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Rib Somatic Dysfunction and Chest Wall pain

Rib 1 Movement elevation and depression
Rib 2-5 Pump handle inhalation and exhalation
Ribs 11-12 Caliper type inhalation and exhalation
Ribs 6-10 Bucket handle inhalation and exhalation lateral and superior motion with inhalation
5 Articulation on ribs 2 demifacets on costovertebral (ribs 2-9) costotransverse costochondral (except rib 11-12) chondrosternal (except ribs 8-12)
Rib 1 somatic dysfunction elevation or depression tender point
Ribs 2-10 inhalation or exhalation anterior or posterior subluxation tender points
Ribs 11-12 inhalation or exhalation tenderpoints
Posteror Subluxation pushes rib angle more posterior
Anterior Subluxation pushes rib angle more anterior
Posterior Rib tender points rib angles
Anterior rib tender points palpate rib shaft
Assessing subluxations Palpate rib angles
Prominent subluxations posterior subluxation
Depression subluxations anterior subluxation
Rib Treatment Guidelines (4) 1. First treat related thoracic dysfunctions 2. Treat subluxations if symptomatic 3. Treat key rib for remaining respiratory dysfunctions 4. Consider pathology and viscerosomatic reflexes
Posterior rib counter strain lean into tenderpoint
Anterior rib counter strain lean away from tenderpoint
Rib OMT indications Chest wall pain back pain tension headache Thoracic outlet syndrome shortness of breath/cough postural problems congenital anomalies
Causes of Chest Wall pain scapula pain syndromes Rib pain syndromes
Scapula Pain Syndromes Snapping Scapula Scapulocostal syndrome
Scapulocostal syndrome Insidious onset of pain in the superior and posterior aspect of the scapula Pain radiates to the shoulder girdle, neck and chest wall Trigger points on the chest wall and medial and deep to the scapula
Rib Pain Syndromes pectoralis trigger point sternalis trigger point xiphoidalgia costochondritis rib tip syndrome
Rib tip syndrome Lancinating pain chondral mass of ribs 8-10 reproducible clicking at painful area
Myofacial release used to treat subluxations and respiratory restrictions
Created by: tjamrose