Chest pain

Articles

Who has never felt back pain near the shoulder blades sometimes for no reason or as a result of harmless movement such as checking a blind spot or sneezing?

Anatomy

The chest region is complex because several structures are implicated in this region. The rib cage is the region where ribs form rings protecting our vital organs. The ribs on each side go from our sternum (in front) and then connect with 2 corresponding vertebrae in the back. We have a total of 12 ribs, including 2 floating (that do not connect to the sternum).

Biomechanics

The ribs have a rotating motion at the vertebra during breathing (inhalation / expiration) and also, during back movements (rotations, bending). In addition, a multitude of nerve circuits and several muscle layers overlap in this area of the body. The origin of back pain can be the result of a simple injury and be referred pain.

Origin

Sternum

An impact to the sternum can affect the mobility of the rib with its corresponding vertebra in the back due to the ring-shaped anatomy. This creates a restricted range of motion of the arm.

Coughs/sneezing

A repetitive cough or an intense sneeze can increase the pressure at the abdominal level and cause an expansion of the rib cage. This can also cause a rib/vertebra joint blockage. It can also result in an increase in the tension of the respiratory muscles, including the intercostals that are between each side.

Posture and other injuries which impact

Poor posture usually involving the neck will result in a more rounded posture of the back with some rigidity. In addition, fragility in the lumbar could then compensate by a higher dorsal stiffness.

A shoulder injury will change the mobility and control of the scapula as it slides over the rib cage. It “holds” in place mainly by the complex musculature connecting it to the shoulder and the thoracic spine. So the alteration of the movement of the shoulder will result in an indirect change by muscle and joint compensation in the spine and corresponding ribs.

Physical Therapy

Physical therapy treatments are effective in this type of problem. A detailed and specific evaluation lets us identify the probable sources. We then have the ability to restore the movement of the ribs and spine, reduce muscle tension, identify an external source (e.g. the shoulder) and correct it. We will also provide postural guidance and chest strengthening and mobility exercises, including scapular strengthening exercises.

An evaluation will help us better guide you to your recovery.