Dislocated Ribs: Symptoms, Treatment, and Causes
Can You Dislocate a Rib?
Though there is a wide amount of literature available on the Internet about the phenomenon of ribs "popping out" and of rib dislocation, according to Bahram Jam at the Advanced Physical Therapy Education Institute in Canada, "there are no studies to date that support the notion that a rib subluxation can be reliably diagnosed by manual palpation or that manipulation of ribs can result in the ribs “going back to their place."
Essentially, there is no scientific evidence to support the idea that ribs can be dislocated. That is not to say, however, that the phenomenon people are experiencing doesn't exist. Rather, that the terminology used to describe it is inadequate. Mr. Jam suggests using a different word, such as sprain, to describe the issue of rib pain and a soft lump after some physical trauma.
This article will attempt to help people who are experiencing rib pain or sprain symptoms understand what they might be able to do in order to make it better.
What Happens When It Feels Like You've Dislocated a Rib?
Many people have described rib "dislocations" after activities like starting a lawn mower, sneezing, or coughing. Some say they hear a "pop" and feel a small lump over the injured rib. It often occurs in the mid back and may cause difficulty breathing.
If the rib cannot be dislocated, what is really happening?
It's possible that ligaments in the rib get sprained when stressed suddenly — this might cause a bodily response in the muscles that makes the lump appear. The lump might disappear after being manually manipulated because the muscles are relaxing.
What's the Difference Between Broken Ribs and Dislocated Ribs?
- A rib is broken when the bone itself is cracked.
- It is "dislocated" when the ligaments surrounding it are sprained.
How to Know What Kind of Rib Injury You're Experiencing
Trauma, such as a direct hit to the ribs, severe rib sprain, contact sport collision, a vehicle accident, or a fall, can cause rib injury. If you experienced major trauma to your ribs because of one of those incidents and are feeling rib pain, you should see a doctor so they can properly diagnose you as you might have a broken rib.
On the other hand, a "dislocated" rib, or rib sprain usually occurs from much milder activities, such as sudden movements around the house.
This type of injury is especially common in those with flabby bodies and weak muscles. When people with those conditions exert physical effort together with awkward body positions, a rib injury might result.
The first two common signs of a "dislocated" rib are a lump on the injured area and tenderness when you breathe.
- You have high risk of rib injury if you play sports like football, boxing, wrestling, hockey, or basketball.
- Also, if you have experienced rib sprain or rib "dislocation" before, you have a high chance of re-injury. Repeatedly suffering chest injuries also increases your chances of rib sprain.
- Obese people with weak bodies can easily "dislocate" or sprain their rib.
- Also, certain medications that weaken cartilages in your body can make you more susceptible to injury.
Symptoms of a "Dislocated" Rib
Depending on which rib has been injured, the discomfort or pain may be felt in your back or chest. After some time, the skin over the injured ribs may swell and bruise. The moment the injury happens, a popping sound can be heard and a lump may surface over the rib.
A few other things that you might experience are the following:
- Difficulty and excruciating pain whenever you sit up, breathe, or strain
- Pain when walking or moving
- A lump on top of one of your ribs
- Painful coughing
- Difficulty in breathing
- Tenderness of the injured area
- Other ribs becoming numbed or paralyzed
If you have experienced blunt trauma to your chest, such as after playing a sport, being in a car crash, or having a bad fall, it's possible you have broken ribs and you should see a doctor.
If you are experiencing this injury, you should apply first aid. Tell somebody to get you an ice pack, lie down on your bed or sofa, and place the pack on top of the area where the pain originates.
Remember the RICE mnemonic that stands for
Take an over-the-counter pain medication and try to avoid movements that cause pain.
It's possible that your rib will get better on its own with rest and icing over the next couple of days. You could also try using a foam roller (carefully), or massaging the rib while twisting in the direction of the injury (carefully so there is no pain).
If your condition doesn't improve, you may want to seek professional help. And if the pain is worsening rapidly, then you should absolutely consult a healthcare professional.
What to Expect at the Doctor
Osteopaths, physical therapists, and other specialists of the spine or sports injury specialists might be the best choice for you to see to help recover.
If you visit one, they will ask you about the recent activities that you did and the symptoms you felt. Aside from that, you will also be asked about your medical history. They will also check your body for any other injuries and perform external examination.
After that, you might undergo x-ray for your spine and chest. In some cases, you might need to undergo MRI (Magnetic Resonance Imaging).
If the rib was only sprained, the doctor may or may not correct the rib depending on the severity of its injury. More often than not, doctors prescribe pain killing medications to help the patient recover and let the rib heal on its own.
Your doctor might also manually manipulate your rib to help reduce the pain or possibly wrap the ribcage. The doctor may advise you to wear gentle compression clothes or chest paddings to aid in relieving the discomfort you will feel while moving.
Depending on the severity of the injury, the doctor may prescribe you other medications.
Healing time depends on the severity of the injury — it may take anywhere from a few weeks to a couple of months to heal.
A couple of days after your rib is treated, you can start rehabilitating. You might find it helpful to use a warm compress to alleviate the pain and the swelling of the area that was affected by the injured rib.
Instead of a warm compress, you can also use heat liniments, ointments, lamps, soaks, or a hot shower. If you have access to whirlpool treatments, then do that.
The heat will improve healing speed and blood flow. It will also make you feel comfortable. However, when applying heat to your injured area, be sure that you lie down straight or in a natural position. If done correctly, the muscles on top of the rib will become relaxed and will make you feel relief.
When it comes to diet, you need to eat protein rich foods. Protein will help you develop muscles easier. A few of those protein rich foods you can eat are eggs, milk, cheese, poultry, fish, and meat. The extra muscles will help protect your ribs.
In some cases, your doctor may tell you to take vitamin and mineral supplements to hasten your recovery.
Is your rib hurting?
Exercise and Rehabilitation
For a few days, it is recommended that you stop doing any strenuous physical activity. From time to time, you can also use ice packs to alleviate the pain. You can use ice packs to relieve the pain for three to four times a day, 20 minutes every session.
The amount of time you need to recover depends on your physical condition, age, and severity of the injury. Most people, however, recover after six weeks of rest.
Make sure that you rest and prevent your chest from moving unnaturally or too much.
Be aware of your posture. Always be aware of how you sit, stand, walk, and lie down. If you feel that your muscles or ribs are resisting your movements, then consult your doctor again.
Ask your doctor about the best exercises for regaining mobility and how best to use ice in order to facilitate recovery. They may recommend strength training to increase back strength.
Some of the most effective workouts to strengthen the muscle groups in your chest are rotational motions, pull downs, and rowing. Be sure to follow safe practices while doing these (i.e. using a spotter, not using too much weight, etc.)
When rehabilitating your muscles, you do not need to put a lot of effort into building strength and you don't have to do so many reps that you achieve muscle failure. This is risky as well as a lot of work. All you need is to stress your muscles in order for them to grow and become strong enough to prevent another injury.
Of course, when starting out, make sure that you use light or small weights. Also, be gentle with the workout. You need to stress only your muscles, not your whole body.
On the other hand, if it is a regular activity that caused your injury, stop doing it for a while. If you have no idea what caused it, you might want to analyze your lifestyle. Your doctor might help you figure out the area of your lifestyle that need changing.
After your injury, be wary of the condition of the injured area and your body. Even if you do not feel any dislocated rib symptoms, you should watch out for the following:
- The skin on your chest area is cold, pale, and/or numb.
- You become nauseous and you vomit frequently.
- You still experience difficulty in breathing and shortness of breath.
- You experience possible signs or symptoms of infection such as fever, dizziness, muscle aches, and/or headaches.
- You feel tingling and prickling sensations on your chest.
- You feel new uncomfortable sensations in your body, especially during your recovery and medication period. Though, that might be the side effects of your medication.
- You hear audible pops from your chest.
- You experience minor rib dislocation that you can push back to normal repeatedly.
If you experience any of the above, immediately talk to your doctor.
Here are simple tips to avoid this injury in the future:
- Exercise—Strengthening the muscles in your chest and back area is the best way to protect your ribs from being dislocated. Bench presses, pushups, and rows are ideal for this.
- Warm up before doing any activity—If you do strenuous physical activities, whether for work or for recreational purposes, always warm your body up. A few people advise that you should stretch first. However, it has been proven that stretching before a workout raises the chances of you injuring yourself.
- Wear protective clothing—If you are into contact sports, always be sure to wear chest protective clothing when sparring or practicing. Save your body for the real game.
- Avoid participating in contact sports altogether—It might be easier to re-injure yourself if you start playing again.
As you can see, muscle conditioning is the best way to prevent this type of injury. Also, take note that arthritis can also worsen the injury, so if you do activities that put you at risk of having another dislocated rib, it's better to stop.
If you cannot let go of your hobbies and you have been injured, you must make sure that you rehabilitate your body first. Ask you doctor for the best way to do this.
As mentioned before, it might be possible to mistake a sprained rib for a fractured rib since they have similar symptoms. Unlike a "dislocation," however, fractures can happen to multiple ribs at the same time. Also, rib fractures are rare since the collarbone (clavicle) protects the rib cage from getting damaged.
Normally, rib fractures are associated with other injuries and accidents. For example, the first and second pair of ribs commonly become fractured when a person experiences facial or head injuries.
Commonly, the ones that get fractured a lot are the ribs in the middle part of the rib cage. They are fractured when a person experiences crushing incidents and direct blows to the chest. The most prone to fractures are the seventh and tenth rib pairs.
When it comes to the lower ribs, a fracture can be life-threatening. The lower rib cage houses the diaphragm. When those ones are fractured, the person might experience diaphragmatic hernia. Its treatment will most likely involve surgery.
Just like dislocated ribs, rib fractures make it painful to move and breathe. However, rib fractures tend make people have flail chest — a part of the chest that moves differently or independently. Also, grating sounds can be heard when breathing.
On the other hand, adults are more prone to have rib fractures than children are. Unlike older people, children still have chest walls that are more flexible. It will require a huge amount of force for their ribs to fracture because their bones tend to bend rather than break.
Pregnancy and a "Dislocated" Rib
"Dislocated" ribs are a common problem in pregnant women. However, contrary to popular belief, the baby is not the prime reason a woman could have this injury while pregnant.
Usually, the main culprit is the hormone relaxin. Relaxin is a polypeptide that causes pelvic ligaments and the cervix to relax. It makes things it a bit easier for women during delivery.
Unfortunately, too much of this hormone can make women feel pain in their ribs and can cause sprained ligaments. Even if the problematic rib is corrected, it might be re-injured.
The best way to help women with dislocated ribs is to let them wear an orthopedic rib brace every day. The brace can lessen the pain that the rib is causing. It might be necessary to consult a physical therapist or osteopath regarding the best course of action.
Thankfully, this problem will disappear once the pregnancy is over because the body will stop producing relaxin.
- Jam, Bahram. "Ribs don’t Sublux, Ribs don’t “go out”…so what’s going on?" November 1, 2015. Advanced Physical Therapy Education Institute. Retrieved December 30, 2016.
- "Rib Sprain." (n.d.) Osteopathicinfo. Retrieved December 30, 2016.
- Brown, Jim. "Bruised Ribs: What You Need to Know." April 19, 2012. CorePerformance. Retrieved December 30, 2016.
- Mangusan Jr, David. "Rib sprain - Common Causes, Symptoms and Treatment of Rib Sprains in Sports." (n.d.) PhysicalTherapyNotes. Retrieved December 30, 2016.
- "Dealing with Your Dislocated Rib" (n.d.) Men's Health Tips. Retrieved December 30, 2016.
- Dock, Elly. Dislocations. November 5, 2015. Healthline. Retrieved December 30, 2016.