Curl your client into a tight fetal position, with hips and spine in flexion, knees to the chest, and chin tucked. Once you’ve identified which costovertebral joints are restricted, position your client on his or her side, with the restricted joint on the upper side (e.g., for right-side restrictions, your client would lie on her left side). Test all ribs, using caution and using very little pressure on the lowest two pairs of floating ribs. An unyielding rib or tenderness with the test reveals an issue with that rib’s costovertebral joints. Each rib should give slightly when you put anterior pressure on it. Whichever position or assessment method you choose, be sure you’re feeling for the boney hardness of the rib itself, and not getting distracted by any remaining tightness in the soft tissues over the ribs or in the laminar groove. A variation is to reach under your supine client, and with your fingertips, lift each rib from underneath. Each rib can be palpated just lateral to the muscle mass of the erectors, or on the upper ribs, just medial to the scapula.
With your client prone, use what manual therapy teacher Art Riggs calls the “piano key” method: using either your fingers, thumbs, palm, or forearm (as in the Erector Technique, Image 2), check each rib’s anterior mobility in turn. Since the costovertebral joints are obliquely arranged, with the rib lying anterolateral to the transverse processes of the vertebra (Image 3), these joints also allow a small amount of anterior rib movement as well this anterior movement is an indicator of freedom at this joint.Īssess this anterior mobility after you’ve the erectors with the previous technique.
Free costovertebral joints allow the ribs to change their angle in relation to the spine, lifting with inhalation, and dropping with exhalation. Deep to the erectors, the area around these key joints is filled with ligaments and small muscles, which when shortened or hard, can bind the ribs and vertebrae together into an immobile mass.
One of the most commonly overlooked places that ribs lose mobility is at the costovertebral joints, where the ribs articulate with the spine. Work the entire length of the erectors but be extra-sensitive over the lower floating ribs and the lumbars. You might ask your client to gently let the breath expand under your touch, releasing from the inside the same places you’re working from the outside. Once they’ve released, on your successive passes feel deeper into the back’s myofascia, working slowly, layer by layer. Begin with moderate pressure, to prepare and warm up the superficial layers.
This will help your body position be more stable and give you a bigger “footprint” in your client’s awareness, which will help him or her to relax into your touch.Īllow the slow relaxation of the tissue to set the pace for your gradual gliding movement down the back. Keep your other, non-working hand on your client, close to your forearm. Image 1 courtesy Primal Pictures Image 2 courtesy .Īt first, feel for variations tissue density, rather than attempting to release or change anything. Images 1 & 2: Use the flat portion of your forearm to gently release the iliocostalis group (orange), the most lateral of the erector spinae. I’ll discuss four techniques for restoring ribcage mobility, taken from ’s Advanced Myofascial Techniques series. No matter what the cause, skilled hands-on work can be an effective way to help re-establish lost motion. Restricted rib motion can arise from the usual things that cause us to lose mobility: stress, postural and habitual stance, inactivity, disease, pain, or injury. Fortunately, this multiplying effect works both ways: not only can breath resections make us feel bad, but even small, incremental improvements in rib freedom can improve well-being on many levels. Since we take approximately 24,000 breaths in a day, even small changes in our respiratory efficiency will have cumulative and far-reaching body-mind effects. The unpleasant, hard-to-breathe sensation? That’s what restricted rib motion feels like, whether the restrictions are from connective tissue constriction, pain, posture, or habit. How much did your ribcage move, and where? Take another breath, this time without moving your ribs quite as much. Image 1 courtesy Primal Pictures Image 2 courtesy.