Understanding Rib Alignment and it’s Relationship with Lower Back Pain

Throughout the fitness industry today, one of the biggest assessments used comes from simply raising the clients hands overhead. As simple as it sounds, it is, in my opinion, the most difficult assessment to correct. Now, what is this assessment telling me, you may ask. Rib alignment, which basically determines our overhead mobility, anterior core strength, and overall posture.

Generally speaking, in terms of the lower back, there are three common postures that are seen today. They include spinal extension, spinal flexion, and optimal/recommended spinal posture. Without getting too complicated, extension and flexion are the postures we want to correct in order to get back to optimal alignment.

From left to right, normal posture, flexion, and extension.

So, what does this have to do with our rib position?

Typically, people that already live in extension are unaware of their rib positioning, which leads to excessive rib flare. This causes tons of pressure on the lumbar spine under heavy load, which can lead to herniated discs, spondylolisthesis, vertebrae fractures, etc.. (1) Another issue which occurs in extension patterns is, the lumbar erector muscles of the lower back are always “turned on”. Because of this, the muscles can never relax, eventually fatiguing and causing pain. (2)

Here’s an example of excessive extension, notice the position of the rib cage and the butt.

Extension and flexion patterns also prevent us from reaching our maximal force production levels. This could occur from the pelvis, ribcage, or head regions. (3) If we have a faulty setup at any one of these positions, there is a loss of stability which leads to energy leaks and less than optimal strength. Let’s take a look at the head, for example.

Here’s an explaination from Todd Bumgardner, MS from his article “4 Weightlifting Myths, Destroyed” on T-Nation.

“Let’s start by keeping something important in mind – the majority of the cervical spine is designed/adapted for stability. Most of the mobility is in the first two vertebrae, not the inferior five. Creating false stability by jamming the articular structures of the spine together de-centrates the cervical spine and reflexively inhibits the muscles of the inner core (diaphragm, pelvic floor, multifidi, transverse abdominus).

If these muscles don’t fire first, the recruitment of the outer-core (abdominals, spinal erectors, glutes, lats) is skewed and a neurological inhibition cascade follows. Long story short, with your neck extended your brain thinks your spine isn’t stable, or safe, and it limits neural drive to outer-core and prime movers.” (4)

So as you can see, false positioning of certain body parts leads to unwanted stability at others. For false rib positioning, the anterior core can’t fire properly, causing the lumbar erectors to pick up the slack. As I stated earlier, the potential for injury is much greater in this position rather than with proper bracing techniques.

Now that we understand what rib flare is, and the negative side effects that inhibit our performance, how do we correct it?

The cue I pound into all my clients heads that live in extension is a simple one, “bring the ribcage down”. I teach this by having them lay on their backs on the floor, and taking a nice deep breath into their chest. Next, I have them realize that as they breathe in that their ribcage rises as their chest. As they exhales, my cue is to have them driving the ribcage and belly into the ground. This allows the ribcage to get into proper position and also limits the excessive arch in the lower back. I teach this on the floor because, if we were to do it standing, it is much easier to fall into a kyphotic (hunchback) posture without even realizing it. Laying supine on the floor, in order to fall into a kyphotic position, your head and neck would have to come off the floor, which the client would be much more cognizant of.

An example of optimal rib positioning, avoids arching the lower back by keeping the ribs “down” through bracing.

For an exercise standpoint, what I prefer to do with my clients is hammer different drills on the floor. Various breathing patterns, core stability, and core strength exercises are implemented until they are mastered. From there, I progress my clients to tall-kneeling, and half-kneeling variations of exercises, which force the core and glutes to fire in order to perform the movement properly. These progressions give a sense of recognition that allow the person to understand what properly alignment should be not only for the movement being performed, but for all exercises. Eventually, we perform different core movements on our feel like Pallof presses and anti-rotation chops to really hammer the abdominals and obliques.

Along with the core, I put a huge emphasis on glute exercises as well. Glute bridges, pullthroughs, and split squat variations are some of the primary movements I use to teach glute activation and strength. Mini band walks as well as side-lying hip abductions are my two favorite movements that force the glute medius to fire when executed properly.

Combined, strengthening the glutes and anterior core will allow us to get back into an idea posture. If we can avoid improper posture, we can avoid faulty movement patterns, which lead to nagging and frustrating injuries. Butt tight, ribs down, core tight. As simple as it sounds, these three cues combined will lead to new strength levels never seen before in the gym!

References

1.) Gentilcore, Tony. “Simple Squat Fix: “Owning” Your Rib Position.” Tony Gentilcore. N.p., 4 Oct. 2013. Web. 28 Oct. 2013. <http://www.tonygentilcore.com/blog/simple-squat-fix-owning-rib-position/&gt;.

2.) Hanna, Thomas. Somatics: Reawakening the Mind’s Control of Movement, Flexibility, and Health. Reading, MA: Addison-Wesley, 1988. Print.

3.) Starrett, Kelly, and Glen Cordoza. “Midline Stabilization and Organization (Spinal Mechanics).” Becoming a Spple Leopard: The Ultimate Guide to Resolving Pain, Preventing Injury, and Optimizing Athletic Performance. Las Vegas: Victory Belt Pub., 2013. 52-54. Print.

4.) Bumgardner, Todd. “4 Weightlifting Myths Destroyed.” Testosterone Nation. N.p., 5 June 2013. Web. 28 Oct. 2013. <http://www.t-nation.com/free_online_article/most_recent/4_weightlifting_myths_destroyed&gt;.

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