Question
What can be done about dislocated ribs in the spinal area that was caused by a fall onto your back.

Answer
Dear Laura,

Dislocated ribs can be a very painful condition, but one that rarely needs any intensive intervention.  What first needs to occur is to determine if the ribs are subluxated or are they truly dislocated.  The only way to do this correctly is with x-rays of the spinal articulations with the rib heads.  

A dislocation implies that the bone surfaces of adjacent structures in the joint are not touching.  A subluxation implies that the bone surfaces still touch, but with altered position or movement and the joint movement may be completely fixated.  Both will stress the joint capsule, however, the joint capsule may be be torn with a dislocation.

Either way, the first initial treatment is to have a doctor (chiropractic physician or orthopedist) manipulate the ribs back to their correct position and then stabilize the chest where the subluxation/dislocation occured.  A chiropractor would be better than an orthopedist because they are better educated on spinal kinematics and manipulation.  You may also need to have the joint manipulated 4-6 times to restore the normal motion. The best way to stabilize is to gently strap/compress/brace the chest.  However, care needs to be taken as the strapping is placed so that lung capacity is not compromised because if you restrict the amount of air that that can be inhaled this can lead to bacteria accumulation in the lung or pneumonia...which is the last thing you want at this point.  

How I would treat this:  Kinesiotape applied tightly and directly over the area of rib subluxation/dislocation.  I would use 3 to 4 inch strips of tape and pull them hard enough to ripple the skin under the tape.  Then apply an ace bandage over the entire rib cage to help reduce range of motion.  This is where you need to be careful...you need to have a full chest of air when this bandage is applied...so full deep breath and hold while being wrapped.  This will help to ensure that you can take a full breath.

You need to limit reaching and lifting (no more than 10 lbs), no throwing, no running or cardio.  Take it easy for the next 4 weeks with only controlled and deliberate movements and allow the joint capsule to begin healing with scar tissue.

Utilize ice on and off for 2o minutes at a time, 1x and hour, to reduce local inflammation and decrease pain transmission.

Hope this helps Laura.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoastehalthcare.net