Expert: Dr. Victor Dolan, DC, DACBSP - 8/17/2008

Question
While i was doing  a seated military press. I moved my body to make an adjustment in posture while holding the weight overhead. It was a machine and the bar didn't move. when i did that i heard a popping noise in my right rib. it is in the area that extends farthest out to inner chest. it is painful to the light touch or rub across it. i hate going to dr for non emergency and was hoping you could shed some light on this. it is painful whether standing or sitting.

Answer
Hello David,

Sorry to hear of your pain.  Congratulations on working out to keep fit and stay healthy.  It is better to wear out then to rust out.

From your description it sounds like you have a rib pain, in the front of your chest, where your rib meets your sternum, am I correct? This would be called the costo-chondral junction.

Whether up front in the chest, or in the back- off the spine; rib 'connection points', can '>pop<' out and cause pain.  When this happens, cartilage, joint capsules, muscles become bruised and inflammed.  A Doctor of Chiropractic , perhaps with a sports injury practice would be a good choice to evaluate and perhaps treat this complaint.

A Doctor of Chiropractic, after examination, may find it necessary to Xray, or may not.  There is very small chance of an occult (hidden) fracture, but this is HIGHLY unlikely.  There is high likelihood of a rib out of position, and/or an intercostal muscle strain (little muscle between the ribs).

In my Staten Island Chiropractic office I utilize an information handout on strains / sprains / bumps / bruises that may be helpful to you as well:
+++++++++++++++++++++++++++++++++++++++++

P.R.I.C.E. =    P  protection.   R rest.   I  ice.   
    C  compression.   E  elevation.

Hurt  yourself ??  injury/ trauma/  bruise/ not even sure - - a broken bone ??

You should certainly get to the Doctor or trained health professional to be looked at if you think it is bad enough.    BUT in the meantime, some simple steps may help. PRICE.

The  PRICE  protocol will usually help just about any musculoskeletal injury.

P = Protection;  protect the area from further injury- stop what you are doing, can you  pad  or bandage the area ? Tape the area? Do something to protect the area !

R = Rest;  rest the area as much as possible, if a part is damaged, give the body time to   repair the area

I = Ice;  ice is a potent anti-inflammatory; it will slow swelling, help with pain control (ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the  injured area for 30 minutes; then back on again

C = Compression;  to help prevent swelling compression may be helpful- for example  if it is an ankle, wrap the ankle with an ace bandage and ice the area.  Many body  parts may not be applicable to compression.

E = Elevation; again to fight swelling and pain, raising the injured body part above the  heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part

PRICE  may  help :    Sprains,  Strains,  musculo-skeletal injury,  bruise,  contusion

Sometimes  a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain.  Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction).  In the spine, a sprain/strain  is a misalignment,  a ‘kink’ in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation.   Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!

         Spinal = Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)  ;   ( subluxation COULD be any joint )
The vertebral subluxation complex is the underlying cause of many healthcare problems.

A  subluxation  interferes with the proper functioning of the nervous system  (the master system  which controls and coordinates all function within the body)  and may cause various other conditions, symptoms and problems.

This is a serious condition identified by its five parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.  Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint.  CORRECT the subluxation !!!!
++++++++++++++++++++++++++++++++++++++++++++++

You may have subluxated a rib joint.  Be evaluated. Be treated as necessary.  This Staten Island Chiropractor (with an advanced credential in sports injuries- "DACBSP"  see http://www.acbsp.com )
sees many subluxated ribs.  Adjustment, physiotherapy, and perhaps kinesio taping ( you may have seen kinesio taping on american athletes in the olympics!) usually work well to mitigate the problem.

I hope this helps, I wish you Good Health Naturally.


Good Luck.

Dr. Vic Dolan, DC
http://drvictordolan.chiroweb.com    (email newsletter)
http://WWW.DocDolan.net
http://www.GoodHealthNaturally.info