I can’t be the only one who has had this problem. (It’s the kid germs - I swear - they’re the worst!) The congestion and coughing are so severe that it HURTS to cough. Kind of like when you laugh so hard it hurts, but in only bad ways. There’s nothing funny about rib pain when you’re already sick! Here’s some explanations and resources to help you get through this mother *%coughing$# sick time. Excuse me ;-)

Information:

Rib Pain from Coughing: Causes & Treatments - K Health

New York City’s K Health doctor, Dr. Edo Paz discusses rib function and pain from repetitive coughing. He recommends anti-inflammatories to help with the rib pain, cough suppressants, applying pressure on the ribs when coughing, and seeing a doctor to rule out serious medical problems.

https://www.youtube.com/watch?v=5HtduTQ7XWU

Rib Pain When Coughing: Is It Serious? - AllergySymptoms.org

Causes of rib pain discussed on this AllergySymptoms.org website include: costochondritis, joint conditions, injuries (rib fracture), and lung disorders. Costochondritis is described as inflammation of the cartilage of the rib, and when coughing, can become painful and tender.

https://allergy-symptoms.org/rib-pain-when-coughing-is-it-serious/

Why do I have pain at the back of the ribs? What is causing this? - Osteo and Physio

Rib pain can also be caused by rib head dysfunction, somatic dysfunction, trigger points, and/or tension of the diaphragm.

https://youtu.be/a-h8RCF_fWA?si=k_81_IAasTbiOhCt

Tip Clip - Lindgren's Test for 1st rib mobility - IAOMUSVIDEO

This is a visual demonstration assessing 1st rib mobility. The RESOURCES section below provides tips in which to address this dysfunction.

https://youtu.be/PrDZD1erucI?si=Y_fFE9ALSeIbtHKy

McKenzie Back Exercises - StatPearls - NCBI Bookshelf

Just in case it’s something more severe that involves disc issues, here’s some information from the National Library of Medicine that discusses postural syndrome, dysfunction syndrome, and derangement syndrome - plus a list of McKenzie extension-based exercise progressions.

https://www.ncbi.nlm.nih.gov/books/NBK539720/

Pain Under Right Rib Cage; 12 Common Causes Everyone Should Know - Northwell Health

In the event this is not orthopedic-related, here’s some other concerns that could be causing pain under the rib cage.

https://www.northwell.edu/news/insights/pain-under-right-rib-cage-12-common-causes

Resources:

Self-Care Techniques

Breathing Exercises - Memorial Sloan Kettering Cancer Center

This page contains simple visuals of easy to follow breathing exercises including: Splinted Coughing, Shoulder Rolls, Diaphragmatic Breathing, Shoulder Blade Squeezes, Overhead Chest Stretch, Quick Sniffles, and Deep Breathing.

https://www.mskcc.org/cancer-care/patient-education/breathing-exercises

Rest and Recovery: How to Sleep with Intercostal Muscle Strain - SleepFoundation.org

Recommendations discussed on this website include the use of rest/ice/heat/pain medications, deep breathing, meditation exercises, neutral positioning and minimizing external pressure, and practices for good sleep hygiene.

https://www.sleepfoundation.org/physical-health/how-to-sleep-with-intercostal-muscle-strain

CHEST & RIB PAIN. BEST Exercises, Stretches & Advice for COSTOCHONDRITIS - Performance Sport & Spine

Gentle exercises in the acute phase demonstrated here are: wall plank, wall rotation isometric, resistance band isometric row and shoulder external rotation, 90/90 degree shoulder rotation stretch, and a floor angel. Continue watching the video for activity modification suggestions.

https://youtu.be/VsBFw32FxoY?si=7CoIiVVDAxqQOFMQ

First Rib Self Release Technique - SpineCare Decompression and Chiropractic Center

Grab a yoga strap and get that 1st rib moving! Learn how in this video.

https://youtu.be/sVKjQCSm_ic?si=pmlP8FAmNLJjIE_m

First Rib Self Mobilization with Movement with Lacrosse Ball - PAR 5 Physical Therapy

This is a 30” demonstration lying on the back with a lacrosse ball placed along the 1st rib while performing repetitive shoulder flexion.

https://youtu.be/B7K5Trm3rvE?si=HYfJ3vaZ5HLNl2-B

Rib Out - How to Pop Back In Place Yourself! - HM Massage

This video demonstrates a self-performed “pin and stretch” technique to address anterior rib pain and a foam rolling demonstration for posterior rib pain.

https://youtu.be/59YI1M31hcM?si=hlYw984ZuFvadNHj

McKenzie Method for Treating Mid Back (Thoracic Pain) - Thoracic Extension in Lying - Physical Therapy & Hand Clinic of Hillsboro

In this 8-minute video DPT Sam Schroetke references a skeleton model to explain thoracic pain and demonstrates thoracic extension in lying to help with thoracic/mid-back pain.

https://youtu.be/0gOiOKwYrNg?si=sTrz8ekBEfcFc9_4

Thoracic Spine Mobility Low Back Pain Yoga Release Follow Along - Annie Pilates Physical Therapist

This is a 20-minute follow along Thoracic Mobility Yoga Flow practice with Annie, Physical Therapist and Certified Pilates Instructor.

https://youtu.be/DkmO6owfNC0?si=84_3PmsoENBhL9eT

These are fantastic - but require another set of hands!

Muscle Energy for Anterior and Posterior Ribs - Ryan Seals

This is a quick video demonstration of a posterior protruding rib correction using a simple muscle energy technique.

https://youtu.be/b4wB8ZaSj_M?si=D2KX4VrXWFtWes3J

Pain Free Functional Rib Mobilization - Modern Manual Therapy

This video contains a mobilization with movement technique to address posterior rib pain.

https://youtu.be/0_tSr8cgWww?si=Zc0kXlvKDPGdjpY-

OMT: Muscle Energy - Ribs 1-12 (Inhalation Dysfunction; Respiratory Assist) - Osteopathic Clinical Skills

Different manual techniques are demonstrated here for ribs 1-2, ribs 2-6, ribs 7-10, and ribs 11-12 providing isometric resistance during inhalation. These. Look. So. Lovely!

https://youtu.be/Uo7Tla9itpk?si=dE57apqpQu6ghmNw