In June 2015 I was an overenthusiastic pole newbie who believed her muscles were ready to take in anything because she assumed she was strong enough (sounds familiar?). I installed a pole in my room and self-taught myself spin variations, choppers, and inverts, which I falsely jumped into. I also practiced basic two-armed spins for ten minutes before heading off to work and did that without warming up (who has time for that, right?). Luckily, up to some time, none of this irresponsible way of training caused me any pain or injury. However, misfortune usually lurks where least expected.
I woke up on a work day thinking obsessively of a baby-spin variation. The evening before, it wouldn’t work, so I thought I’d give it a quick try before catching my bus. Of course, I couldn’t waste time warming up. Why should I, when up to this point, no harm has ever happened? Jump, heave, hold on tighttt…OUCH!! I got off the pole. Along with the radiating pain somewhere under my right shoulder blade, it really hurt to breathe. My right ribs wouldn’t feel right for months to come.
Rib pain (sometimes combined with upper back pain) when breathing, extending your arm in certain ways, getting up from bed, pulling up your pants…etc. are all symptoms of a rib injury. The injury could be bruised or broken ribs, pulled or torn intercostal or surrounding muscles, or (let the drums roll) a disconnected rib joint. Believe me, the pain was so awful that I actually believed I had a combination of broken ribs and torn muscles. I was scared and I hated myself for not being careful.
Different rib injuries cause more or less the same symptoms, which is why it is hard to know what exactly is wrong. A doctor will usually perform an x-ray to exclude broken ribs. When this is ruled out, as in my case, the doctor might tell you it’s an injured muscle or inflamed rib intercostals. I heard that one from four doctors already. I waited patiently for five weeks and stayed away from the pole. I took normal dance classes (hip hop, ballet, jazz) after three days’ complete rest and avoided anything that caused stabbing pain. The pain, however, radiated almost all the time. By week 4, it had gotten better but something still “jammed” in there and hurt me. I thought if it’s a muscle issue, it should not take that long. Muscles heal fast because they are best supplied with blood. Moreover, placing my hand over my ribs where it hurt in front, I felt a hard bony bulge. But then again, why didn’t the x-rays show anything?
I swear I thought I had a tumor. I showed it to three doctors, and all three acknowledged the bony bulge but reminded me that the x-rays showed normal ribs. They said it could be inflamed rib cartilage because the area got irritated from my false move. The area being spoken of is the front upper ribs right underneath the breast, extending slightly below the armpit. That’s where it hurt and that’s where the abnormal bulge was. Inflamed cartilage does not cause a big bulge like that!
Another symptom I had was a nagging pain underneath the right scapula, which misleads doctors into thinking that the rhomboid muscle has been pulled. Which is why one doctor jabbed 6 cortisone shots right into that area. I roll my eyes every time I remember this. The cortisone did nothing and pain killers relieved me a little but something was still not feeling right after six weeks: I constantly had the need to crack my upper back and something always “locked” and felt tight whenever I sat up. The bony bulge got smaller but was still there. Anyhow, I resumed poling after the stabbing pain disappeared. For two months, things felt bearable and I believed I was healed until one day by the end of a pole workshop, that terrible pain when breathing came back. Oops I did it again!
My condition is called the floating/slipping rib syndrome. I found that out after I extensively researched online. Whenever I googled for rib pain, I got “costochondritis” hits, where most articles described it as a mysteriously recurring inflammation of the intercostal muscles, which patients need to deal with all their lives by taking NSAIDs (nonsteroidal antiinflammatory drugs) and rest. It makes me upset to see how shallow this information is. The fact is that there is an answer. There is a clarification to why this reoccurs and there is a solution to it.
The condition is a mechanical one. The “slipping rib syndrome”, “jammed back-rib joints”, or “costochondritis” are all the same name for one thing: from one trauma to your rib joints, the ligaments and cartilage get stretched so that even after the pain goes away after a few weeks, it is still likely for the same condition to occur repeatedly and without pre-warning. This explains why I’ve had this more than two times already without me doing any “stupid mistake”. As for the bulge, I believe this is the result of the displaced rib, which has slightly slipped out of its joint and went askew. Now when one rib slips out of its joint, its awkward position eventually causes the muscles between the ribs and some surrounding muscles to become irritated and inflamed. That’s where the rib pain comes from. But this doesn’t mean it’s a muscle problem. The muscle pain is just a resulting symptom.
So how do we fix it?
Researching, I found for now 2 offered solutions:
1) Prolotherapy: a ligament and tendon reconstruction, or regenerative injection therapy. You can read more on Caringmedical.com:. I am still skeptical about this method as there are no confirming studies. I have still not researched too deep on this since I am currently embracing solution #2.
2) Manual adjustment of the rib back-joint: You have to be devoted with this one and should do this for 2-5 minutes at least twice a day, on good days as well as on bad days, especially if your sport activities are strenuous on the upper body. For this, you need a curved object that can target the back joints and you need to press your back against the object and carefully wriggle your upper body on it. You will be able to sense the joint “unlock” and you will hear some lovely cracking sounds.
The foam roller alone will not do as it is too flat to address the area we need to target, but that does not mean it is useless. So use it too if you have one. Massage balls are probably not hard enough. I personally find the Back-Pod to be most useful for this situation. The BackPod, developed by physiotherapist Dr. Steve August, is a massage device designed to correctly address the back rib joints and get them to unlock. So it is a form of self-manual therapy. I prefer it because it does not require the patient to be completely dependent on his/her chiropractor. This is all well-described in the Mr. August’s video:
The comments in the video also provide answers to questions one might want to ask. This physiotherapist from New Zealand is the only medical source I could find online which has a good understanding of the condition and proposes a solution for it. To me, he does not seem commercial and is very quick to answer concerns of people watching his videos.
So here it is. I hope I can spread my word to the sport community to relieve you guys from this frustrating condition. If I have any updates, I will immediately let you know. Eat well and healthy and listen to your body.
PS: If the injury is fresh and the pain is stabbing, do the joint mobilization exercises gently and avoid anything strenuous because there is a possibility to cause damage to the surrounding tissues as long as the slipped rib is not in good position.
Tips every athlete should know:
- Apple skin contains a substance that works against muscle weakening and atrophy.
- The increase of various foods such as onions, garlic and other foods high in sulfur will aid in tendon tear prevention. Some individuals, who use excessive antibiotics prior to a tear, will result in weakening of the tissue. So please avoid taking antibiotics.
- Do not take NSAIDS. Using NSAIDs (non-steroidal anti-inflammatory drugs) will result in additional damage to any chronic tendon problem. They do this by removing the sulfur necessary for the collagen formation associated with tendon repair.
(The contents of this article have been carefully checked by Lea. Nevertheless, we raise no claim to completeness, timeliness, quality, and accuracy. We can not take any responsibility for damages arising from reliance on this article. This article does not replace the consultation of a doctor.)
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Lea was born in 1983 to Lebanese parents and currently works as a software engineer in Germany. In 2011, she started taking hiphop and modern jazz classes for the first time in her life, during which she noticed that she loved moves and jumps that required strength and flexibility. Dancing became an obsession and she never thought this would lead her to a stronger obsession: pole acrobatics! In 2015, a girl sweetly approached Lea and told her that she had strong arms and should therefore try out pole dance. And that’s how it all started! Lea took her first class in May 2015 and immediately decided to buy her own pole and install it at home. She started taking regular classes as of January 2016 and makes up her own pole choreographies at home.