Rib pain during pregnancy and postpartum
by Bryn Zolty, PT
Rib pain during pregnancy and postpartum can make everything difficult. Taking care of kids, lifting, carrying, rolling over in bed, getting out of a chair, and even breathing can hurt.
In many cases, this is due to musculoskeletal changes that occur during pregnancy. Your ribs start changing position even before your uterus is large enough to push pressure up into the diaphragm and rib cage. Therefore, it is thought to be hormonal changes that may play a large role in the alteration of the rib cage.
Rare Musculoskeletal Pain Cause
In rare cases, women will experience transient osteoporosis during their pregnancy. Throughout your pregnancy the amount of calcium transferred from you to the baby increases drastically. It starts at about 2 mg/day and by the 3rd trimester it could be as much as 250mg/day (1)! As with anyone with osteoporosis or osteopenia, there is an increased risk for fracture in your bones including the ribs. A weakened bone can fracture under normal forces, and if you suspect this you should contact your doctor.
Muscle dysfunction, painful joints, stiffness, and trouble with normal daily activities can be treated by a physical therapist. If you are pregnant or postpartum and have a pelvic therapist nearby, contact them and make an appointment. They have additional training to help a woman during and after her pregnancy.
When Rib Pain Is Not Musculoskeletal
There are many causes of chest pain that can occur during pregnancy. These include cardiac causes, clots, pneumonia, heartburn, peptic ulcers, shingles, and more. Your physician will help order any tests needed.
Get Started Before You Make An Appointment
For some women, the musculoskeletal changes that occur during pregnancy do not go away on their own. Here are some ideas to get started in case you are not ready to start physical therapy.
For getting your abdominal muscles fully back on-line immediately postpartum
How to help your abdominal muscles immediately after delivery (connectpt.org)
Improve Mobility During Normal Tasks
If you feel it is difficult to find time to exercise and stretch, start with incorporating lots of movement into your day. Add trunk rotation and side bending into your normal tasks. This will help mobilize the ribs and the spine. It can also help encourage the obliques to mobilize the ribs as well.
If your ribs feel wide and “stuck out’, focus on a long, full exhale. And absolutely work this breathing pattern into all kinds of stretches and yoga poses.
If you are pregnant and past your first trimester, it is important to monitor how you feel when laying on your back and limit this position. This breathing exercise can be done in sidelying, sitting, standing, reclined, or any other comfortable position.
If you feel like getting up and moving, some of these yoga poses may help. Combine them with your 360 breathing. Note she is twisting away from her bent knee in many poses to avoid compression in the groin and maintain open space for your baby.
Make an Appointment
Rib flare left untreated can cause altered function of your core muscles. When you feel ready to attend therapy, your therapist will help customize a stretching, breathing, and strengthening program specific to your body.
1 Women's Health in Physical Therapy. Jean and Glenn Irion.Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, ©2010