The thorax has been for many years a misunderstood area of the body. We once thought it was meant to be stiff, but now we understand that in fact it is responsible for up to 60% of your torso’s rotation.

Not only that, we have become much more aware that rib dysfunction can contribute to pain in other areas of the body. Understanding the position of everyone’s ribs or “rings” is extremely important no matter what problem they come in for.

The anatomy

The thorax is made of 12 vertebral bodies, each with an intervertebral disc in between. Each vertebral body is attached at either side to a rib. This complex – the ribs on either side and the vertebral body in the centre, is often called a “ring” (the thoracic ring approach). Each ring is meant to sit in a perfect position with ample space between the ring above and below, and is meant to move in a very particular way when your body moves. So these rings move when you breathe, as you walk, and when you do almost any other task.

Symptoms of thoracic or rib pain

• Pain in the middle of the back (the thorax)

• Can be a dull ache or a catching type pain with certain movements such as breathing

• The pain can also be at the side or at the front of the rib cage

Causes

• Poor postures such as when sitting at desks for long periods of time or breastfeeding

• Thoracic outlet syndrome

• Schermanns disease

• Osteopororsis or osteoarthritis

• Ankylosing spondylitits

• Hypermobility

• Disc inflammation

• Facet joint problems

Asessment

• Subjective assessment: We will ask you lots of questions about the hip itself, about the rest of your body, any past injuries or surgeries, about what you do each day, your exercise routine and your health in general.

• Objective assessment of the thorax and ribs: We will assess the individual position of each rib and how well it moves.

• Full body assessment: We will always look at the rest of your body to see if there are any areas that could be contributing to your problem. Often however, the ribs contribute to problems in other areas especially the pelvis and lumbar spine.

Treatment may include

• Connect therapy approach

• Muscle releases and soft tissue massage to the thorax and muscles of the ribs including diaphragm release

• Joint mobilisations

• Muscle releases and soft tissue massage to any other part of the body that is contributing to the problem

• Retraining the way you breathe

• Individualised exercise program including stretching exercises and strength training

• Taping