifting techniques - Avoid motions that might cause rib subluxations.
• If a rib does subluxate, see a chiropractor as soon as possible for proper treatment.

References:

Taking Your Back to the Future by Michael Gazdar, D.C., C.C.S.P.

Basic and Clinical Anatomy of the Spine by Gregory Cramer, D.C., Ph.D. and Susan Darby, Ph.D.

Other articles directly about posture are:

• December 1999, January 2000, February 2000, March 2000, April 2000 , May 2000 - Current series on back pain and correcting posture.
• December 1998: Psoas - Hidden Influence on Posture
• September 1997: Better Posture…Better Health…Better Dancing
• June 1996: The Graceful Illusion.

You are invited to watch a video of good and bad posture on the beach in Fort Lauderdale, Florida by Paul St. John, LMT. It is a real eye-opener. Please call if you would like to watch it at my clinic.

Next article: If I'm ready, let's check the correction of my own posture - I'm still working on improving my ability to stand tall naturally. Until then, I have a couple more topics to cover on back pain.

Dr. Rick Allen is a chiropractor, massage therapist and dance student in Portland, Oregon. Dr. Rick welcomes your questions and suggestions for future articles. However, he cannot make specific diagnoses or treatment recommendations unless you visit him in person. He can be reached by phone: 503-257-1324, mail: 221 NE 78th Avenue, Portland, OR 97213, e-mail or World Wide Web: www.CascadeWellnessClinic.com

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