Hey everybody, it’s Doctor Jo. Today I’m gonna
show you how to mobilize your first rib. It can cause a lot of problems like numbness
in your arms or even headaches. So this is a good way to try and get some of that calmed
down for you. THere’s some simples exercises, let’s get going. The first thing you can do
is grab a belt or something tight, maybe even a long beach towel. But you want it to be
something firm, not like those bands that give. Put the belt around the top of your
neck and shoulder on the side that hurts. Hold it here with the other side and if you
can, if your arm’s not hurting badly enough, grab behind you, so your kind of at and angle.
Almost like a seat belt like when you’re putting the seatbelt on. You want to take your neck
and side bend towards that side and kind of turn down cause that makes those muscles those
scalene muscles relax so it’s holding on to that first rib there. You want to push down
towards that opposite side. And give a nice big pull, hold it there, and take a deep breath.
As you let the breath out, pull even harder. And hold it there about as long as you can,
30 seconds, and then relax. If that gets pretty easy, and your not feeling quite as much of
a stretch, you can actually then take a ball, racquetball, tennis ball, something kind of
firm, and put it in that same spot. Right where that first rib rolls around the neck
to the shoulder. Put it there, press down, side ben your head again. Nice deep breath,
and I’m pushing down as I’m breathing out. Holding, holding, holding, and then relax.
You can do this as many times as you want throughout the day because that’s gonna help
move that rib and make sure the space in between isn’t getting pressed on any nerves or vessels
in there. So there you have it, if you have any questions, leave them in the comments
section, and if you’d like to check out some more videos, go to AskDoctorJo.com. Don’t
forget to follow me on Facebook. And remember, be safe, have fun, and I hope you feel better
soon.

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Dennis Veasley

65 thoughts on “First Rib Mobilization for Neck & Shoulder Pain Relief – Ask Doctor Jo”

  1. OMG!!!! thanks for putting together this awesome vid admist all the turkey madness and BF push-n'-shove.
    how wide should the belt be to appropriately isolate the first rib? does it matter if i compress the clavicle as well?
    is this effective in helping thoracic outlet syndrome? 
    sorry for being so inquisitive. I'm still riding out my pumpkin pie sugar high. Need some pre/rehab advice not to aggrevate my ulnar nerve compression which always worsen after lengthy freestyle swimming session.

    thank you dr jo =-)

  2. Some people suffer from First World problems like not being able to charge all your iDevices at once because you don't have enough plugs ūüôā Well today I have a video for people who suffer from First Rib problems which can include neck pain, shoulder pain, arm and hand numbness or tingling, and even headaches. Check out the video for more info.

  3. Great video! I will try this. However, where exactly does the strap and tennis ball go? Is it anterior or posterior to the clavicle? The placement of the strap looks easier, b/c it's more of general placement, therefore even if I'm not precisely on point, it will still offer some benefit. But with the ball, it seems that the location of placement is more important. I will try the strap first for sure. BTW, my left arm issue is getting much better. I did something new recently. I've done this exercise before, but it seemed to help relieve some pressure in my thoracic outlet. I did side-lying DB internal rotation with a light dumbbell. Does the subscapularis have any bearing on thoracic outlet syndrome? I've not read anything yet on it, but it seems to have helped a lot. I got a lengthening and strengthening effect going from external rotation (nice stretch) to internal rotation (targetted subscap strengthening). I also did it with shoulder abducted to 90 degrees, which significantly reduced the pec major's moment force, thereby targeting the subscap better.

  4. Got a question. Do you pull down on both sides OR do you pull down from front but stabilize strap from back? BTW, this stretch is great. I like it. Just did it and it felt good. But should it be done on both sides for equilization?

  5. Thanks Doc! I have a cousin that's a PT. He said my neck pain & numbness in my hand was caused by this rib. During therapy, he would work this rib in the manner thatvyou show with the belt. Workedvgreat, but after my treatments were done, the pain came back. Heat, my tense unit & my Saunders traction provides some relief, but now, because of your video, I have a way to manipulate that rib myself without having to go for therapy. Thanks again!

  6. i have got question Doc.my wife has left upper front chest and shoulder ..pain so sometimes it very hard to move hand …and pain in normal breathing. visited some doctors but not recoverd yet,…seems muscle cramp in upper ribs …so plz is there any physiotherapy regarding this pain …hoping to get reply soon. thank you¬†

  7. I've been doing this for TOS upon the recommendation of my PT, but was challenged by an injured wrist (to go with injured shoulder/AC, etc). I found that a martial arts gi belt works great to step on with my foot, and then do the rest as normal. It's long enough to stretch from my foot over my shoulder and down to the waist in back, so I can grab it and pull. 

  8. Came across this as I was searching for an answer for why one rib is elevated. I also always have neck pain on the same side as the elevated rib. So I am trying these exercises- thanks! Also wondering if sleeping on my side is causing this problem. I cannot sleep on my back – tried for 3 months once and the habit wouldn't stick. Any advice, and/or other exercises to do to fix the elevated rib (BTW, I know I don't have scoliosis so that's not the issue!) Thanks!

  9. I can't wait to give this a try. I have been getting chiropractic adj's for this rib subluxation but it just doesn't seem to last.

  10. Thank YOU! I've been struggling with this for almost 9 months. Just figuring it out & don't want to have to depend on someone else to fix it for me…like Ever. It's been just wicked. And I will follow you on FB. =:)

  11. Hi, can you tell a bit more about where the ball is to be placed? Not great at anatomy here, so trying to make sure I do it right. I have TOS and first rib mobilization is supposed to be really helpful.

  12. Hey Dr. Jo,

    I am pretty sure I have a misplaced first rob and this remedy seemed to help a lot. However, when I am training (bench press for example) lately my right arm, which is where I'm having neck pain, feels numb or "dead" and I can barely press anything with my right arm. Is the first rib causing impingement on the brachial plexus leading to my shoulder imbalance? Please let me know what you think. Thank you!

  13. Hi Dr. Jo,

    My PT diagnosed me with a raised first rib (on my right side) and it's really becoming a problem. The worst part is that sometimes when I take spinning classes I get this dull/achy pain that starts in the side of my neck and then a sharp pain will shoot through my armpit area and into my rotator cuff and end in my abdominal/stomach area. My shoulder/rotator cuff and stomach will be extremely tender (made worse by taking deep breaths) and my stomach will become extremely distended. The pain in my neck/shoulder might go away within a few hours but the stomach pain/discomfort can last days. The pain feels like a nerve spasm and I think it has to do with my raised first rib but the stomach pain/bloating is what's really throwing me for a loop. And just as a side note, I also had this same pain happen when I was working out on one of those Jacob's Ladder machines in which I was putting pressure on my shoulders (similar to spinning).

    Also thought I should mention that I had my gallbladder removed this last March. I was taking a spin class and the pain became so bad that I ended up going to the hospital. They thought it was my gallbladder (which actually did need to come out) but this pain has been happening even after the surgery and I feel hopeless. 

    Even after all my PT visits I am still having the same issues and am so frustrated and confused. Any insight or advice you could provide would be very much appreciated. I just want to understand what's going on! 

    Best,
    Ainsley

  14. I have been swimming for 2 years and 2 months ago, i joined a crossfire style gym. i was doing hanging snatches and this pain developed. after watching this video, i notice that the same exact areas you pointed out, hurt me. now, after i did the snatches, i didn't feel pain. its when i went to bed that night, i think i slept in an awkward position and its been hurting me for a week now. my question is: what caused the pain? i figure this area would be a little stronger from the swimming? it hurts at the top position of a jumping jack, if i bring my arm across my body, stiffness in a lateral raise, and, without moving my arm, bending over at the waist hurts my arm. what gives??  

  15. thank you so much for this video!  I've been in PT for lower back issues related to SIJD, Spondylolisthesis and scoliosis.  I've just started PT for my neck pain (next will be the knees!). My PT therapist told me that I have an elevated first rib which that is causing my neck pain.   I have found that when my SIJD is out of whack that my neck often feels like it's catching.  When I lower my head forward and move my head gently sway my head from left to right I can feel and hear clicking.  I'm wondering if you think the lower back pain and neck pain can be all related?   And can the "catching" feeling and clicking be related to the elevated rib?

  16. Over a year ago I dislocated my clavicle and first rib on the sternum side. Which has left me with all of the symptoms you have listed. I've had so many sleepless nights because of shoulder pain and arm/hand numbness while lying down. When this first happened I was adjusted by a Chiropractor and had a massage. After several adjustments the clavicle seems to be in the correct alignment. But the first rib is still not connecting to the sternum correctly. I have a tender lump on my chest to prove it. I've had x-rays, which show tendonitis of the bicep and rotator, bursitis, and first signs of arthritis. Have also seen an Orthopedic Surgeon that told me no surgery is needed, its a muscle problem. The muscles in my entire should are sore and tense. Therefore, I understand that part but I still have a rib out. I've spent the past 2 months in physical therapy. Not really understanding the technique they are using but I gave it a shot and received zero improvements. (I laid on a table and the therapist would place one or sometimes two of her hands on areas of my shoulder or lower back that she felt was painful. No pressure or massage was used, but energy instead.)  I feel, I am still having this problems because the first rib is still out of place. I would like to try this technique but wanted to check with you first because I don't want to cause any more injury to my shoulder. The video seems to be dealing with the back side of the first rib, not the front. Would this be helpful or is there another technique to try?

  17. Hello Dr. Jo,

    Great vid. I was diagnosed with TOS a few years ago, and I've noticed that I feel relief from some of my symptoms when I shrug my shoulders. It seems to me that shrugging of the shoulders relaxes the scalenes, which as a result opens up the area between the scalenes and the first rib, which takes pressure off the brachial plexus. Is this true? Will stretching the scalenes and mobilizing the first rib help in opening up this space permanently?

    Thanks!

  18. i do have swelling of the lower ribs of my left side.i feel very uncomfortable while walking sitting and sleeping.can u provide any exercises to relieve from this discomfort.

  19. Thanks so much for taking the time to make these videos and sharing them for all! I have cervical spine stenosis (spurs, facet joint arthritis and degeneration) and DDD – had C5/6/7 fused in my mid 30's and now that I'm approaching mid 40's the spinal levels above are showing signs of accelerated wear from the change to my neck curvature. The random spurs like to irritate nerves in my upper traps, scalenes, levators, rhomboids, SCMs…so I'm sure my first rib sits about even with my ears now (lol, well that's how it feels some days). I work closely with my orthopedist and PT to manage symptoms and maintain as much mobility as possible – and I've had to relearn 'stretching' coming from an athletic background – I always wanted to push push push but to keep this train wreck (haha) in motion it's all about being gentle. These two stretches are not in my book of work but they are now! Thanks Dr. Jo!

  20. I wonder if I need my first rib adjusted. That shallow area behind my clavicle is tender and in hurts when lightly pressed. At the same time the top of my neck on the same side has a great amount of dull pain. My left pinky is tingling also which is on the same side of my neck pain. I told my chiropractor and he adjusted my neck, which provides some relief, but the pain comes back only with a few minutes after.

  21. DR Jo. I have suffered greatly since 2009 in my C5 and C6 and C7 and T1 and T2 areas. I was injured in the military in 2009 and again in 2011, and both times my neck were involved. When the pain first began, I have even had other Docs say I was faking, or exaggerating the pain. I learned to wear my "mask" and to just "deal with it" so I would not be shamed by Docs. After many years of pain, I have found a good team, but, no relied. — I really really suffer with these issues. Migraines, right arm pain, alloydona, and muscle spasms so bad I wanted to throw up. I was in a muscle spasm tonight, and I am sick of muscle relaxers (only make me sleepy, does not cure the issue). I was desperate for help in my muscle spasm tonight. I watched this video, found an old belt, and got to work. I don't know if I have "first rib issues" or not, but, this video felt so good, I am going to do this every night from now on. Even if I may never be cured, your video helped me tonight. Thank you. (BTW — on top of my injuries, I also have a "loss of cervical lordosis" on top of Fibro and RA, so, those contribute to my pain too) — Again, thank you for your video.

  22. My first rib has been out of place for a very long time- so every time my PT guy pops it back into place- it returns to the old spot as soon as I lift my arm up a certain way… How long until the rib stays where it is supposed to?

  23. Hi Dr Jo ! I fell on my left shoulder a couple months ago. An osteopath said my first rib is out of place. is this exercise which will help to put in back into place ? Thanks in advance ;o))

  24. Hi Jo, i notice your Guitar there. I'm having Neck/Shoulder/Finger(pinky/ring) discomfort (likely from playing 'my' guitar too much). my research leads me to believe it's likely 'Thoracic Outlet Syndrome' and possibly first rib. I'll try this exercise for a while. Have you had any similar discomfort from playing guitar and can you suggest any other videos to address that? Thanks so much.

  25. Wow this worked perfectly lol
    Sometimes i sleep wrong and i wake up with a messed up rib and bugs me all day, week. I finally understand why my neck was locking up. thank you wonderful vid!

  26. OMG, thank you so much for this video! I have had neck pain near my shoulder for a while that has recently gotten worse. I was desperate, as it was the weekend and I had no idea what was happening and couldn't see my Dr. Looked around online to see what parts of the body were in the area and landed on the first rib. Then found your video and tried the technique. Third time I did it, I heard and felt something pop! The pain is not nearly as bad now. I still have a headache, but hoping this will help. Is this exercise something I should keep doing, or is it a one time thing?

  27. Doctor jo, I came across your video tonight and after years of pain and severe depression from it, you just saved my life. For the first time in years and just after doing 10 reps of those pulls at 15-20 seconds I have so much relief in my neck and collar bone area. You seriously saved my life. Thank you so much. I am a follower of yours for life

  28. This is amazing – for months I've been dealing with unrelenting neck/back/shoulder discomfort and extreme tightness and have just figured out (through my chiropractor) that my first rib is likely subluxated. I also feel a cracking sometimes when I take breaths or move my neck/back. It's been terrible, but this exercise feels great – like it's doing the "right thing". Fingers crossed this helps long-term!

  29. Can elevated first rib cause pain, tightness and nerve sensation problems in the traps, levator and rhomboid area or is it exclusive to hands and anterior shoulder?

  30. Had my first rib pressed on today by my PT, hurt like a full ten. Don't want that done again. Three minutes of agony. Does feel better after though.

  31. Hi, I started having issues on my right side after coming home from a flight that involved carrying heavy bags all on the right shoulder (was trying to protect a left operated shoulder). Got weird pain in the right clavicle that turned into buzzing in the brachial plexus, burning pain, elbow pain, shoulder blade pain, middle finger pain and some tingling. Had a C spine MRI which showed nothing, and tried an epidural in the C 7 spine which did not help. My chronic pain doctor suggested it may be an elevated first rib. I am going to try this, however I noticed in other videos that the person stretches the head to the opposite direction to give the scalenes a stretch, while you try to relax them by going in the same direction of the affected shoulder. Do both work? Could you also comment on whether you think it may in fact be the first rib? Thank you

  32. Can this help with trapezius pain? My dr. said my left shoulder was elevated from tight upper back and neck muscles. I also feel a tingling in my back trap, alongside my neck, behind my ear that sometimes goes to the temple/face area, all on the same side.

  33. I'm hoping this helps. I started having pains in both collar bones 5 months ago. Doctors were confused and couldn't tell what it was. The doctor at the veterans hospital mentioned the first rib and did some "counter strain" movements on them. The left side feels better but the right still hurts. I'm going to try this method in addition to his work. Hoping for the best!

  34. Good video. I'm having nerve pain in what looks like the dorsal scapular nerve – can the elevated first rib clamp down on nerves that go into the back or is it just the arms?

  35. Hey Doctor Jo,

    I recently have been in physical therapy due to shoulder neck and jaw pains. after about a month into the treatment it became to expensive. due to my terrible posture from the past three years working out and sitting, i have horrible pain in that area of my first rib. when i press on it it begins to tingle. In your professional opinion if i keep doing this stretch everyday will i get better?

    P.S my physical therapist did mention and try to work on my first rib during that time as well.

  36. You saved me a lot of money right now for getting the first rib realigned every couple of months. thanks you so much

  37. I've been having pain in my traps, rhomboids, and levator for almost 2 years and physical therapy doesn't work or dry needling. The chiropractor helps but only for a week or so. The stretches are fine but I'm a small woman and can't really pull down very hard what do you suggest.

  38. IS it possible to move that rib too far or move off line? I try this yesterday, I found relief and then I tried it again and it felt the strained area moved forward and now it's even strained and tighter than it originally was…… Please help!

  39. Hi Dr Joe,

    My right arm has been hurting cos I was punched by my brother in the collarbone area 7 years ago. I also have bad posture and am double-jointed, so my shoulder is quite unstable. Recently, my physiotherapist diagnosed me with elevated first rib and has prescribed me scapular training exercises. It is helping, but some days the pain still results in breathing difficulties. Do you have any other quick-relief methods for when acute pain comes? Thanks!

  40. We are supposed to be stretching something when we do this. What are we stretching? Also, if this elevated rib thing can be caused by carrying weight on your shoulder, how can putting the same pressure on the shoulder cure it? I'm confused!

  41. At about 1:30 in the video, you mention "if you're not feeling quite as much of a stretch". What is being stretched?

  42. This helped my collarbone popping and clicking sound that is also painfull. It happens when I do external rotation with my shoulder or when I do shruggs in some positions. It is still clicking but not that hard and pain is almost gone. What could cause this problem? If you have any videos that may help please write down the link. Thank you ūüôā

  43. So, I go to physical therapy. I had/have severe lightheadedness for over a year and when I looked over my shoulder my eye would go blind. Also, my hands and arms were going numb.  I didn't think too much about it to be honest. When something happens to me that's gradual, it doesn't bother me like it would if it was an immediate onset. Every time I go into physical therapy, they say my ribs are out of place up there and they put them back into place. I do my exercises and everything is great. But then the moment I get into the car, they are out again. My question is, is there anything else I can do to prevent them from coming out and causing all these problems. Being this lightheaded all the time is no way to live and I'm so tired of it. They get so mad at me when I come back and the ribs are not in the right place pushing on my arteries. They think I'm doing something to make this happen and am not taking my recovery seriously, which frustrates me because I'm tired of living this way. Do you think a massage might help?

  44. Hi Dr. Jo. I have a question. Do you think this would also work on the second or third rib? Im on the mend from a torn bicep tendon and I guarded it for too long. I've gotten the shoulder back and down for the most part, but I'm still working on keeping it all the way back. I feel like there are more ribs elevated that may be hindering my progress. Any recommendations?

  45. Dr. Jo, thank you for the video! I tried it and, unfortunately, it still doesn't seem to take the pain away. My chiropractor keeps saying it's my neck (C5-C7) but a year of adjustments didn't resolve the issue. The MRI shows a bulge between C6 and C7 but it's not pressing on any nerves or the spinal cord. I feel right-sided pain at the base of my neck that radiates into my shoulder blade and shoulder. I've seen other doctors too (orthopedic surgeon, physical therapist). I don't know what to do. It never goes away. Any suggestions for treating lower neck issues?

  46. Are there specific stretches to do that will prevent this mofo from elevating? My current stretch regimen isn't enough. Also what should most of us avoid, such as planks, push ups etc?

  47. I have hypermobile Ehlers-danlos syndrome. I have so many issues with my neck, trapezius muscles, and dislocations on the top first rib. Really excited to try this out. Thank you

  48. Thank you very much for this video! ‚̧ԳŹ Normally I let myself suffer with the pain hoping it will slide back into place on its own….then I drag myself to the chiropractor after a week or so and the rib is firmly held in place by some really angry and overstrained muscles. Thanks to your video and the belt I was able to mobilize the rib and and move my neck normally again!
    Thank you!

  49. I am going to try this but I think it is my 2nd rib that is not moving. Is there anything like this for the 2nd rib?

  50. Hi. I think my first rib is out of place. Every time I touch near that area by the rib I get a strong shock! Feels like electricity running through my whole body. I can't even get a massage in that area. Do you think this stretch will help? Thanks

  51. Do you think mountain biking can elevate the ribs? I had/have tos and I am still active since I've rehabbed enough to go back to the gym and such, but my left side pops up occasionally but my right seems to stay put. I picked up biking recently I sit up more at a 45 angle, so I can't imagine that straining my neck muscles that much…

  52. Thank you. I have a bulging disc at c7 and also just had tendon surgery on my arm. After playing golf my hand went numb. First rib is usually the culprit. This helped me ALOT

  53. I've dealt with not only numbness and tingling but burning sensations as well on both arms. Did a bunch of TOS exercises, got adjusted by my chiro 17 times, got a healthy x-ray of my C spine to rule out major issues.. Yet still left with some tingling, as well as puffiness and feelings of inflammation in my hands. Can you help me please, my chiro doesn't know why it's puffy – what does pain, swelling in hands usually a sign of?

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