When Rib Pain Isn't a Rib Problem: A Pregnancy Case Study

What’s the connection between ribcage and diaphragm tension when it doesn’t originate in the ribcage?In this episode, Lynn Schulte, PT walks through a recent pregnancy case where she saw just how interconnected the growing uterus, uterine ligaments, diaphragm, and ribcage can be – even before the baby is large enough to physically push upward into the ribs.A pregnant client of approximately 17 weeks presented with a painful, “vice-like” sensation around the left anterior ribcage. As Lynn assessed her body, she discovered something unexpected: the uterus was growing significantly toward the right side.Key Discoveries from this Episode:How looking for connections rather than isolated restrictions can help you find the cause of pain and dysfunctionWhy the position and direction of uterine growth may be an important clinical clueWhat to watch for when comparing ribcage mobility side-to-sideWhy pregnancy can reveal or amplify pre-existing movement and tissue restrictionsThe importance of re-assessment after every meaningful interventionClinical TakeawaySometimes the ribcage restriction you feel may be responding to what is happening much farther down in the pelvis. An expanding uterus may be contributing.When you find a rib cage or diaphragm restriction in a pregnant client, don't automatically treat it as a rib cage problem. Check what is happening below it.If the uterus is growing or being pulled toward one side, assess the tissues that may be influencing that position – including the uterine ligaments and surrounding abdominal/fascial tissues.Then reassess the rib cage after addressing the pelvic restriction.Frequently Asked QuestionsCan the uterus affect the rib cage before the baby is large enough to reach it?Potentially, yes. The uterus begins expanding well before the third trimester, and its changing position can alter tension through its supporting tissues and surrounding abdominal structures. This case suggests that uterine position and tissue tension may influence rib cage and diaphragm mechanics earlier than we typically expect.Why would the uterus grow more toward one side?There can be many reasons for uterine asymmetry, including the position of the uterus, surrounding soft-tissue tension, ligamentous restrictions, abdominal/fascial relationships, and fetal positioning. A uterus favoring one side isn't automatically pathological. The clinical significance comes from the overall pattern – pain, restriction, asymmetry, tissue tension, and how the body responds when those restrictions are addressed.Why assess the rib cage when a pregnant client presents with pelvic or uterine restrictions?Because the pregnant body is an interconnected system. Changes in the position and mobility of the expanding uterus can influence tension through the abdomen and trunk, while diaphragm and rib cage mechanics can also influence how the client moves and breathes. Assessing both regions can help you identify which restriction may be driving the other – or whether they're responding to a shared underlying asymmetry.How can I learn to work with the uterus and the pregnant body?If you want to expand your clinical toolbox for treating the uterine ligaments, abdominal tissues, ribcage, and diaphragm, check out the Holistic Treatment of the Pregnant Body live training or online course.Connect With LynnHave a comment or question about today’s episode? Message Lynn on Instagram or Facebook, or Email Lynn.Subscribe to the Birth Healing Summit PodcastDon’t miss an episode! If you enjoyed today’s podcast and are interested in more topics to support your clinical practice and treatment sessions, find us on your favorite podcast app. Follow or Subscribe to the Birth Healing Summit Podcast on:SpotifyYouTubeApple PodcastsBuzzsproutAmazon PodcastsTo learn more visit: InstituteforBirthHealing.comVisit Institute for Birth Healing to learn more about how to care for the pregnant and postpartum body: CLICK HERE