Expert: Dr. J. Shawn Leatherman - 6/26/2007

Question
I'm a 30 y/o woman who suffers from extreme intercostal tightness on my left side from a chest tube placement 12 years ago.  I haven't been able to take a deep, full breath on my left side in 12 years since the chest tube placement, and my pulmonologist says that the reason for this may be scarring from the chest tube (it's nothing to do with my lungs).  What I feel when I take a deep breath is tightness at the bottom of my left ribcage in the front and up my side along my intercostals.

Anyhow, I'm interested in seeing a chiropractor about this and wondered what types of treatments I might be offered.  Sometimes if I massage the area where the chest tube scars are (in the intercostal area) I am able to take a much deeper breath, but it doesn't last long (a few minutes).  I'm also wondering what kinds of exercises, if any, I might be prescribed.

Also, have you ever heard of something like this?

Answer
Dear Kim,

I would agree with your pulmonologist that the scar tissue/adhesions are the cause of the problem.  Unfortunately, scar tissue is always weaker, less elastic, and more prone to pain transmission than normal tissue.  It is just a consequence of the type of collagen used to form the scar and the processes of re-establishing the nerve supply to the tissue.  This can be especially painful if you had not received any manual therapy to the area as the scar tissue was initially forming.

If you want to see a Chiropractic Physician for this specific issue, I would recommend that you seek out the care of one who has advanced training in some form of soft tissue technique such as Graston, or Active release.  Chiropractic adjustments will not specifically address the area of the of the scar but will likely help reduce some pain transmission via the intercostal nerve supply.  It works by stimulating the spine and associated mechanical receptors to reduce pain receptors from activation.  

Anyway,spinal adjustments will be beneficial, but In my opinion to address your specific problem, the myofascial tissue work will give you the most benefit.  Check out the below links for more information on the above listed techniques and to help you locate a qualified chiropractic physician.

www.activerelease.com
www.grastontechnique.com

Stretching will help to aid in the flexibility of the tissue and reduce the inelasticity around the scar and can be performed easily by lifting your arms overhead and bending from side to side.  you may need to incorporate some trunk rotation (twisting) as well for the best effect.  Any personal trainer, physical therapist, or chiropractor can give you additional guidance if needed.

Good luck Kim!

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