Rib pain, Covid 19 / Coronavirus
Rib pain is common following coughing fits. The huge amount of coughing some experience with Covid 19 can lead to rib joint dysfunctions and persistent pain.
This patient was in her 40’s and had previously been fit and well, a regular Pilates class attendee and an occasional jogger.
Covid 19 knocked her flat. For several weeks she was bedridden, coughing constantly and feeling dreadful. Slowly over 4 weeks, the symptoms reduced and she was able to avoid the hospital. Just.
However, during the worst of the Covid 19 period, she developed pain in her left rib cage and spine which radiated around to the font under her heart. She had moments of worry that the stress was affecting her heart but as it was worse every time she coughed she decided it was unlikely.
However, as the coughing reduced the pain on deep breathing, cough, and to turn her trunk did not really change.
She found that even the increased depth of breathing associated with walking (Covid really left her unfit) produced pain in the back and ribs.
This lady’s husband suggested that she sought our help as we had successfully treated his ribs in the past as part of a car accident/seatbelt problem.
On examination, the lady had a very stiff trunk and rib cage and a very tender couple of ribs. Just alongside the spine. The ribs attach to the spine at two different small joints. They then attach in the front via cartilage to the sternum. They move up and down with your breathing like a bucket handle. Any dysfunction at these points of attachment can be very painful, especially to breathe deeply.
Typically this is caused by trauma – a fall or impact. Rugby is great for it! However, hard coughing fits can do the same thing.
Once they have become sore or strained or stuck the multiple muscles around the joints spasm and prevent normal motion from returning and thus everything stiffens up more and more.
There are nerves that come from these levels and travel around the chest – giving pain in the front.
Treatment was aimed at restoring the movement and function in the joint and breathing pattern.
The mainstay is manual therapy to release the tight soft tissues and muscles before then moving onto mobilisation of the rib itself and bringing in breathing to the movement. We have many manual techniques that work very well to restore normal function.
Happily, this lady felt better after the first session – if a little tender from getting these stuck areas moving. However, within 3 days she was able to breathe deeply normally again. we worked once more on the restoration of full function. This lady is now fully pain-free and build back into her Pilates and jogging as part of her recovery from this horrible virus.
Don’t let rib pains beat you! Let us help!
References
