Saturday, February 19, 2011

What a Slip Up

Last night, my friend Scott Breeden posted something on my Facebook wall.  He posted a link and said "Don't know why I didn't mention this to you earlier..."  The link was for information on a condition known as floating/slipping rib syndrome.  I'd never heard of it.  It almost sounded fake.  I read the link he sent me, and continued to Google it.  Susan Kuijken, a former FSU cross country and track standout, had this condition.  It greatly affected her running.  Her complaint was a frequent, severe right-sided "stitch."  Stabbing pain that came on no matter how slowly she went.  After several cortisone injections in the area, which did help, she ultimately had the slipping rib removed.  She runs pain free now. 

Slipping rib syndrome is quite uncommon and occurs in the 10th-12th ribs.  These are the ribs that are either "false" or "floating" in that they are not connected directly to the sternum.  Rather, the false ribs are connected via loose connective tissue, and the floating ones aren't connected to anything.  These ribs don't do well under extreme stress, and can become dislocated.  The 10th rib is usually the culprit.  Once dislocated from its connective tissue, the rib "slips" up and over the rib above it.  In doing so, it can also catch the diaphragm and the costal nerve.  The main symptoms are chest/upper abdominal pain and radiating lower back pain.  It's on the right side 70% of the time.  If severe, it can cause referred left shoulder pain.  The pain is dull/aching at rest and severe during exercise, especially high-impact sports.

Sound familiar?  It did to me.  But I haven't had any trauma.  Except--pregnancy is a cause.  Further, a rapid delivery is another cause.  Rowan was born in 3 hours.  As you can imagine, carrying a baby certainly puts a ton of stress on your ribs.  And I'm guessing that if you run through your pregnancy, there's even more.  I did both.

I'm not saying I have this.  I'm just saying this is the first thing I can read about and say "Oh, yeah, that's like what I have!"  I'm kind of baffled that no one has mentioned it to me.  It definitely needs to be investigated.  And guess what?  It's hard to diagnose.  Figures.  It won't show up on standard x-ray/CT scan.  It generally has to be diagnosed by a practitioner who is familiar with the rib cage and what position the ribs are supposed to be in.  Chiropractors and thoracic surgeons usually make the diagnosis.  Conservative treatment involves rest and nerve blocks.  The only cure is surgery.  If I have this--they can go ahead and sign me up for the surgery.  I'll be looking into finding a chiropractor to see in the next week.

I ran 12 today.  I was in a lot of pain during, as well as after.  But I survived.  17 tomorrow.


  1. Interesting indeed. Go easy on yourself during that 17 tomorrow.

  2. I actually had two slipping ribs and had the tips removed about 6 months ago. I'm not really running but am swimming and walking and breathing MUCH better. It can be diagnosed using a 'hooking maneuver' which can reproduce the slipping event. A thoracic surgeon is really the best option for diagnosis and treatment if it is not healing on its own. (Unfortunately the chiropractor made things much worse so watch out!)
    Good luck - i know it is a frustrating experience!