Chiropractors/Dislocated ribs

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Expert: Dr. J. Shawn Leatherman - 1/9/2009


Question
What can be done about dislocated ribs in the spinal area that was caused by a fall onto your back.

Answer
Dear Laura,

Dislocated ribs can be a very painful condition, but one that rarely needs any intensive intervention.  What first needs to occur is to determine if the ribs are subluxated or are they truly dislocated.  The only way to do this correctly is with x-rays of the spinal articulations with the rib heads.  

A dislocation implies that the bone surfaces of adjacent structures in the joint are not touching.  A subluxation implies that the bone surfaces still touch, but with altered position or movement and the joint movement may be completely fixated.  Both will stress the joint capsule, however, the joint capsule may be be torn with a dislocation.

Either way, the first initial treatment is to have a doctor (chiropractic physician or orthopedist) manipulate the ribs back to their correct position and then stabilize the chest where the subluxation/dislocation occured.  A chiropractor would be better than an orthopedist because they are better educated on spinal kinematics and manipulation.  You may also need to have the joint manipulated 4-6 times to restore the normal motion. The best way to stabilize is to gently strap/compress/brace the chest.  However, care needs to be taken as the strapping is placed so that lung capacity is not compromised because if you restrict the amount of air that that can be inhaled this can lead to bacteria accumulation in the lung or pneumonia...which is the last thing you want at this point.  

How I would treat this:  Kinesiotape applied tightly and directly over the area of rib subluxation/dislocation.  I would use 3 to 4 inch strips of tape and pull them hard enough to ripple the skin under the tape.  Then apply an ace bandage over the entire rib cage to help reduce range of motion.  This is where you need to be careful...you need to have a full chest of air when this bandage is applied...so full deep breath and hold while being wrapped.  This will help to ensure that you can take a full breath.

You need to limit reaching and lifting (no more than 10 lbs), no throwing, no running or cardio.  Take it easy for the next 4 weeks with only controlled and deliberate movements and allow the joint capsule to begin healing with scar tissue.

Utilize ice on and off for 2o minutes at a time, 1x and hour, to reduce local inflammation and decrease pain transmission.

Hope this helps Laura.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoastehalthcare.net  

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Dr. J. Shawn Leatherman

Expertise

I can answer questions on general chiropractic care, sports injury, whiplash and auto crash, mild traumatic brain injury, structural and functional rehabilitation of the spine, nutrition for inflammation and repair, fitness training, nutrition for sports performance and other general health and nutrition related inquiries. I currently lecture on automobile trauma, occupant kinematics, and forensic risk analysis to local EMS, Fire and Police, as well as nutrition and sports injury to community groups. Rest assured all answers are generated from my clinical experience, and scientific research.

Experience

I have accumulated over 1100 hours of post-doctoral training to include; Certifications in Spinal Trauma and Mild Traumatic Brain Injury from the Spine Research Institute of San Diego, Certification in Chiropractic Spinal Trauma from the International Chiropractic Association, Certification in Low Speed Auto Crash Reconstruction and Certification in Forensic Risk Analysis from The Center for Research Into Automotive Safety and Health, Certified Proficiency in spinal and extremity diagnostic procedures from The Motion Palpation Institute, Certified in Sports Injury and Rehabilitation from the National University of Health Sciences and The American Chiropractic Board of Sports Physicians, Nationally Certified Fellow of Structural Rehabilitation from The Chiropractic Biophysics Organization, and I have advanced training in manipulation under anesthesia and nutrition. Feel free to check out my website for course listings: www.suncoasthealthcare.net

Organizations
International Chiropractic Association, Florida Chiropractic Association, American Chiropractic Board of Sports Physicians, American Academy of Pain Management, Chiropractic Biophysics, Spine Research Institute of San Diego, Center for Research Into Automotive Safety and Health, Motion Palpation Organization, American Academy of Manual and Physical Medicine, Fort Walton Beach Chamber of Commerce

Education/Credentials
B.A. (Psychology)The University of Cincinnati B.S. (Human Biology)Cleveland Chiropractic College D.C. (Doctor of Chiropractic) Cleveland Chiropractic College C.C.S.T. (Certification in Chiropractic Spinal Trauma)The International Chiropractic Association C.C.S.P. (Certified Chiropractic Sports Physician)The American Chiropractic Board of Sports Physicians. *CCST and CCSP 120 hour certification courses are not recognized by the Florida Chiropractic Board due to the fact that they are not 300 hour diplomate level courses*

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