Dealing With Dislocated Ribs

Owie!
I bent down to untie my shoes for a yoga class in Columbus, Georgia, stood up and suddenly, couldn’t breathe. I had a sharp, stabbing pain under my left shoulder blade and my entire left side felt like it was on fire and simultaneously frozen. I couldn’t stand, sit, twist, or breathe without pain.

I lasted all of an hour of telling myself that I would be fine before giving in and calling a chiropractor, explaining that I thought I had dislocated a rib and that yes, I had done this before.

Kayaking can be hard on our bodies, whether playboating, river running, or running waterfalls. But it doesn’t have to be a big impact that can cause problems. The first time I dislocated a rib I was squirt boating on the Ottawa, and all it took was twisting to the right. That time, I didn’t know what I was dealing with, and it took me several days to realize that I hadn’t tweaked a muscle in my back or had a big knot behind/between my shoulder blades.

The second time, my back was stiff and sore from long days in the car, but I was impatient to get on the water at Glenwood Springs, reasoning that I could just take one warm-up ride. I did, and one spin was all it took before I called the chiro. I’ve struggled with rib pain- some minor, some major, like this last incident, which kept me off the water for a week- for several years. I’ve seen many other kayakers struggle with similar issues and thought I would share some of what I have learned.

Triggers:
While everyone is different, when my back muscles- specifically my traps and rhomboids inflame, they aggravate my costo-vertebral joint and the little muscles that attach my ribs to my spine, pulling my rib(s) out of place to create the exquisitely painful situation mentioned above. This can happen from overuse, like trying the same trick on the same side over and over and over again, from having poor technique that rounds my back, exposing the little muscles in between my ribs and my spine, or even from having poor posture as a result of being sat in the car or at the computer all day. Or apparently, from tying my shoes after ten days of kayaking and going to the gym with not enough rest or stretching.

Root Cause?
Visiting the chiropractor in Columbus, GA, they took X-rays, and I learned that a significant contributing factor to my “chronic” rib problems actually originates in my neck. C4 and your C5 vertebrae, it turns out, can pinch on a nerve that runs down your arm, with a tiny little branch that runs down right to my problem spot in the middle of my back, causing those muscles to aggravate and pull my ribs out of place.

A big reason for this? Repetitive whiplash-like trauma (i.e., kayaking and mountain biking), age, and a little luck, I guess.

So how to deal with it?
Though eventually your body may relax and let your ribs go back into place on its own, if you are like me and a WIMP, you may want to deal with it more immediately. Keep in mind that I am not a doctor, but if you suspect a rib may be out of place, I highly encourage finding a knowledgeable chiropractor that can help reduce the errant rib to provide (almost instantaneous, if sometimes temporary) relief.

But what if you aren’t around a chiro? And what can I (you) do to help prevent this from happening again? After chatting with the chiro, living with dislocated ribs, and excessive googling, I found a few of the following resources. (Again, disclaimer. I am not a doctor.)

Short Term
First, NSAIDs- anti-inflammatory drugs can help lessen inflammation and pain. I found that the combination of Tylenol and ibuprofen (Advil) worked best for me.

Ice/Heat can both help. I like to use the 8-hr heat packs that stick on your back, available for purchase at most drugstores and Wal-marts.

I also encourage using a Voltaren Cream, Arnica Gel, or CBD oil for topical relief.

Massage: My new best friend is my Thera Cane, which helps me hit trigger points in my back to help the muscles release. Rolling on a foam roller, or a tennis ball or small massage ball while moving your shoulder can also target the sore spot in question. Or you can pay one of those fancy massage artists to help you.

Rest: It may take time (way more than you want) for your muscles to calm down and allow the aggravated joint to heal.

Longer term, you may, like me, need to work on posture and technique to prevent triggering the muscles from being angry. I bought a computer stand to help while at work, and am trying not to walk and be on my phone at the same time. I have also used KT tape for postural cues to keep my back muscles in a better position. I have been working on refining my cartwheel and split wheel technique, tricks I know for a fact tend to aggravate my ribs.

I (apparently) also need to work on my neck- stretching, strengthening, and using traction to create return more curve to the spine and create more space between the disks, so they stop pinching on the nerve in question.

One of the best resources I have found for explaining and targeting rib dislocation problems is Dr. Alex Ritz’s Instagram account. He has a bunch of great videos with some additional PT exercises. I haven’t tried his exercises yet, but I will soon!

Massive Thanks to my main chiro man, Dr. Steve Olsen (Cobden, Ontario) and Dr. Mike and Dr. Brodwyn in Columbus, GA, for fitting me into their busy practice and helping me work through the last week.

Happy paddling!

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