In the next couple of months I will teach our SMRT: Shoulder, Axilla, Ribcage, & Upper Back class twice. I want to explore why working on the ribs is critically important to pain relief in this region of the body. Specifically this short post will be looking at the muscles that attach to the upper 6 ribs and their additional attachments. Serratus anterior originates from the anterolateral aspect of ribs 1-8 (this means it has 8 digitations coming off of the upper 8 ribs) and inserts on the anterior aspect of the medial border of the scapula. This muscles action is to move the scapula into abduction. But what happens when the upper ribs become compressed and the fibers of serratus anterior move closer to one another? The muscle becomes shortened, which can pull the scapula into abduction. We could follow this through the change in the humeral position into the forearm, etc., and we could track all the musculature that would be effected by the upper ribs becoming too close to one another.
Instead let’s look at serratus posterior superior. This muscle originates on the spinous processes of C7 through T3 and inserts on the posterior aspect of ribs 2 through 5, under the scapula. Serratus posterior superior sits deep to the rhomboid muscles with fibers running in exactly the same direction. So, again what happens to this muscle if the upper ribs are compressed? The muscle shortens. The compression of the ribs is likely to cause misalignments and compression of their corresponding vertebrae, namely T1 through T5, while the shortening of serratus posterior superior will add to the what is happening in the vertebrae and pull C7 into the tension. When C7 becomes involved, the first rib will also be pulled into the pattern. Along with all of this all of the muscles with attachments on C7 through T5 will be directly affected. These muscles include trapezius, splenius capitis, splenius cervicis, rhomboid major, rhomboid minor, longissimus cervicis, and spinalis capitis.
Three other muscles that should be taken into consideration are pectoralis minor, which attaches ribs 3 through 5 to the coracoid process of the scapula, and contributes to shoulder pain complaints; iliocostalis cervicis, which attaches the upper 6 ribs to C4 through C6, and contributes to neck pain complaints; and transversus thoracis, which attaches ribs 2 through 6 to the dorsal aspect of the sternum and the xiphoid process and contributes to middle and lower back pain.
So, next time your client is complaining of shoulder pain, upper back pain, mid-back pain, lower back pain, neck pain, etc., could the ribcage be the root of the problem? Yes, absolutely the answer is yes. Please join us either in Cromwell, CT from May 29-31, 2015 or in Grand Junction, CO from June 26-28, 2015 for Full Circle’s SMRT: Shoulder, Axilla, Ribcage, & Upper Back course to learn to quickly and painlessly open up the ribcage. https://efullcircle.com/workshop-schedule/