Finding Your Neutral Posture: The Ribs
In our previous post, we discussed how posture plays a crucial role in how we could be healing or hindering any postpartum core dysfunction! Our muscles best perform in midrange position, and for our core that is a neutral spine. Ribs stacked over pelvis tends to find neutral, and this position allows for unified function of the diaphragm, abdominal cavity, and pelvic floor during breathing.
Since having ribs stacked over the pelvis tends to be the first step towards finding neutral, what if there is something going on in the ribs that is preventing this from happening?
Movement Pattern: Rib Thrusting
Rib Thrusting is a compensation pattern that affects the muscle balance of the anterior to the posterior side and compromises core stability. It is a common movement compensation that we typically see when mama is pushing weight away from her body. Examples would include: bench press or overhead press. Common reasons for rib thrusting can include: poor initial positioning, poor breathing pattern, weight is too heavy, lack of mobility of the shoulder, and lack of body awareness.
Why does this matter?
If mama is thrusting her ribs, she is bringing her spine out of that neutral position and decreases the interaction between her diaphragm and the rest of her abdominal cavity. If this interaction is decreased, then mama’s ability to establish intra-abdominal pressure to protect her spine during a loaded movement is also decreased.
During inhales, the increased pressure in the abdomen stabilizes the spine, while during exhales, muscular force stabilizes the spine. If the pressure within the abdomen cannot be establish by optimal diaphragm functioning, then it decreases the muscular force that can be generated during the exhale. Thus, overall stabilization of the spine during this lift is compromised.
Since our body is connected, movement in one place tends to cause movement in another. When our ribs thrust forward, the response is usually an increased curvature in our lumbar spine (low back) and an anterior tilt of our pelvis (forward tilt, think booty sticking out). This results in some muscles overlengthening (abdominals, glutes, hamstrings) and others shortening (hip flexors, back extensors).
Additionally, the more time mama spends in this thrusted position, the more aggravated her linea alba (the connective tissue between her six-pack abs, aka where most pregnant and postpartum women will have diastasis recti) will be, and the more the healing process in the postpartum will be hindered.
What can you do to help prevent or correct rib thrusting?
1. Bring awareness to it. Mama can’t fix what she can’t feel. Once she can feel her ribs thrusting during movement, sometimes that is all she needs to fix it. It’s okay if awareness doesn’t immediately correct it; we are never striving for perfection, we are striving to re-establish the mind-body connection that is sometimes lost during pregnancy and postpartum as we explore our new state of normal.
2. Check initial positioning. Is she already set up in a thrusted position? Are her ribs generally stacked over her pelvis? Sometimes adding a mini squat to the starting position helps to keep the ribs stacked. If she is in supine, bring the feet up on to the bench can help realign the pelvis and help with positioning during the press.
3. Refocus breathing pattern. How is she breathing during the movement? Syncing breath can really help change the entire movement. We encourage our mamas to use the approach of “exhale on exertion” when it comes to lifts. During the harder part of the movement (typically the press or push), she focuses on exhaling and lifting her pelvic floor. This encourages her to keep her ribs in their position and prevents her from bearing down on her pelvic floor.
4. Decrease the Weight. Sometimes the weight is just too heavy to achieve the lift without compensation, and that is okay. Fitness in pregnancy and the postpartum is not about PRs or competition; it is about being strong enough to adapt to postural changes during pregnancy and being strong enough to hold your baby without pain.
5. Mobility Work. There may be some restriction that is preventing the movement from being achieved. Typically, we find prenatal and postpartum mamas have really tight chest muscles and front side of their hips. Essentially, their front side is restricted and may prevent full range of motion of muscles on all sides. Think about it like this: if your chest muscle is tight, it would cause your shoulder to roll forward and would overstretch your upper back and neck muscles. If you tried to extend your upper back, the restriction on the frontside would prevent you from fully extending. In a future post, we will discuss our program’s mobility work.
Mobility Restriction: Rib Flare
Rib flare is a compensation pattern that affects the muscle balance of the right to left side of the body. Rib flare tends to be to the left side, because our internal organs are not evenly balanced, and our diaphragm is not symmetrical. Our stomach is on the left and is a bit more pliable than the liver that resides on the right side. Another theory of ours is that since the optimal position for our baby is left occiput anterior (tends to sit on the left side of the uterus), then this contributes to more restriction during pregnancy on the left side of the diaphragm.
Why does this matter?
Rib flare results in an uneven pull of abdominal muscles during movement and may contribute towards hindering the healing of any diastasis. Think about it like this: if your left rib is flared, then your abdominal muscles are being stretched towards the upper left and bottom right. What do you think that is doing to your core as it tries to heal in the postpartum?
Earlier in this post we discussed how overstretched and tight muscles are an issue, this notion applies to your core muscles but now in a diagonal pattern as opposed to a front versus back side. Overstretched muscles are weakened, while tight muscles decrease the range of motion everywhere. If half of your core is weakened from a rib flare, how do you think it would affect a postpartum mama’s ability to stabilize during movement, and more importantly heal?
What can you do to help prevent or correct rib flare?
1. Myofascial release of the ribs can be helpful in preventing rib flare by releasing the tension, and then we can support the new range of motion with proper alignment and strengthening. There is typically a movement pattern or postural habit that contributed towards the flare, and if we only release the tension but don’t correct the actual issue, then it will return.
Press your fingers under your rib cage, and feel for areas of tenderness. Similar to using a lacrosse or tennis ball for trigger point, but we are using our hands instead to massage out some tension.
2. Refocus the Breath. Once we have released the tension that will allow for us to move into more effective alignment, bringing back our focus to our breath is key. The rib flare could have been a result of restriction in the movement of the diaphragm, so by allowing the diaphragm to move through it’s entire range of motion during an inhale and exhale, we are supporting a more optimal movement pattern with breath.
3. Strengthening Exercises. Movements that focus on a diagonal pull can help strengthen that diagonal pattern across our torso. Diagonal pull aparts or opposite pulls are great movements to help with this!
For diagonal pull aparts, hold a resistance band in each hand, both hands in front of you. As you begin to pull the band apart, focus on a very slight crunch towards the bottom hand. Focus on keeping the ribs generally stacked over the pelvis and exhale as you pull.
For opposite pulls, you can either use a cable machine or resistance bands tied to two sturdy structures, such as a door frame or squat rack. With one hand in front of you, and another behind you, pull both hands towards your torso while keeping the chest and hips square. With control, slowly release the hands back to their starting positions, again focusing on keeping your chest and hips square. If this movement is too easy, introduce an unstable surface such as a foam pad or bosu ball!
Rib thrusting is a movement pattern that contributes towards a muscle imbalance of the anterior and posterior sides, while rib flaring is a movement pattern that contributes towards a muscle imbalance laterally. By aligning our rib cage over our pelvis, we are allowing for optimal function of our diaphragm!
As a reminder, these blog posts are not medical advice and are strictly for education purposes. If you have any medical concerns, please consult your medical provider and/or local pelvic floor physical therapist!
Mamaste, the mama in me honors the mama in you.