Rib Flare: Why This Can Happen Postpartum and What to Do About It
A common scenario I’ve seen play out time and time again is women who are postpartum notice that their ribs seem to look and feel wider than they did pre-pregnancy. Maybe they notice a dress doesn’t fit quite as well as it used to, even though they’re the same weight as before, or they had to lengthen where their bra hooks in order for it to fit around their ribs, either way, it leaves them guessing if they are just imagining things, or did their ribs really expand after giving birth? First of all, no one is imagining anything, and what they may be experiencing is what we refer to as “rib flare”. In this blog post, we are going to dive into this topic, explain the why and the what behind it and give you some practical tips to take away from this in order to start working on adjusting that rib flare!
What is rib flare, why does it happen and is it normal?
Rib flare refers to the outward protrusion of the lower ribs, which is often noticeable because they have expanded out further than they normally have been and may give a “jutted out” appearance.
This can happen for several reasons, but the most common reasons being pregnancy and/or poor breathing mechanics. A few other culprits of rib flare include:
thoracic spine stiffness
weak core muscles
shoulder breathing
chronic poor posture
To explain the “why” a little further, during pregnancy, as the baby grows and the uterus expands, your organs will move upward and the only space left to go is outward into your ribs. Since this goes on for several months, your body can start to compensate for this expansion by shifting your ribs into that flared, outwardly protruded position. And when the baby is born, as we all know, things don’t always just “bounce back” to the way they were before, nor should we expect them to! Hello, we just birthed a whole baby!!
Now, moving on to the “Is this normal?” question…I really dislike classifying postpartum dysfunction or conditions as “normal”, but what I will say is that rib flare is very COMMON postpartum. If we think of it as “normal”, that can often lead us to also think that because it’s normal, there’s not much that can be done about it or that we just have to accept it for what it is…which IS an option; however, there is also a lot that we CAN do to work on rib flare! It will take time, consistency and effort, but correcting rib flare is absolutely possible with the right guidance!
Is rib flare always on both sides or can it be one sided?
Rib flare does NOT always affect both sides, sometimes it can one sided or unilateral. Unilateral rib flare can occur due to various factors besides just pregnancy. It could be musculoskeletal issues and postural imbalances. Some common reasons for one-sided rib flare include:
Pregnancy: We could have tendencies during our pregnancy that cause one sided rib flare - muscle imbalance, baby position, breathing pattern, scoliosis, etc.
Scoliosis: Scoliosis is a condition characterized by an abnormal sideways curvature of the spine, which can cause the ribs to protrude more prominently on one side, leading to rib flare.
Muscle imbalances: Weakness or tightness in specific muscles on one side of the body can contribute to uneven rib positioning. For instance, muscle imbalances in the intercostal muscles or the muscles around the rib cage can result in one-sided rib flare.
Injury or trauma: Previous injuries to the chest or rib cage can cause asymmetrical changes in the structure of the ribs, leading to a visible rib flare on one side.
Poor posture: Prolonged poor posture, such as slouching or favoring one side of the body, can lead to muscular imbalances and skeletal misalignments, resulting in rib flare.
Musculoskeletal conditions: Certain musculoskeletal conditions, such as costochondritis (inflammation of the cartilage that connects the ribs to the sternum), can lead to localized pain and discomfort, potentially causing changes in rib positioning.
Remember, it’s always important to consult your doctor for an accurate diagnosis, but make sure if you have your suspicions that you seek that out!
How do we fix it?
In some cases, this might just be your anatomy and that is OKAY! The ribs have many muscles that attach to them - back muscles, core muscles and the diaphragm being particularly important. And because our breathing directly affects our ribs/rib cage along with the fact that it literally houses our diaphragm, this is why diaphragmatic breathing is SO important when it comes to helping rib flare.
Properly performing diaphragmatic breathing really can be the missing piece your rib flare because it uses all of these muscles in a coordinated way to properly bring the rib cage down without "rib gripping".
If you’re needing a refresher on diaphragmatic breathing, read below for a quick review!
diaphragmatic breathing
Diaphragmatic breathing is the very FOUNDATION of healing postpartum (vaginal or c-section) and also when healing any pelvic floor dysfunction. Diaphragmatic breathing allows us to connect to the pelvic floor, deep core, and diaphragm in order to be able to fully lengthen (relax) the muscles and then shorten (contract) the muscles.
If you’re needing a reminder on diaphragmatic breathing, make sure to check out my blog, “Where to Start with Early Postpartum Recovery”, but simply put, diaphragmatic breathing is using our diaphragm and pelvic floor together to allow for full lung expansion, organ movement, and full muscle range of motion.
For a quick recap:
When you inhale…
The diaphragm CONTRACTS and goes DOWN
And the pelvic floor RELAXES and goes DOWN
When you exhale:
The diaphragm RELAXES and goes UP
And the pelvic floor CONTRACTS and goes UP
If you tend to breathe into your upper chest OR typically just breathe into your belly, both of those can negatively impact your rib flare. Instead, you really want to promote 360 degree breathing, meaning when breathing you should notice breath entering your body all the way around your body, not just your chest or your belly in the front of your body. Figuring out how to breathe properly and promoting diaphragmatic breathing is also tied into how you manage pressure inside your body and how to distribute it to work in your favor…versus against you!
Aside from diaphragmatic breathing, what else can be done?
There are several different manual techniques as well as focused mobility and exercise movements that can be done to encourage those ribs to pull back in and “unflare”, if you will. Let’s start with my two go-to manual techniques for this:
Self-mobilization of the lower ribs utilizing a towel for reinforcement of the correct position and coordinating with your breathing
This is a technique you can use while you are laying down working on your diaphragmatic breathing. Simply wrap a towel around your lower ribs, grabbing the ends of the towel with your opposite arm and “hugging” your ribs with the towel during the last part of the the exhale portion of diaphragmatic breathing. It would look something like this: Breathe in (pelvic floor drops down, relaxes and 360 degrees of expansion feeling your breath go into the towel), as you then breathe out, you gently “zip” your lower core up, feel your pelvic floor engage, and at the end you gently pull the towel ends together giving a gentle “hug” to your ribs, encouraging them to pull in together.
Manual Release
You can use various techniques for fascial release, but I do prefer the “skin rolling” technique for going over the ribs. You want to make sure to follow the lines of the muscles going over the ribs (internal and external obliques - which actually go in opposite directions of each other), as well as the rectus abdominis. You want to make sure to skin roll going down both directions. You may notice some tension, sensitivity or restriction when you hit a spot that has increased tightness. Other manual release options are rib cage release and diaphragm release where you can cup your fingers under your rib cage and apply gentle pressure up into the backside of your rib cage. This same technique can be done into your diaphragm just cupping your fingers more up and in towards your diaphragm at the top of the rib cage.
These techniques can help with rib flare by allowing the ribs to return back to where they came from. Oftentimes, all the exercises and mobility in the world won’t do anything if fascial or muscle restrictions and tension are keeping those muscles “stuck”. Performing these self-mobilization and manual techniques can be the key to allowing more mobility through the ribs and guiding them back in the direction you want them to go by combining your breathing, manual techniques AND specific exercises to do the trick.
3 Exercises to Try for Rib Flare:
1. Thoracic Cat Cow
2. Banded Diagonal Chops
3. Thread the Needle
These exercises are meant to work through thoracic spine and rib mobility as well as core recruitment in order to improve rib flare. As with anything, musculoskeletal change takes TIME and CONSISTENCY. Nothing happens overnight, but with the right guidance, perseverance and awareness of what the goal is, real change with your rib flare can happen!
Looking for more guidance with rib flare?
My Mind Body Core Program has a specific Rib Flare Program which gives you 4 exercises to perform weekly to improve rib flare along with educational extras and videos to demonstrate all self-mobilization and manual techniques. This Rib Flare program really pairs BEST with my FULL Mind Body Core Postpartum Program! If you’re looking for an all-encompassing postpartum rehab program, make sure to check out Mind Body Core by clicking the button below.