Rib Flare
- Austin U
- 3 hours ago
- 2 min read
A rib flare is a common description for someone displaying an asymmetrical rib cage with a rib, or a number of them, flaring out. Common explanations include weak core muscles, ineffective breathing techniques, and deviations in posture amongst others. I say this often, but the pattern we are seeing is a strategy utilized by the body to accomplish a task. Some muscles are limited in their output, while others are most likely higher in activity. Some connective tissues are elongated; others are compressed. The bony representation we see is an attempt by the body to move at the expense of the shape of the ribs.
The bony representation we see is an attempt by the body to move at the expense of the shape of the ribs.
The rib cage consists of twelve pairs of ribs, each attached to a vertebrae in the thoracic spine. Some ribs float while others are described as “false” and “true” ribs attach directly to the sternum. The lower levels are false and floating, described as such because of their limited connection to the sternum. They tend to be the ones most affected in a flaring situation because of their inherent mobility. Certain movement patterns will put the ribs in a position to flare, meaning their back side is heavily compressed via musculature and the front side is unable to constrain that compression. That inability to provide a constraint leaves us with a rib that looks to be pointing forward and usually laterally due to the rotation involved. This is not a dysfunction, it is a strong pattern that has created a shape change of the thorax.
Let’s use the external oblique as a point of reference. It attaches to rib 5-12 and has a great ability to bend them in ways that require the bones change their shape and result in a flaring presentation. If we attempt to increase the strength of someone’s core muscles, with obliques often being considered a part of the core, then we may be amplifying their compensations. We need to appreciate the nuance in that sometimes it comes down to actually reducing a muscle’s activity level to allow others to kick in. This might entail putting someone in a position like side-lying to off-load them, reduce external oblique activity and promote the expansion of the lower rib cage.
The lower rib cage is highly mobile due to its anatomical shape, making it prone to the description of flaring. A rib flare is not an anatomical dysfunction, but a strategy used by the body to move in particular ways. In this circumstance, some muscles have gained leverage and have become more active than others, resulting in a shape change of the thorax. We can most likely alter this change via positions and activities that reduce the activity of those muscles and promote the ability to compress or expand more uniformly.
Austin Ulrich, Physical Therapist
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