Knots under shoulder blade

One of the most common complaints that people come into my office with is upper back and neck pain.  Many people with upper back tension will describe a "knot under their shoulder blade" or "knots in their upper back." Nine times out of ten, the root of their issue is a rib that is either stuck or out of place.

This is a surprise to many of my clients because they believe that their pain is stemming from sore muscles as a result of poor posture. Muscles and fascia do play a role in this, but no amount of massaging or Rolfing the soft tissues will alleviate their pain without the rib actually moving back into proper alignment. 

How does it feel when a rib is out of place? 

  • tight in the upper back and/or neck
  • pain under the shoulder blade
  • pain when breathing deeply
  • pain when sleeping on that side

People ask me all the time HOW their rib got misaligned in the first place. I had a rib slip out of place when I fell snowboarding. My clients have reported car accidents, sports injuries, falls, sleeping "weird", carrying a heavy bag, and even hugging someone at the wrong angle!. Other clients have absolutely no recollection of any impact or injury. They just woke up one morning and the pain was there. 

The other explanation for ribs becoming misaligned is more about our global postural patterns. Just about everyone has some degree of asymmetry in their body, which means that there is a slight S-curve in their spine. When the spine curves, the ribs also have to adapt to this curvature, which displaces them slightly and predisposes them to being misaligned. Then over time, as we sit hunched over the keyboard, we add muscular tension to our pattern and a rib can get pulled out of place.

Regardless of how it happened, the solution is the same: put the rib back into place and loosen the tight tissues that were pulling it in the wrong direction. Strengthening weak muscles can help too, but neither loosening the tight stuff or strengthening the weak stuff will fix the problem without the rib moving back into place. When the rib does move back into place, the client will hear or feel a click, accompanied by immediate relief.

Keeping the rib back home is not always easy because our bodies adapt to our misalignments and it takes time to teach the muscles and fascia to keep the rib seated in the correct position. This is especially true if the rib has been out for many months or years. But fear not! I have had people come in with ribs that have been out for over fifteen years and their pain is gone. Clients may still have to come in every so often to remind that rib to stay in, but most people would agree that this is better than dealing with discomfort on a daily basis.