Question
Hello,
Since an auto accident in 2010 left me with a bad case of whiplash, my first rib has been causing a lot of problems for me. It took a long time (two years) for me to even determine what the problem was. With weekly massage, and some physical therapy and an osteopathic adjustment I traveled hours to get my rib settled back where it should be. I have some muscle issues I am working through because it was so up and forward for over a year though. I am concerned though, because the rib keeps wanting to get stuck elevated. I can generally put it back and the pain decreases, but is there anything else I can do to help stabilize it? There are no health professionals in my area I have found who are willing to help me, much less believe me when I say my first rib moves around like this, it is so frustrating. Am I going to be like this my whole life, or can I do more?
I am so desperate.
Thank you for your time,
Stephanie

Answer
Hi Stephanie,

You have a complicated issue.  The stark reality is that there is no proven system for dealing with what you have.  It's all trial and error.   We can conjecture over the possibilities, based on assuming that certain anatomy that attaches the 1st rib can be the cause.    Looking at it from this perspective, one would assume that keeping the anterior neck muscles supple and conditioned would help (Scalene muscles).   It can also be assumed that working out any scar tissue or adhesions in the surrounding joint articulations might be helpful.   Keep in mind that joint manipulation is a kinesthetic skill, and an art, and one person's version will be different than another's.    I've seen some forms of joint manipulation that look like a subtle little press on the bone, and others that remind me of a Ninja movie...    I would suggest finding someone who has completed the FAKTR(.com) course at best, and the Graston Technique course also.   You also should consider finding a credentialed sports chiropractor (www.acbsp.com) who has a lot of experience treating extremity joints.   I'm thinking about your shoulder and it's relationship to the 1st rib as part of the "shoulder girdle" complex.    FAKTR, for example, might consist of you having a band around your head, with an elastic exercise tube attached, and the tube attached to the wall or door.   You would do resisted neck exercises that shorten and lengthen your neck muscles that attach to the 1st rib (scalenes), in slow rep's at mild tension, and while doing instrument-assisted soft tissue treatment to the neck muscles.   This would be a FAKTR prototcol.   Sometimes the combining of dynamic exercises movements with instrument-assisted soft tissue therapy is what it takes to created improved function, and, thus, better odds of being stable during global body movements.       I hope this information proves beneficial for you.

'Best of luck with this!  

Dr. G'