I would put ribs in my top 3 for BBQ preference and #1 in treatment Hierarchy. The concepts we will discuss here and on the Whiteboard Wednesday video I have learned from sources such as The Postural Restoration Institute, Bill Hartman and the content king Zac Cupples.
Why these concepts matter is something that every therapist/coach/practitioner/nerd must learn on their own. I hope to convey that message here.
Let's recap the video....
Ribs move. Ribs move when we breath. Ribs have a normal movement pattern and an abnormal movement pattern. Just like your squat...
Ribs motion (being that it is located in our "core" and all movement begins in the middle of our core and moves out to the extremities) matters for all movement. If your jaw hurts when you chew, your neck is tight at your desk, your hips feel like junk when you squat, your shoulder still hurts, your back hurts carrying your backpack, your calves are jacked (in a not sexy but sucky kinda way) or if you're developing bunions on your feet. Your rib cage and pelvis provide a base for the extremities, and are intertwined when experiencing painful deviations from the norm.
The first disclaimer I will plug in is that not all injuries, dysfunctions, pains or issues have a rib cage component to them.....but a ton of them do. So lets blog about it.
Rib Cage Mechanics 101 (input emoji with the nerd glasses)
The Rib cage is a semi-circular cage that contains the lungs (and other things). As the lungs inflate, the ribcage must expand in a 360 degree manner to provide space for the incoming air. We must inhale to survive (oxygen and what not) and we must exhale to inhale. When we inhale and the rib cage expands (in a 360 degree manner) it is not symmetrical balloon-like expansion. Rather, the ribs that are connected directly to the sternum (with a single line of blue cartilage in the pic below) move mostly forward, the ribs connected indirectly by the blue cartilage in the picture below move mostly out to the side.
This will be the majority of the nerdy stuff, don't bail.
This counts as the same nerdy stuff.
As you can see in the second picture there are two main motions the ribs do to accommodate air. The top moves forward and up slightly, the bottom of the ribs (not shown as well I know, but imagine the entire side of your ribcage) moves up and out to the side.
Now I know what you are thinking, but how do we get air to come into our lungs in the first place.......oh, you weren't thinking that? This is awkward. I'll just tell you anyways.
The Diaphragm
The respiratory diaphragm; aka the thoracic diaphragm; aka the parachute above our belly contracts like any other muscle. When all the fibers shorten they pull down (as seen below).
We inhale, the diaphragm pulls down and creates a vacuum, creating a pressure gradient that encourages air to rush into our lungs from the outside world. This pushes the ribs into the motions described above.
Then, we relax the diaphragm muscle and it recoils, pushing recycled air back out into the world. 20,000 thousand times a day.... Neat!
[Side note, has anyone not seen the Nature is Neat videos on youtube, friggin' hilarious.]
Back to the ribs. Pun intended, because the back of the ribs expand too. While it is not as dramatic as the anterior and lateral (forward and sideways) motion of the ribs; it does still occur, and is absolutely necessary for a number of reasons. The most important reasons (to me) are that the back ribs provide a base for the shoulder blades. Also, the muscles that connect the ribs to the pelvis in the back are often culprits of producing some pretty serious back pain. Reduced expansion of the back ribs creates decreased congruency of the shoulder blade on its base, and therefore the need for either increased muscular activity to compensate. Or, allows for a weaker shoulder mechanism. This is HUGE for pushing movements like push-ups, overhead pressing, and starting bar fights. A good super push will either make or break a bar fight. You do not want a floppy shoulder blade while you are shoving grown men in a bar.
In fact, you don't want to shove grown men in a bar. Don't do that, even with good posterior rib cage expansion during breathing.
I digress.
The low back is often compensating for muscle imbalances in the legs, but also can be locked into overdrive by a rib cage that doesn't expand in the back and lengthen and relax the low back muscles. It's like starting your back oven, and forgetting to turn it off after you finish making dinner.
Let's get to the MAJOR KEY IMPERATIVE IMPORTANT POINT of the day.
Tri-planar Activity of the Diaphram, Rib Cage, Pelvis, and Extremities
Even more important is the understanding that the pelvic floor is the pelvic diaphragm, and its function is just as much breathing as it is holding our guts. It also pulls on your pelvic bones and the bottom of our spine, from the inside! So, if your thoracic diaphragm and its ability to push the ribs around affects the shoulder blades and back, the pelvic diaphragm does the same thing for the pelvis and legs. The effect the thoracic (by the way, thoracic means chest and back aka "bro day") diaphragm has on our shoulders, our pelvic floor has on our hips and legs.
If your body has developed a pattern of movement that limits your ability to move appropriately in one or more of the three planes of motion, you very likely have developed this compensation on the inside, in your thoracic and pelvic diaphragms as well.
Whoa, that's some heavy stuff man.
Last nerd thing for the day right here, legit this time.
The two diaphragms need to have an ability to move in a balanced fashion in three planes of motion, seriously check the tri-planar blog.
If your shoulder rotation, hip rotation, squat pattern, push pattern, or something feels grossly asymmetrical or painful on one side, and not on the other, it is usually indicative of an asymmetry on the inside as well (yea, you just said that). Well now you might remember!
If you just stretch and stretch and stretch that outside of the hip or shoulder, but never address the inside, YOU WON'T FIX YOUR PROBLEM. If you need help identifying if you have an inside issue in addition to an outside issue see a therapist who speaks this language. It is unfortunate but this level of understanding is not standard curriculum for your physical therapist, chiropractor, osteopath, orthopedic surgeon or any health care provider for that matter. You have to be a legit nerd, who still watches useless albeit hilarious youtube videos to find this info.
If you are a coach, therapist, or HCP check the sources listed at the top of the blog. Zac especially puts out a TON of usable info that can expand your ability to get awesome results with your clients.
If you read this blog and thought wtf is this guy talking about, are having some sort of pain and want answers....email your questions to john.hfap@gmail.com.
Check the WW video here for some awkward elaboration and demonstration on these concepts here.
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