“I am recovering from 3 broken ribs and feel like my shoulder and neck are out of joint or misaligned slightly and always need to be cracked. Also stretching those high muscles produces a deep joint crack in my lower spine as if the muscle reaches from way down there to up into my shoulder. How can I fix this? Is this still due to muscle compensation? My rib breaks were about 8 weeks ago.”

Tracineal110 asked the questions above. First off thank you for asking, and I am sorry you are going through this. You bring up some good questions that might help some other people out there in regards to not only broken ribs, but all therapy and rehab.

The first item that needs to be addressed is the feeling that your neck and shoulder are out of joint or misaligned and always need to be cracked. I hear this comment/question all the time and I have to assure you that your neck and shoulder are likely not dislocated or subluxed, otherwise known as out of the joint. Is it possible? Yes, but you would have likely already sought out more medical attention after 8 weeks. If they were truly subluxed or dislocated there would likely be neurological symptoms that you could not ignore. Misaligned is a very broad term which implies there is a standard alignment that all humans must maintain or pain will exist. If this standard exists, no one can agree on what that threshold is that would definitively cause pain. I understand this is how it feels, and I have felt this way as well, after sleeping on a friends couch; however when muscles guard/ or tighten to protect an area, this tension might send signals to our nervous systems that we are not familiar with and we might feel “stuck”, “misaligned”, “crooked”.

Although ribs can fracture throughout your thorax, the change in breathing patterns, and movement patterns due to muscle guarding and spasm can easily set off a chain of events leading to neck and shoulder pain. This chain reaction is why I included the injury in my underestimated injuries series. There are such close ties between the neck, shoulder and thoracic area, that if one is hurting, all three must be evaluated closely, as dysfunction will likely be discovered after broken ribs. The altered breathing patterns can also affect the lumbar spine stabilizing system resulting in low back pain. These alterations possess the ability to cause overused global musculature like the paraspinals, and possibly pain.

I honestly can say I have no clue why if someone is stretching their neck their low back would crack, but there are many stretches out there and many ways people go about doing them. Are there muscle/fascia/neural connections between them? Yup, but I have never encountered the finding that when stretching your neck, your low back cracks. Maybe some of my other practitioners out there have and might have a better explanation (help please!).

Is this due to muscle compensation? Depends on what “this” is. But if I assume you mean “this” is the tightening of your muscles, then it is more likely due to protective mechanisms our body has rather than compensation, due to certain muscles “not working”. First thing that needs to occur before any muscle can stop it’s protective mechanism is to reduce the pain or the threat of pain that the body is perceiving. Without this, the protection will likely continue. After pain reduction (regardless of how long after the injury this occurs), increased movement and progressively challenging tasks should be used to reinforce ease of movement and to prove to the system that there is nothing to fear with exercise, daily tasks, movements, etc.

“How do I fix this” cannot appropriately ever be answered via the Internet without a proper evaluation and assessment from a professional. Period. It infuriates me when I look at articles that say things like “do these three things and fix your back”. Humans are not cars and were cannot simply be fixed. We need to take peoples’ emotional states, biological states, movement histories, preexisting conditoins, etc into account. An article that makes broad statements has the same ability to hinder someones healing as it does to help them. The right information for the wrong condition isn’t valuable. Evaluations and assessments exist for a reason, and that is so people can properly be guided into the right path of treatment or even to the right professional. There are questions that would need to be answered if you are to visit your local rehab professional, like how did you fracture your ribs? Have you had a history of neck or shoulder pain in the past?  What bothers them/it now? Which ribs were broken? Etc..

I hope that these answers have shed some light into why broken ribs suck so much, and some other topics about rehabilitation in general. Get to your local PT, chiro, or Osteopathic Doctor if you are suffering from broken ribs.

Always evolve