How to know if rib is dislocated?

Hi everyone,
I fell while walking up my stairs 12 days ago (yes--this would be a better story if I had done something less embarrassing than falling UP the stairs). During the fall I braced myself with my left hand on the wall--my shoulder moved back while my chest fell forward and I heard a "pop." Since then I have had a dull to severe ache in my upper/mid back to my left side. Sometimes it's like a toothache, other times it is a sharp pain (particularly when I sneeze). I thought at first I pulled/ripped a muscle, tendon or ligament, but I am starting to wonder if I dislocated a rib. The pain seems to radiate under my arm toward my chest. I have a definite spot that I can pinpoint that huts to touch and I have noticeable inflammation.

I am prone to subluxations/dislocations, but have never done anything to my ribs before. I have been wearing my shoulder immobilizer due to shoulder dislocations and I have noticed that my back feels a bit better when I have it on--it's super tight around my chest--then the pain comes back when I take it off.

Anyone know how to tell the difference between a dislocation and something muscular-esque? Trying to avoid the doctor game if I can, but my pain and movement is not getting better.

Thanks so much for any help!
ouchy, Julie

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Hello JulieRW,

Remember that ribs can dislocate from the front or back as well as inward or outward. My ribs dislocate outward from the back, so I can only describe what that feels like to me from that experience. When my rib dislocates, I have dull to sharp pain radiating from my back to front. I can feel and see the rib pressing outward on my skin and my skin is reddened by the pressure against it. It hurts to breathe so I end up just taking shallow breaths and sometimes it feels as if my rib is poking my lung. Because my muscles spasm resulting in the rib being locked out of position, muscle relaxants have been the most effective method for me to get the rib back in place.

Is it possible you fractured your rib(s)? Maybe having images taken would be wise.

Gentle hugs...

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For me, a dislocated rib is so agonising that I find it difficult to breathe, even gently - taking a deep breath would be out of the question. I dislocate from the sternum, and the pain in that area makes it very difficult to use my arms also. Lifting my arms above my head is pretty much impossible. This normally triggers a bout of costochondritis for me, and the agony is just a living nightmare! Lying down always makes my rib pain worse due to the pressure on the rib cage. Sitting up with good shoulder support is the only semi-comfortable position. I definitely can't lie on my back as I feel like an elephant is sitting on my chest. The heat that comes off my chest during these episodes is incredible!

Sneezing is the absolute worst. I've been Google-ing "ways to stop sneezing" and found some hilarious suggestions. One is to shout "pineapples" when you feel a sneeze coming on. Afraid to say it doesn't work. However, one sneeze a few weeks ago actually re-located my rib. I heard and felt a very loud crack in the sternum/rib join and over the next few days actually started to feel better! So sneezing is not always bad!

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Consider visiting a chiropractor to check you out... The first time I dislocated a rib (from my back), the "regular doctors" just gave me muscle relaxers and told me I had a back spasm. After about two weeks of agony - the pills didn't help at all - I went to a chiropractor to check me out. He diagnosed the dislocated rib (I didn't even know a rib could dislocate before then) and put it back into place. It did take a week or so for all the inflammation to go away, but there was some immediate relief. Good luck!

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Hi Julie,

Your pain sounds like a subluxed rib to me. I have a rib that subluxes in the middle of my back (bra line) outward. If I don't get it in immediately the muscles around it tighten up and eventually I can't even move my neck. If the muscles haven't locked it down I can get it back in myself. The arm is held at a 90 degree angle at the side (like you are holding a tray but palms inward). In a straight line move the elbow back. You want perfect posture. If that doesn't do it try laying in bed on a soft ball like a racketball or tennis ball and that might do the trick. To prevent future rib subluxations, I roll my back out frequently on a foam roller and that has really helped to keep it in place and reduce discomfort.

By the way, I think the reason that I have this particular problem (originally occurred during coughing) is that I have a very unstable shoulder (probably torn something) that I have lived with for 20+ years. When you have these kinds of injuries you start recruiting the wrong muscles and creating muscle imbalances.

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Last month my costochondritis flared up in pain and every time I would type at the computer, I'd pull my shoulders back afterward and get 6-8 cracks down the front middle of my rib cage. I went to a chiropractor for another reason for the first time in over 2 yrs and he told me I had a rib out. It didn't surprise me at all but I don't know if it had ever happened before - likely it has happened since I've had some terrible bouts of costochondritis on and off through the years. But I had also noticed that it looked like I had lost some weight since the ribs were sticking out an inch or two under the collar bone. That is the rib that is out. He has adjusted it 2 times and my husband has adjusted it twice too (he watched the chiropractor and just copied the maneuver.) But it's still out. He said it would take a while to get it right.
Does that sound right? Or do you all get your ribs back in place in one session? The muscles have calmed down a lot so that should not be the problem.

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It has taken me a few days to get my sacrum back in but it is surrounded by large muscles. I wouldn't think that would be such a problem with a front rib. If you guys are manipulating it and its not going back in then my guess is that you have muscle or faschia tightness elsewhere promoting it to stay out. Its all connected. A common problem for people on the computer all of the time is tightness of the forearms and shoulders. For me that tightness and inflammation is at the elbow and top of the shoulder and prevents some lateral movement of the shoulder region (which pulls at the those ribs). It wasn't even noticeable to me and was only pointed out recently during therapy. So I would try gently messaging the areas and joints neighboring the ribs before you try getting it back in place.

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My daughters pt taught us how to find a rib that is out. If you feel your ribs and one is higher or lower than the ones surronding it, it is probably out. Then if you can get the muscles to relax with heat and light massage we have found that gentle pressure and deep breaths can pop them back in.

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Thank you all so much for your responses! I'm still not so sure what is going on, but I am realizing that heat and compression really seem to help the pain. I can't feel anything sticking out and haven't felt any relief by trying to relocate it, so perhaps it is something else...and I'm not sure the pain is as sharp as some of you describe. Breathing doesn't hurt, just couching and sneezing (triple ouch). Thanks for the tips--I really appreciate all of you taking the time to help! Thinking I will reluctantly drag myself to the doctor...

Julie

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I've dislocated ribs before, unfortunately, and the pain is unmistakable after you know how to recognize it. For me, taking a deep breath was a killer. I also had a bump on my back where the rib was popped out. I am unable to put them back in myself, so I rely on my very gentle chiropractor/friend of the family to coax it back in.

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I dislocate and sublux ribs... As everyone else notes,even drawing a shallow breath can be agonizing with a rib dislocation- any movement at all is agonizing... But when I "sublux" a rib, it feels just like what you've described (when it's in the midback). The best fix for me is days of heat, muscle relaxers, and laying flat on my back, knees up with arms at sides as often as possible-- also avoiding any activity/ task that involves arms positioned out in front of my body- this is huge for me- unfortunately my ribs are out more then they're in. Hope you get relief soon!!
God bless

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I went to the chiropractor again today. I got sick after the adjustment and he got to looking at my symptoms and wants to call a fellow doctor. The problem is he is not that familiar with EDS so he is treating me like a horse. But he really is baffled why lying down would make me so sick or hurt so bad. But that distracted him from trying to get my rib back in. We went to lunch and then I went back to his office and said can you get my rib? He tried again and said it's better but I can't tell. Then I told him some was hurting in my mid back. He checked it and corrected it and then said "it was another rib out!" hmm well at least it wasn't excruciating. I have had them so that I couldn't breath and it is so awful and goes on and on forever until the pain calms down enough to breath.
But usually it isn't that painful for me fortunately.
I keep constant aches through my ribs and actually every joint, neck, hips wrists, etc. So maybe it just can't get it's fair share of the attention from me LOL.

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Yes-- I have noticed that my pain level is directly related to my activity level. The more I move my upper body, the worse it gets. By evening, I'm toast. But with a 3-year-old, who has time to lay on the couch? :-) I've noticed that I can take a deep breath and the pain just remains dull...but as I breathe out and my lungs are almost empty, I have a shooting pain .

I keep trying to contort myself (with your tips) to see if I can reduce it, assuming there is a subluxation, but haven't felt any change. Thanks for all of your suggestions--it took me a while to figure out how to best reduce my shoulder, so I figure if I did sublux a rib it may be the same process of trial and error.

Thank you!

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JulieRW I have no idea how to get ribs back in either. I'm incredibly squeamish so the idea of trying to get my ribs back in makes me feel sick so I haven't really tried! Also scared of making things a lot worse like I did when I put my dislocated hand back together...

I normally just wait for them to go back in, and after speaking to my GP that's what she said any hospital would do also (unless it was poking out of the skin or anything drastic). My culprit rib is directly under my right breast so I can't really get to it easily if that makes sense! I do wonder if pushing them back in or getting chiropractors to do that is actually good in the long run? My osteopath won't go near my ribs at all, in fact I believe it was an adjustment that loosened mine off to start with...

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Hi there. Thanks for this post and everyone's reply. I often wonder what it feels like to dislocate a rib. I want to comment on something SASO said. She mentioned that when hers is out, she has to take shallow breaths. My husband just fractured his rib and the doctor mentioned that he needs to do his best to take full breaths because shallow breathing can lead to pneumonia. Just wanted to throw that out there. I hope you feel better.

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Thanks for mentioning that!

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You know I really love you guys. I spend a lot of time lurking and just reading in the forums but the more I read it's like my whole life makes since now. I am so thankful for this forum and each one of you who presents us all with a piece of your pain. I though a lot of these things were just me or just a normal part of life. This is what my mom would call air bubbles lol. Very painful feeling that runs along a rib and hurts to breath for a few minutes in the front. Then as I was older I have been in the ER with very very painful situations where I was told anything from gurd to gallbladder. I have even went into the doctor and said listening have a extreme pain on the right side of my back and I can't breath also I am very dizzy. dX was acid reflux. I was in theER when I was about 16 for muscle spasms so bad I couldn't breath it was painful but they never found anything at that time. My whole left side of my back went numb at 16 too. It is pretty amazing to have an answer. I thank GOD every day that I have an answer. Again I thank you all for your courage to keep talking and advocating for Ehlers Danlos Syndrome. The more we talk the more people will listen and learn. The more they learn the sooner Ehlers Danlos Syndrome will be diagnosed in a persons life. I am so exhausted most the time there is no way I could do it alone lol I am sure most of you feel this way. I wish I could just have a bit of normal energy some day lol.

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EdenRose, I feel the same way! You mentioned the air bubbles...I get that a lot too. Is that dislocation then? Will dislocations show up on xrays? I've been having more trouble with this but mine is always in the front, never my back, but will often run the course from top to bottom on one side. The deeper the breath I take, the more the pain grabs me. SASO, I can see why you take shallow breaths. Hard to weigh the pain vs potential pneumonia huh? Eeek!

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For me there are 3 ribs that seem to chronically dislocate/sublux at least. They always would kind of go "pop" on me in the night when I'd roll over or lay in a bad position, but it wasnt until after I went on the elliptical for 14 minutes that I began to get severe chest pain that radiated down my arm and into my neck. That rib I'm sure dislocated, I was terrified I'd torn something in my aortic valve because I felt a ripping, pulling feeling in my chest, combined with the pain so I went to the ER for it. It gets esp worse if I move my left arm backwards or lift anything heavy. The other two ribs that give me trouble are lower, one on the right one on the left. The one on the right is a floater rib, mostly irritated by torsion. I have a tendancy to lean funny when I sit for long, like I'm slouching to one side or the other, something I'm trying to correct myself of. The doctor actually thought I had severe scoliosis until I sat up straight! He laughed it was the fastest cure ever. The lower left rib presses more on my lungs. Tonight I was wearing a new bra, and didn't put two and two together until I unhooked it that thats why my breathing had been so shoddy.. See I have a cold at the moment, so I just thought it maybe moved to my lungs.. It was amazing how much easier and less painfully I could breath though once I took it off! And disconcerting, I don't want any more loose ribs -_- Going to have to strengthen my core so they stop subluxing!

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I've had the best luck dealing with my dislocating ribs with my chiropractor and would strongly recommend you see one that is at least somewhat EDS-aware (i.e., no manual adjustments, etc). If the rib was injured as a result of a fall and you normally don't have rib problems, getting it relocated will immediately reduce your pain levels and you will have a good chance of it healing normally.

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Sounds like a sublux to me. That radiating pain around the side is pretty characteristic. If they take the xrays straight on they may not see it though. They could only find mine at a 45 degree.

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