What Is A Rib Flare? A Complete Guide to Understanding, Assessing, and Fixing It
Dec 23, 2024
One of the most common questions I get is “how can I fix my rib flare?”
It’s important to appreciate that when we are discussing postural asymmetries, there isn’t anything inherently wrong.
As I have discussed in previous posts and content, posture is a reflection of how we are and are not able to move.
With that said, it’s important to understand a couple of key things when it comes to rib flares:
- What is a Rib Flare?
- How does it come to be?
- How does it impact movement?
- What can I do to improve it?
In this article we are going to cover all of the above and provide examples of exercises that I have used with my clients to get great results.
What is a Rib Flare?
Before we get into assessment and exercises, it’s important to first understand what a rib flare is and how it’s caused.
A Rib Flare is when the lower ribcage begins to protrude forward, usually caused by a lack of motion somewhere else.
This could be at the feet, knees, hips, shoulder and head/neck.
In my experience, many are frustrated as they mention that they have “tried” everything to improve it and it won’t resolve.
This is because most have a narrow perspective of the ribcage position, as they only focus on the ribcage itself, and not how the other areas impact the ribcage position.
The important thing to appreciate about the lower ribs is that it doesn’t attach to the sternum (chest bone) directly.
Instead it is attached by cartilage which is important because this means they are quite flexible, subjecting this area to more compensatory positions compared to those that are directly attached.
When we breathe in, the lower ribcage opens. This will expand the front and back of the ribcage simultaneously, which is important to create an ideal shape of the ribcage for positioning the shoulders and the hips.
When we exhale, the ribcage will narrow side-to-side and front-to-back to get the air out of our body.
As mentioned, breathing will impact the positions of the shoulder and hips sockets, which can impact how they move.
Compensations Associated With A Rib Flare
If there is a lack of mobility at certain joints, our body will compress certain areas, which pushes our centre-of-gravity forward, thereby changing the position of the ribcage and pelvis.
In my experience, those who lack the ability to extend, flex and internally rotate their hips/shoulders, will often extend at the posterior (back) lower ribcage, shoving it forward and causing a flaring of the ribs.
This means that muscles around the posterior ribcage get stiff as a reaction to the positions and lack of motions at certain joints.
The Impact of A Rib Flare on Assessment Measurements
From an assessment standpoint, if you were to lay someone on their back, because their back is arching around the lower ribcage, it gives false assessment measurements because they are resting on their upper back and hips more.
As an example, so you yourself can feel this, lay on your back with your legs bent. Then, think about arching your back so your lower ribcage goes towards the ceiling.
You should feel yourself leaning on the top part of your shoulders and your pelvis tilting forward.
If you were to lift your arms overhead, you may feel as though you have a lot of range.
This is because by flaring your ribs, your shoulder sockets are now facing up and out to the side, positioning them for a lot of external rotation which is needed for shoulder flexion.
If you were to raise your hand overhead again, then breathe out all of the air and pretend someone was pushing your ribs down, you would see your hands won’t go overhead as much.
When we are missing shoulder flexion we will tend to flare our ribs at the point where we max out our shoulder flexion.
The reason this is important is that far too often I see practitioners prescribing exercises based on the notion that these people have more shoulder mobility than they truly have.
This puts them in a position where they have to compensate just to perform the movement that isn’t appropriate for them.
Additionally, when someone is missing hip extension on one side, they will tend to arch through their lower back, their lower ribcage, or both.
You may see this in a split squat, or coming up from a toe touch when they are arching their back.
By understanding the underlying movement limitations at the shoulders, hips and other areas, we can have a plan of attack to choose the right exercises and program effectively.
Exercises for Rib Flare
When trying to select the best exercises for a Rib Flare, it’s important to understand the mechanics outlined above.
From there we can draw on certain principles that will tick as many boxes as possible.
One of the main things we need to do is to shift our centre-of-gravity backwards, while respecting the fact that we likely don’t have a lot of shoulder flexion to play with.
We also have to open the lower pelvis and ribcage to ensure we get the shift back by reducing the tension on the areas that are pushing forward.
Exercise 1: Prone Pillow Breathing Exercise
This is why I really like the Prone Pillow Breathing Exercise, because it accomplishes all of the above.
By setting up into this position, the pillow will act as a constraint that closes the front of our body and forces air to fill up our back, creating the expansion we’re looking for.
The deep hip flexion will open the back and bottom part of our pelvis creating a similar result to our ribcage.
Exercise 2: Hooklying Pullover
Another exercise I really like to give to my clients is The Hooklying Pullover.
By progressively bringing the arms overhead, we are forcing muscles like our external obliques to kick on, closing the lower rib cage which will effectively open our back.
Using a dumbbell is effective, but I prefer a kettlebell, especially if we have the ball going overhead. This will create an even bigger pull as we go overhead, leading to increased activity of the obliques.
Summary
The Rib Flare is a common presentation in the lower rib cage.
It is a reflection of an inability to perform certain movements in other areas of the body.
By understanding how this lack of motion can show in the lower rib cage, we are able to select the best exercises for that person to restore mobility in areas they need it.
If you want to learn more about how to create an effective assessment and exercise selection process to address compensations like this, then check out our EVOLVE Biomechanics Mentorship.