The Dynamics Of Rib Pain
Dr Anders Vinther presented on this topic at British Rowings 2015 Sport Science and MedicineConference and coauthored a recent editorial with Dr Jane Thornton in the British Journal of Sports Medicine examining the research to date. Vinther, a research physiotherapist at Herlev University Hospital, Copenhagen, Denmark, is widely regarded as a leading expert in the field of rowing rib stress fractures.
Vinther outlines his findings and explains what he believe rowers and coaches should know about rib injuries.
What is a rib stress fracture?
It is important to know the difference between a stress fracture and a traumatic fracture, explains Vinther. The main difference is the number of loadings that result in the actual cracking of the bone. It takes time to develop a stress fracture, whereas a traumatic fracture happens suddenly from a single loading.
The symptoms of a developing stress fracture can appear early on when a rower feels some discomfort in his or her ribs. Vinther calls this first stage a bone stress injury. It is a continuum, he says, that starts with a small stress on the bone that develops into micro cracks and then bigger cracks that may turn into an actual fracture.
Reasons for rib stress fractures
Vinther stops short of endorsing any particular brand of dynamic ergometer though, pointing out that there appears to be no major difference in peak loading between the various dynamic systems currently available.
Common Causes Of Rib Pain
Many cases of rib pain are not serious and resolve with either no or minimal treatment. Other times, rib pain is thought to be a medical emergency that requires immediate attention.
One of the most common causes of rib cage pain is a chest injury or a direct blow to the chest due to traffic collisions, falls, or sports-related contact. This can lead to bruised ribs, broken ribs, pulled muscles, and fractured ribs.
Fractured ribs are cracks or breaks in bones designed to protect the upper body. A fractured rib is also known as a break in cartilage that connects the ribs to the breastbone.
Lets take a look at the many other causes of rib pain.
Use Of Hot Or Cold Pads
Hot and cold pads are commonly used for various reasons to get relief from pain and discomfort. The same can be used for Costochondritis.
Applying hot or cold pads in the areas of discomfort can help reduce the pain and discomfort. Even though the refile is not permanent it can help control the pain.
Some professionals also suggest using heating pads with some medicated cream for better and quicker results.
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Who Getsankylosing Spondylitis In The Ribs
Theres no way to tell who may develop rib problems, says Minna. You can have people who have very severe joint disease but have minimal spine involvement, says Minna. On the other hand, you can have people that have maximum spine involvement and no peripheral disease . Its not a linear thing where as you get more inflammation and more disease, theres a certain progression toward rib involvement, he explains. It can be very random, says Minna.
Musculoskeletal Causes Of Isolated Chest Wall Pain
Large chest wall and abdominal muscles
Larger chest wall muscle groups can also be strained. The Pectoralis major muscle is a large muscle at the front of the chest. It used to rotate the arm inwards, pull a horizontal arm across the body, pull the arm from above the head down and pull the arm from the side upwards. Pectoralis Major strain can happen during vigorous sports activity classically weight training. Its weak point is where the pectoralis or pec muscle tendon attaches to the upper humerus though rarely its tendinous insertion to the upper ribs and sternum can also tear. Symptoms of a pec major sprain include a sudden sharp pain at the front of the upper arm, near the shoulder and depending on the grade of muscle strain, swelling of the front of the shoulder and upper arm. Tests which reproduce pain help confirm the diagnosis and include getting the patient to pull their arm across the front of the chest or rotate it inwards against resistance. A visible gap or lump in the muscle may appear.
Though not strictly a chest wall muscle, the upper Rectus abdominis muscle and External oblique muscle can also be strained, torn or even ruptured leading to pain, which depending on the site of injury can lead to lower chest wall pain and pain when pain twisting from a seated position or when rising from a bed particularly if flexing .
Stress fracture of right first rib in a body builder
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Be Mindful And Observe Yourself
Often during anxiety attacks, we let our brains run wild. One anxious thought leads to another and our brain rapidly starts multiplying all the negative thought patterns that make us feel as if were losing control.
The best way to instantly tackle anxiety is to be mindful and observe your thinking to see whats going on. To begin observing yourself, focus on your breathing and direct your attention inward to quiet your mind and focus your attention. As your thoughts begin to stray or you begin to think about a feeling or sensation , observe that you are distracted and re-focus your attention on your breathing. Doing so, you will see that your negative thoughts might not make as much sense as you think. Breathe deeply and try to calm yourself. You will feel instantly better. If you practice self-observation often enough, you might find it to be a highly useful tool for calming yourself.
Pain In The Right Side Under Ribs
The main reasons for painful aches or sharp jabbing pains in your right rib cage are some kind of chest injury such as pulled muscle or rib injury. Damaging any of your right-hand ribs will feel sore when you press on the injured rib. Sometimes the injury can cause inflammation in your ribs and breastbone which may cause the rib pain to worsen.
Your liver, right lung, right kidney, and gallbladder are all located under your right rib cage. Disease, inflammation, or damage to any of these organs can cause pain in your right side under the chest wall that may feel like rib cage pain.
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Arthritic And Rheumatological Causes Of Chest Wall Pain
|Arthritic and Rheumatic diseases causes of chest wall pain||Less Common|
|Osteophytes of the chest||Relapsing polychondritis|
Arthritis refers to joint inflammation, the most common is osteoarthritis. Related to arthritis are Rheumatic diseases that are characterized by inflammation that affects the connecting or supporting structures of the body most commonly the joints, but also sometimes the tendons, ligaments, bones, and muscles. Rheumatic diseases that primarily affect the spine are considered spondyloarthropathies such as ankylosing spondylitis. See .
Fibromyalgia is a long-term condition that causes pain and tenderness all over your body. When it extends to the chest, the pain feels like an intense stabbing sensation primarily in the centre of the chest, around the breastbone and rib cage. Its thought to be caused by your nervous system not being able to control or process pain signals from other parts of your body. The condition is also linked to increased sensitivity to pain, headaches. extreme tiredness , muscle stiffness, difficulty sleeping problems with mental processes such as problems with memory and concentration. There is no specific diagnostic test.
Fibromyalgia and the associated paired tender points
Osteophyte of the sternum . It was excised with relieve of pain
Rib Cage Tightness Tension Aches Pains:
This symptom is often described as:
- It feels like there is a tightness, tension, aches, and/or pains in the ribs or rib cage area.
- It can also feel like there is a tight band around the ribs or rib cage area
- It can also feel like there is a pressure in the ribs and rib cage.
- It can also feel like there is a burning sensation in the ribs and rib cage area.
- It can also feel like there is a knot or ‘stitch’ in the ribs and rib cage area.
- It can also feel like your ribs or rib cage area is bruised and sore.
This rib cage tightness symptom can persistently affect one area of the ribs or rib cage only, can shift and affect another area or areas of the ribs or rib cage, and can migrate all over and affect many areas of the ribs and rib cage over and over again.
This rib cage tightness symptom can come and go rarely, occur frequently, or persist indefinitely. For example, you might feel a tightness in the ribs and rib cage once in a while and not that often, feel it off and on, or feel it all the time.
This rib cage tightness symptom can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.
This rib cage tightness symptom can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur out of the blue and for no apparent reason.
This rib cage tightness symptom can change from day to day, and/or from moment to moment.
All of the above combinations and variations are common.
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Intercostal Muscle Strain Symptoms And Diagnosis
The symptoms of intercostal muscle strain may vary slightly, depending on how the injury occurred, and may include:
- Sudden, severe upper back/rib pain. Upper back pain or pain in the rib cage may be significant and come on suddenly, especially if the injury was caused by sudden impact or a blow to the chest or back. Additionally, a sudden increase in physical activity can strain an intercostal muscle and lead to sudden, intense pain.
- Gradually worsening pain. Upper back pain may develop progressively over several days or weeks if repetitive, gradual stress is placed on the intercostal muscles. This type of muscle strain is most common after participating in sports such as rowing, swimming, or softball/baseball.
- Muscle tension and stiffness. Muscles may react to an injury by tensing up, causing upper back pain and stiffness with everyday movements such as bending or twisting the upper body. Tension in the intercostal muscles may also lead to muscle spasms, increasing pain.
Injuring the intercostal muscles can potentially lead to further complications. While rare, such complications may include irritating an intercostal nerve or complications due to shallow breathing.
When To Seek Medical Advice
A change in the type of pain. Call if it feels different, becomes more serious, lasts longer, or spreads into your shoulder, arm, neck, jaw, or back.
Shortness of breath or pain gets worse when you breathe
Weakness, dizziness, or fainting
Cough with dark-colored sputum or blood
Dark red or black stools
Fever of 100.4ºF or higher, or as directed by your healthcare provider
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What About Physical Therapy
Along with rest, ice, heat, and breathing therapy, physical therapy may ease your discomfort and speed your healing. Your doctor may refer you to a physical therapist after making a diagnosis.
A physical therapist can give you tips for sleeping like trying a recliner so your chest is elevated and for loosening up in the morning. Following a physical therapy program can help you get back to your usual activities sooner.
Bruised Or Fractured Rib
Your rib cage provides a crucial function: to protect your heart, lungs and other vital organs. But this may also mean they take the brunt of the damage in the case of trauma, such as a car accident, steep fall, physical assault or even intense coughing. A bruised rib means the bone is not actually cracked, but it still may have sustained damage. Symptoms for bruised and broken ribs are much the same: pain, particularly when breathing or coughing.
Telltale sign: Injured ribs cause pain when breathing, coughing, twisting or bending.
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Possible Treatments For Chest Wall Pain
Treatment for chest wall pain will vary depending on the cause.
- Musculoskeletal problems. These conditions are managed with heat or ice, anti-inflammatory drugs such as ibuprofen or naproxen , muscle relaxers, stretching, and physical therapy. You should also try to avoid activities that aggravate your pain. For more severe or persistent cases, your doctor may suggest corticosteroid injections to help reduce inflammation.
- Rheumatic conditions. Treatment of chest wall pain is part of the overall management of each of these conditions. Your doctor will help you decide which is medication is best for you.
- Lung infections. Like other infections, lung conditions such as pneumonia are typically treated with antibiotics.
If your chest wall pain is caused by a heart attack or other serious heart condition, you may receive blood thinners or medications that open arteries. Other treatments include:
Why You Should Never Ignore Pain Under Right Rib Cage
Because there are many vital organs protected by the right rib cage, you should never ignore any kind of chest pain or upper abdomen aches. Many people may also be concerned about a heart attack if they feel sharp, stabbing pains in their rib cage. However, its only on rare occasions that pains under the right rib cage are heart-related.
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When To See A Doctor
The urgency with which you should see a medical professional depends on some factors like the duration, severity, and timing of your symptoms. Make an appointment with a primary care provider and try to be evaluated in the next few days if you notice the following:
- Persistent rib pain
- Rib pain that is worse at night or wakes you up while sleeping
- Rib pain associated with increased fatigue, decreased appetite and/or unexplained weight loss
- Fevers and/or chills
The Physical Side Of Anxiety
The brain is a powerful organ. So much that the anxiety, the depression, and the fear can turn mental fears into actual physical pains.
Most people actually experience anxiety as a physical problem, said Jason Conover, social worker for Intermountain Healthcares Utah Valley Hospital. It often doesnt get recognized because the physical symptoms are so apparent and quite troubling that they might think they are experiencing something else for instance, a heart attack.
Anxiety builds tension throughout the body. Conover said in the brain can react to thoughts of fear and turn to the muscles to brace for a moment that is not happening. Much like if you were about to get in an accident or protecting your body to get punched. The action never happens but chemically you just experienced it just from a random fear thought that crept in.
Treating anxiety is important for better mental health and physical health as well. Inflammation builds up from the stress, and inflammation is a culprit in numerous chronic conditions such as heart and gastrointestinal conditions.
Here are several ways that anxiety manifests in physical problems.
Breathing Due to the tension, your breathing can change, Conover said. Breathing can become shorter, shallower, or even holding your breath too long. The lungs do not fully exhale due to the tension. Relaxation and breathing techniques can help.
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Tips To Reduce Thoracic And Rib Pain
Are you experiencing Thoracic or Rib pain?
There can be many reasons for the onset of thoracic or rib pain and it is always advisable to seek assessment from your physiotherapist especially in the case of an acute injury.
However here are Synergy Physios key tips in reducing chronic thoracic, rib and upper spinal pain!
- Spending time in nature a simple walk on the beach, out with trees, forest or surrounding greenery has proven stress reduction benefits!
- Exercise Getting your heart rate up is a great way to reduce stress! A bike ride, a swim, walking running or even a dance class with friends can boost your mood and reduce your stress levels.
- Meditation Would you like to know more about mindful meditation for pain relief?
Here at Synergy Physio, we offer expertise in the management of thoracic and rib cage problems. Like to know more about your thoracic or rib pain?
Treatment Of Rib Pains
It does not matter if it is a bad posture that is the cause of your rib pains. There are methods to treat any case of pain in the ribs. However, the recommended treatment for rib pain depends on the cause of the pain.
If the pain in the rib cage is due to a minor injury, such as a muscle pull or a bruise, you can use a cold compress in the area to reduce swelling. However, if you experience severe pain, you can also take over-the-counter pain relievers such as acetaminophen .
If over-the-counter medications do not relieve the pain of an injury, your doctor may prescribe other medications, as well as a compression wrap. A compression wrap is a large elastic bandage that wraps around your chest.
The compression wrap keeps the area firmly to avoid more injuries and greater pain. However, these wraps are only necessary in rare cases because the stiffness of the compression wrap makes breathing difficult. This may increase your risk of pneumonia.
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If bone cancer is the cause of pain, your doctor will discuss treatment options with you based on the type of cancer and the origin of the cancer. Determining the origin of the cancer will tell your doctor whether it began in the rib and spread from there to other areas of the body. Your doctor may suggest surgery to remove or biopsy any abnormal growth.
Other effective methods to treat rib pain include:
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