The rib cage consists of 12 pairs of ribs that attach from the breastbone (the sternum) in the front and travel around to the back where they attach to the middle back, known as the thoracic spine. The lowest two pairs of ribs are called floating ribs as they don’t attach at the front with the breast bone. During pregnancy, the growing uterus, baby and structures around it push the abdominal organs different directions to accommodate for these changes. To provide this accommodation, the rib cage changes shape by flaring up, providing more space, this is done with the help of the hormone relaxin which provides flexibility and laxity during pregnancy.
Rib pain often starts around the first half of the second trimester of pregnancy as the uterus moves out of the pelvic area. The pain is usually brought about by tightness and dysfunction within the joints or muscles of the rib cage, which is commonly caused by this change in shape.
Unfortunately, for many pregnant women this is more than simple discomfort. It can result in strong pain causing a lot of limitations during activities of daily living, including poor quality of sleep and inability to find a comfortable position. To prevent and improve this pain it is important to keep moving, do the appropriate exercises and give extra attention to your posture.
Rib Pain And Thoracic (mid-back) Pain
Due to its anatomical attachment, rib pain is often combined with thoracic pain, that is, pain in the mid level area of the spine. It is already very common for anyone to have a stiff thoracic spine, however the likelihood is that this increases during pregnancy. Additionally, the enlargement of breast tissue during pregnancy can continue to alter posture and increase strain on the neck, shoulders, and thoracic spine. It is important to include thoracic exercises with the exercise program.
Exercises should include mobility exercises and stretches of different structures, in different angles that these joints move. Since many of the muscles that attach to the thoracic spine also attach to the neck, it is also common that neck pain is also experienced together with thoracic and rib pain. This is why our workout includes mobility exercises and stretches for all these 3 areas.
Rib Pain and Breathing
The ribs play an important role during breathing as they expand when we inhale and relax down when we exhale. Additionally, the diaphragm flattens from its dome shape when we inhale, to create more space for air to come in the lungs, and contracts back up to its dome shape when we exhale to help the “used” air leave the lungs.
Some women also experience diaphragmatic pain and shortness of breath during their pregnancy this is often due to the pressure caused by the growing baby and surrounding structures. Usually this feels like a “stitch” or cramp kind of pain around the upper part of the belly. To help control this kind of breathing it is very important to practice diaphragmatic breathing, during pregnancy this is also called “hug your baby technique.” This is a short clip demonstrating diaphragmatic breathing: https://youtu.be/_87nGViUex8
Throughout this short workout I constantly include deep breathing and lengthening exercises. I personally found these very helpful and relieved most of my pain during pregnancy. It can either be done as a whole workout or you can simply choose a few of your most preferred exercises and carry them out more than once throughout the day.
*If you are not sure always check with your midwife or healthcare provider before beginning a new exercise regime*