Question
Hello,

During the last week of December, I was recovering from a nasty cold and while having a particularly bad coughing fit, I hurt my rib. Initially, I thought the pain would go away since I assumed I pulled a back muscle. After a month, the pain would not go away, e.g. it hurt to sleep on my stomach (my preferred position), could not reach up to grab things from the top shelf w/o pain, pain when putting my jacket, etc. So about the end of January, I went to my primary physician and she told me that I had a rotated rib after doing an examination, and that a trip or two to the chiro would fix me up. Needless to say, the first thing I did was go to a chiro she recommended (who also was highly rated on Yelp! and other sites). It has been 5 visits, and though the pain has been reduced significantly, I still get pain whenever I take in a deep breath. The mechanized gun/ instrument leaves me in more pain than not after an adjustment. This has seriously affected me because I have not been able to do any physical activity in fear of messing up the adjustments. The chiro says it is getting better, but he is not the best in explaining what is happening, what are the side effects, which I always get a nasty headache after every adjsutment, why it is taking so long to heal, etc.

What's not help also is that my husband keeps telling me is once you start seeing a chiro it never stops. I just want to get this rib healed so I can go on with my normal daily activities.
So my question(s) is the following:

1. How long does a rotated rib take to heal, i.e. how many adjustments on average?

2. Is it normal to feel more soreness and pain after the use of the mechanized gun?

3. My pain to best describe it is soreness in the area between my the two ribs right below my right breast, is this inflammation or referred pain?

4. Can I workout while doing these adjustments, because I went from going for 3-5 times a week to zero? Is weight lifting not recommended?

Please shed any light on this.

Thanks!

Answer
Hi Veronica,

Okay.  Here goes.  This is the first problem:  "The mechanized gun/ instrument leaves me in more pain than not after an adjustment."    These methods, e.g. "Activator," when used alone, are absolute crap.   There is no substitute for hands-on joint manipulation, and the "research" that shows how the Activator instrument delivers a lot of force and reduces pain is not convincing, and is not in any way a substitute for hands-on joint manipulation.   No way.   As an adjunct? Maybe so.    Secondly, the condition you describe is very common, and often it can be resolved quickly if the joint mechanics are restored and the surrounding soft tissues are alleviated.   There is no way that the mechanized gun is going to do that.   Those of us in the elite level of chiropractic health care do not use these devices as a sole modality.   The cutting edge of care currently involves the use of combined methods of hands-on joint manipulation, soft tissue therapy e.g. Graston Technique, and the use of exercise methods (often at the same time).   So, for example, I would first "adjust" your spine and ribs by hand, releasing restricted areas in different ways (not just with you lying face down).   Then, I would release the connective tissues, "fascia," surrounding the area [you've seen fascia; it is the fibrous stuff that connects chicken skin to the meat, and you see it when peeling skin off chicken;  I use this description because most folks have peeled skin off chicken and have observed this;]   Fascial weaves its way around everything.   If injured or damaged, or left stuck or still for too long, it will become adhered with scar tissue adhesions.  This in and of itself will be a source of pain.  It will not go away with a clicky gun!   It must be debrided and Graston Technique is one of the best ways to get at it.   So with you in a sitting position {for example} I would have you reach with your arm and twist your torso to the point where you feel the rib pain, and then I would work out the facia while you go back and forth into this position.   Then, I would add some exercise to it by having you go into these positions while holding a weight or pulling elastic tubing.   You can see this on my website's products/services tab: www.drgillman.com; choose the "Graston Technique for Upper Back/Triathlete" video to get an idea of what I'm talking about even though she is not holding weights.   

I've seen these rib things resolve sometimes in one visit.  One visit.  With a lot of chronic soft tissue irritation it can take a few.   And, most importantly, you should leave each visit feeling like something beneficial took place.   

Another thing I noticed in your question regards headaches.  This is not uncommon when soft tissues (fascia) are left irritated.  Brief massage and also heat application prior to joint manipulation can prevent this.  Tugging or banging against "cold," taught, irritated fascia might be the reason for the post treatment headache.  

Lastly, I would hope that your DC and PCP surely evaluated you to rule out cervical spine disc protrusion causing cervical nerve irritation.   It can masquerade as a rib pain when it really is coming from your neck.   

Not all chiropractors will make you come back forever...  I would suggest that you pass all this information to your PCP.  

I hope this helps.

Dr. G'

www.drgillman.com