(Levi responding to Justin)
Hi Justin,
I’m interested in what you were talking about in regards to the patient with the rib issues. I’m curious what the MET for the rib looks like, because i’ve never seen that before. I actually was looking up rib things the other day, because I thought I had a subluxed rib (turns out it was actually referred pain from my gallbladder… misdiagnosed by myself and an urgent care doc… good lesson in differential diagnosing!!). Anyway, so I was doing research on “subluxed ribs”. The term is thrown around everywhere, with many treatments offered by PTs, chiropractors, DOs, and more. I came across an article written in 2015 by a PT, who essentially was saying that ribs don’t sublux. It’s kind of a big misconception. He did a thorough literature search and found only one case report about a confirmed out of place rib (you can type in “subluxed rib” or “dislocated rib” into pubmed and one case study comes up). Ribs get fractured from trauma all the time, and they get xrays all the time, and essentially never does the radiologic report describe a rib being out of place. One would think that if the trauma was great enough to fracture the rib, it would be great enough to sublux the rib… but nope. Now this is all what this PT was saying, but he did offer an explanation to what the anatomical cause of discomfort is, and why manipulations and the such bring relief to patients: sprained ligaments. He also postulated that the “bump” or “elevated” rib that many people call out of place could be due to spasming or guarding muscles, and when the treatment helps, the bump goes away. So he was saying that it’s not that treatment doesn’t help, it’s just that we might be treating something different than we thought. Anyway, just something that I’ve been interested in, so I thought I would share. I’ll attach the pdf article.