AOM3: Rib Flare. Can you really change your ribcage with exercise? And why this is important postpartum?

Welcome back to the anatomy of motherhood podcast. I'm your host, Natasha Caleel. I'm a postpartum corrective exercise specialist, occupational therapist and owner of Fit Mama Santa Barbara. 

In today's solo episode, we're going to be talking about rib flare. Now if you have not heard this term before, you are not alone, because I realized when I started talking about this on tick tock, most people had no idea what I was talking about until I started to explain it. So when I say rib flare, I mean when either one or both sides of your ribcage stick out; you may notice it in the mirror. You may notice that while you're doing core exercises, or you may notice that while you're breathing. 

As postpartum corrective exercise specialist, we focus a lot on the alignment of the torso and your pelvis and how all these things interact together. So when your ribcage is not in good alignment, this can affect things like your core and pelvic floor.

 In today's episode, we're gonna go over the different kinds of rib flare if it's fixable, when it's not fixable, and why it may be a problem for your long-term goals. This is especially relevant for my women who are recovering postpartum and are finding they're still having a really hard time healing their pelvic floor, addressing their dialysis wreck die. They're not sure where to go from there. A lot of times, underlying rib flare can be a cause, and it may be something that you've had your whole life and now just need to start addressing. 

At the end of this episode, I will give you some of my favorite exercises to help address rib flare. And you can always find these on my tic tok @fitmamasb I have a whole series of videos on there, and we will go into more of that a little bit later. Most rib flare I deal with is pregnancy or postpartum-related. 

When we're pregnant, we need to make room for that baby. So what happens to our ribcage it gets pushed up, and it gets pushed out to the side. There's a lot of movement that goes on there to make room for this baby. Now the problem is a lot of times after having our baby, our ribcage does not always go back to where it should. You may notice that your bra fits tighter, that shirts that you used to have don't fit around your ribcage anymore. And this may be because your ribs are flared out to the side or even flared out to the front, and this can be causing a wider ribcage and a wider ribcage angle. 

So I want you to try this right now. Take a really deep breath into your ribcage. Try to make that ribcage as wide as possible. Now imagine being stuck like this all the time. It would make it really hard to take a solid deep breath. Not only does this affect our breathing, but it can affect your core, your pelvic floor, and your low back there are so many things that tie into the position of your ribcage being stuck in this state of inhalation can usually lead to a wide ribcage angle. So what do I mean by that? When I look at a new client, I usually look at how one side of the ribcage is related to the other at the sternum and look at that angle. When it is wide. People generally have more issues with diathesis wreck dye that isn't wanting to heal. And when it is narrow, that can really push pressure down into your pelvic floor. So I find people will have more issues with their pelvic floor with a narrow ribcage angle. 

Now I know I just got super technical with you there but hopefully, you're following along with this. So we're looking at the position of your ribcage if you're able to breathe into your ribcage and if you have mobility through your ribcage because that's also super important. These are all things that are very, very common postpartum, and something that can be fixed. A lot of people believe that once their ribcage gets wider, it can never go back. And that's not entirely true. Now when it comes to rib flare that's not pregnancy related. 

There are a few different kinds and lots of reasons behind that. So you can always have one side of rib flare. This is when one side of your ribcage sticks out. You may notice it in the mirror when you're trying to flex your abs. You may notice it during your core exercises. So this is actually pretty common, and I see this a lot, but it's not usually related to pregnancy. This is something that you've probably had for a long time.

You can also get rib flare from front to back. So this is when the front of your ribcage sticks out. This can be common in both women and men. So this is not a woman's specific issue. This can be caused by posture, poor ribcage, mobility, and tight muscles. So a lot of things play into why your ribcage would be tilted so that your bottom ribs are sticking out. 

I will share with you what happened when I first started talking about this on tik tok. So I did a whole series on rib flare, and in my mind, this series was directed to newly postpartum women, who maybe had a baby a few years ago. and they are trying to heal their core. So that was my target audience with all these videos. Now I have to say almost all my videos went viral, which is crazy to me because I had no idea people were so interested in fixing their ribcage. 

And I was getting all these DMS from these young girls; I'm talking like 15 16, 17 year old girls, So I said, this is something that you need to go get assessed in person. But it made me realize that there are so many people out there that are a)  hypercritical of themselves, because for a lot of people, you are just genetically different than the person beside you. So yes, your ribs may stick out more, or they may stick out less. But there are also a lot of people that had no idea this is something that can be addressed through exercise. 

So that was the notion that I got from all these DMS is, you are the first person I've come across that has been talking about this and saying that I can fix it. And of course, there are lots of other people out there previous to me that have talked about rib flare, but what Tiktok, we all know, it's whatever hits, whatever goes viral, and whatever people are interested in. So that was super bizarre to me. And I was sitting there thinking, is this it? Am I now the rib cage lady, I don't want to be the rib cage lady. 

These weren't even the people I was trying to reach with these videos. But luckily, the videos did get to a lot of people who benefit from them and people that benefit from my services. So I am very, very grateful for Tiktok in that way. It's just it made me laugh. So that brings me to my next point is rib flare fixable? This is a big question that I get, can you really fix it? Or are you just saying that these exercises will help, so it really comes down to the underlying reason behind the rib flare? 

If you have rib flare, and you've had it your whole life, and it's due to things like scoliosis, or other conditions that affect the ribcage, there's a good chance that you will not be able to fix that. But exercise can definitely help prevent it from getting worse. So especially with people with scoliosis, we know this gets worse as people age. So this can lead to one side of the body being very tight. And the other side is very weak. If we focus on balancing this, so strengthening the side that is weak and stretching the tight side, it can really slow the progress and keep it from getting so much worse. Now, this may not make it any better. But it will help with your long-term outcomes and keep you in the best shape possible based on what you're working with. 

When people come to me, and they're like, I've always had this, and so there's no point in dressing it addressing it. I like to challenge that because I think there is still a point, I think you can still get some really great benefits and prevent a lot of other issues that come down the line with having these really strong muscle imbalances. If your rib flare is something that popped up after pregnancy, yes, you can absolutely fix this. I find for a lot of people, it takes about two or three months of consistent exercise of sticking with the routine to really see some change, will you see a physical change, probably. 

But what I really care about is whether is it improving your function or if your ribcage is more aligned with your pelvis. We all know that when everything is in alignment, our pelvic floor works better, which leads to less leaking, and our core fires better. This can lead to a flatter belly better posture to less back pain. These are all the reasons that I really like to bring attention to the ribcage and bring attention to the position of that ribcage and give people exercises that will help change that. 

But when it comes to creating change and addressing rib flare, it really all comes down to breathing and proper alignment. Like so many of the things, I talked about with the diastasis recti and the pelvic floor. It all comes down to breathing and pressure management if you are a shallow breather. If you are super tight through the back of your ribcage and your mid back, you may be breathing only into the front of your ribcage, which can lead to more rib flare, and you may not be able to expand out to the side. 

So if we're not able to get that expansion, it's really hard to get a nice deep breath. So you may be breathing into your belly, which can make the diastasis a lot worse. There are so many ways that our breath affects all the other areas of our abdomen. And I will tell you this is usually something that people never notice on their own. It is so interesting to me when I start working with women, and I put them through a series of breathing exercises. And they look at me and say, oh my gosh, this is really hard in the right, because everything we do is a habit is a pattern, our muscles, our brain, everything gets used to doing things the same way.

 So when we try to change that, it takes a lot of concentration and focus. And that's not for everyone. Some people are just like, I don't want to deal with this make me do squats, and I don't want to address my breathing. And honestly, as a trainer, you sometimes have to meet people where they're at, you can't force people to do rehabilitative exercise, but the ones that do it and the ones that pay attention see such better results. 

Overall, though, if there is one thing that you take away from this episode, it's that I want you to start focusing on your breathing. Can you get that 360 expansion through your ribcage? When you take a deep breath in? Are you breathing into the bottom of your lungs? Are you getting in that oxygen? As a side note, there's a lot of research on how deep breathing can activate our parasympathetic nervous system. Now our parasympathetic nervous system is responsible for calming us down. So this is why yoga is really effective, it really focuses on those deep breaths, in through your nose, out through your mouth, that deep breathing, and that rhythmic breathing is really important for things like reducing anxiety, reducing stress, for having mental clarity. If you are not breathing well on a day-to-day basis, it's really not going to help you in the long run. But of course, I just went on my big tangent there about all the mental health benefits of addressing your rib flare. But what about physical? Usually, when people have a rib flare, they have other issues that are related to it that they have no idea are connected; rib flare can make your back really unhappy. Okay, so especially with our ribs flaring out to the front, think about what's happening to your back; if our front is open, it means our back is compressed. 

So those muscles of the low back can tighten up, can become sore, and they're usually putting in a lot of extra work, and those muscles like our quadratus lumborum. And our extensors are not meant to be under tension all the time. So rib flare can cause a painful back. Now, what about diastasis recti ? It can definitely put a strain on that midline, especially when as I said, you're not able to get expansion through the side of your ribcage; you're often breathing into your belly. So think about that. If you're breathing into your belly, what's happening to that midline where the diathesis where the ABS separation is, which is really common after pregnancy? That part is getting stretched; the better that we can balance our breathing, the less pressure we're putting on that midline, which is going to help your diocese heal faster.

 Now the other area of our body that can often be related to rib flare is our neck which suffers from chronic neck tension. There are many reasons that this can happen. But a lot of times, it comes down to how you're breathing and your posture if you use the accessory muscles in your neck. So these muscles are supposed to help with breathing as the prime movers. So you're using these muscles to lift up and expand through the ribcage because you're not getting that expansion through the diaphragm and through the lower ribs. This can cause chronic neck tension. This is just something that I've noticed throughout the years working with clients. A lot of times, when people have a weak core or rib flare or other issues, they also have issues in their necks. 

And that's something that once they fix the core and the posture, their neck starts to get better without really focusing on that on to my last topic here. Do you have to fix your rib flare? The answer is no. And I get asked this all the time on Tik Tok. I've had people roasting me, saying that I'm terrible for giving women another thing to worry about. And I want to make it clear that it is not all about aesthetics. 

So when I am looking at all these different things, so whether it comes to your glutes or your hamstrings, or your belly, or your ribs, I really care about how they affect your function. So if it is not affecting your function, and you are completely happy with how it is, you don't have to fix anything. But if you do have unresolved issues with your core or your pelvic floor, or your back, then this is something that you probably should address for most people. Incorporating just 10 minutes of targeted exercises each day can make a huge difference. 

They noticed that they have better posture, that their rib flare is less noticeable, that they have more core definition and that they have fewer pelvic floor issues. These are all major wins for me. Now let's finish up this episode with my favorite exercises to help address rib flare. Now remember, everybody is unique. And this is just general advice, I highly recommend that you go see a pelvic floor therapist or a corrective exercise specialist that specializes in rib flare in pelvic floor in core recovery because that is going to be so helpful to have someone get their hands on you and see what muscles are tight, what muscles are weak and give you some exercises that are really appropriate to your unique needs. But if you wanted to start with some things at home, I would recommend this. 

Number 1 - 90 90 breathing. I think I talked about this in my last episode. But I can use this for pretty much anyone because anyone can benefit from this. This is when you have your legs up on the wall at 90 degrees, you can put your hands on your ribcage, and you're simply focusing on breathing into your ribcage. And as you exhale with that nice pursed lip breathing, you're engaging your core and drawing everything in. From here, you can continue to work on your breathing under a brace. So that's when we're holding our core as we breathe into our ribcage. That is a skill that a lot of people cannot do. And it's something that is super helpful, especially as you start getting into more challenging core exercises. Or you can just keep working on those deep breaths, filling up your lungs and then breathing out. Now the reason we have our legs in 90 degrees is if you push your feet into the wall a bit, you get a little bit more hamstring activation, it helps tuck your pelvis under a little bit, which is going to put you in a better position to really find that expansion through your back. So number one exercise 9090 breathing. 

Second exercise is our child's pose with our back body expansion. If you've ever done yoga, you know what a child's pose is. But we're going to modify this, so I want you to take a foam roller or a pillow or a block and put it on the front of your ribcage. Now you're going to bend forward, go into that forward fold and start breathing into your back. When we block the front like that, we are forced to expand through the back of our ribcage. To take a deep breath, you may notice that this feels really tight. Whenever I do this, I have such tightness on the right side of my back. It's insane that I can not get very much expansion there at all. But once I repeat this about 10 times, that starts to loosen up, and I can get so much more movement through my ribcage. So this is a great one to work into your warmup. Okay, so Child's Pose with Back Body expansion.

The other exercise that I like to recommend is the cross-body lunge. So that is when we're lunging and reaching across our body. Obviously, this is a podcast. So I can't show you how to do this. But please go check out my tic toc because it is definitely on there somewhere. And that's working on the breathing into the side of our ribcage. 

Next exercise that I love for rib flare or for people that are dealing with low back pain or have issues breathing into the back of the ribcage is the full squat. So this is when we're coming down into a deep squat like I'm talking but to the ground. So you can put a pillow or a block underneath you if you have difficulty getting all the way down and need a little bit of extra support. But with your feet turned out, sinking yourself all the way down. Really try to find some length through that low spine, some length through that tailbone area. This is such a great stretch, really good for your overall body, and just something that I like to incorporate into my routine. Once again, this can be worked into the warmup, it can be worked into your cooldown, or this is something you can do at the kitchen sink. So just hold on to the sink, drop yourself down into a squat and stretch it out there. I promise you your back pain is going to feel so much better. 

All right, next exercise and this isn't really an exercise. It's really just a way of breathing. But you're going to reach one arm over to the side. Put your other hand on your ribcage and start breathing into that ribcage. It seems pretty simple, but I promise you to keep doing that, you're going to find so much more movement through that ribcage. And that's going to help with correcting those muscle imbalances and that rib flare. Last thing is that if you have any tightness through your back, especially in the Para spinal, those are the muscles that run along the spine. Doing some self massage with a lacrosse ball can feel amazing. This is something that you want to do before your exercises because we want to loosen up those muscles so that you can get some more movement and expansion through that back.

Okay that wraps up my episode on rib flare. I feel like I have said that word probably about 100 times is starting to sound, you know, when you say a word over and over and it starts not to sound real anymore. That's how I feel. But you guys can tell that I'm very passionate about this. This is something that I do care deeply about. I do like to help women fix these imbalances because the best part of my job is when someone comes back To me in three months and six months and is like, hey, remember how I came to you with all that back pain, I just realized that it's gone. I just realized that when I get out of bed in the morning, it doesn't hurt. I realized that my belly now looks so much better even though I haven't lost any weight because everything is firing properly, muscles are coming together, and everything just feels better on a deeper level. So I hope that this is helpful for you to bring awareness to rib flare, what it is when you can fix it when you can't fix it and how you can go about doing that. So if you have any questions, always reach out to me on social media. I'm super responsive on Instagram just DM me @fitmamasb.  And if you want some more exercises to help address this, I do have a membership on my app. I have a core series there that is super helpful for this. So go ahead and check it out on the website. Its fitmamasb.com/membership. So I will see you guys next week. We have a great guest speaker, and I'm excited to share who it is with you. Have a great day