Technique 1: Treating rib pain Francine demonstrates a thoracic spine technique to treat rib pain which gaps the costovertebral and costotransverse joints. This is an effective technique if pain is reproduced with either inspiration or rotation and side flexion.
Technique 2: Using the spinous process to treat mid thoracic or rib pain. This technique is excellent for relieving mid thoracic or rib pain that is reproduced with extension and rotation. The thumb is anchored on the spinous process to block this level; the patient is in flexion and rotation and a hold/relax technique is used to gap the c/v and c/t joint.
Technique 3: Treating thoracic or rib pain that is reproduced by extension. This technique gets the patient to go into a fully flexed position. The therapist can use the spinous process again to stabilise the painful level. You must use inspiration to gap the c/v and c/t joint prior to using hold/relax techniques to treat the stiff segment. Always test and retest which movement reproduces the rib or mid back pain to evaluate the effectiveness of your technique. It is usually much more effective to treat these joints in these flexed positions than applying a P/A force on the spinous process which has the potential to lock the c/v and c/t joint and only aggravate a patients thoracic symptoms.