Massage & Bodywork

MARCH | APRIL 2022

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The Rib Rings Seeing the Forest and the Trees Each pair of ribs, together with the two vertebrae they articulate with and the sternum, can be thought of as forming a single ring-shaped unit. Typically, there is more mobility between adjacent rib rings than between the individual bones they're made up of. Rib-ring mobility restrictions or sensitivity can adversely affect spine, trunk, neck, and limb mobility. Image courtesy anatomy.app. 1 TECHNIQUE By Til Luchau THE SOMATIC EDGE KEY POINTS • Thinking about ribs as parts of larger rings that include the spine and sternum can clarify the complexity of the rib cage's many details. • Assessing rib-ring mobility or sensitivity in each movement plane can help us determine where to target our work with both local and big-picture client complaints. Attention to detail can make all the difference. On the other hand, stepping back and looking at a bigger picture can help us see important things we might have otherwise missed. The rib cage is a place where both principles apply. With more than 100 joints, hundreds of named soft-tissue structures, numerous vital functions (including organ protection, posture, and breathing), and key roles in movement of the spine, upper limb, and walking, working with the rib cage means we need to understand its fi ne details, and at the same time, how they relate to its big- picture functioning. One example of the rib cage's abundance of details: Where the ribs meet the spine, each costovertebral joint has a very small amount of movement. But considering that each of the 24 ribs can have as many as four spinal articulations (typically, with two adjacent vertebrae, the intervertebral disc between them, and a transverse process superiorly), we can see how the cumulative movement range for all these tiny joints together becomes the whole- spine rotation involved in walking, or the side-bending fl exibility needed to reach or step, or the balance of thoracic fl exion and extension mobility essential for comfortable sitting. Techniques such as the Costovertebral Joint Technique (see "Working with Rib Restrictions," Massage & Bodywork January/February 2012, page 112) can help us assess and address the individual costovertebral joints in a thorough and detailed way. But with so many anatomical and functional details, when working with the rib cage it's easy to lose the forest for the trees. As an alternative to narrowing in on the rib cage's details, we're often even more effective when we broaden our focus to include its larger functional groupings as well. One functional group I'm currently thinking about in my own work is the thoracic "rings." 1 Each left and right pair of ribs, the two vertebrae they articulate with, and the sternum can be thought of as forming a single ring-shaped unit (Image 1). Though each ring typically has 13 bony joints within it, rib rings move as a whole in relationship to their neighboring rings, oftentimes more than the bones they're made up of move in relation to each other*. 2 Twisting, fl exing, and side-bending the torso all involve moving these ring-units against one another. In breathing, the rings move like the pleats in a squeeze-box, or the hoops of an unfolding or collapsing Chinese paper lantern. In static sitting or standing, they can be thought of as functioning like a stack of 24 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 2

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