Have you been experiencing sharpness, or the feeling that something has dropped or kicked you in the ribs, or shortness of breath during pregnancy?
Although pregnancy is an incredible journey filled with anticipation and excitement. It can, however, bring on a range of discomforts, one of the most common being rib pain. It is particularly common as you enter the later stages of pregnancy (third trimester) as the baby grows. I am going to delve into the causes of rib pain during pregnancy and offer practical strategies for relief. Understanding the mechanisms behind rib pain pregnancy can empower you to manage it more effectively.
So, What are the Causes of Rib Pain During Pregnancy?
1. Diaphragm Pressure
The diaphragm plays a crucial role in breathing. When you breathe in, it moves downward and outward; when you breathe out, it gently contracts and moves back up. Your ribs also play a part in breathing, expanding, and contracting as you breathe. Typically, the range of diaphragm motion downwards during inhalation is reported to be approximately 1.5 cm during shallow breaths and can move down 6 to 10 cm during deep breaths.
During pregnancy, especially in the third trimester, your uterus grows and exerts pressure on the diaphragm. That pressure can lead to the diaphragm shifting upwards by as much as 5 cm. This change can cause tightness in the diaphragm and rib joints, restricting the movement of the rib cage and resulting in discomfort and pain. This is also why some women can feel shortness of breath.
2. Baby Position
The position of your baby can significantly contribute to rib pain. As mentioned earlier, the baby grows, and the uterus expands. It can push against your ribs and diaphragm. This pressure can be particularly pronounced when babies stretch their arms and legs, often extending under the ribs and causing discomfort. It can feel like the baby is having a boxing match with your rib cage.
According to great resources like Spinning Babies, the ideal position for your baby is for their head to be facing down and their back to rest on your left side with their feet and arms on the right. While it may not always be comfortable, those kicks you feel in your ribs can indicate that your baby is in a favourable position for natural birth. Understanding this can help ease some concerns related to rib pain in pregnancy.
3. Posture Changes
Pregnancy naturally shifts your centre of gravity forward, leading to changes in your posture as you stand. As the lower back shifts forward, the upper back compensates by hunching over. This adjustment can strain the muscles around the ribs, mainly the intercostal muscles, which are situated between the ribs and have nerves running along them.
Proper sitting posture, which generally consists of sitting sitz bones, which are the ischial tuberosity, is a pair of rounded bones that extend from the bottom of the pelvis. Poor sitting posture is when you are sitting on your sacrum instead, meaning you are sitting leaning back on the higher part of your bum. Poor sitting posture can exacerbate rib pain as you lean back through the lower back. The shoulders and rib cage will unconsciously adopt a “crunch” position to try and support the shift, increasing discomfort.
While the relationship between posture and pain is still being studied, many women report reduced discomfort when maintaining good posture.
4. Hormonal Changes
The hormone relaxin is released during pregnancy to help prepare the body for childbirth by relaxing ligaments and muscles, particularly in the pelvis. However, relaxin affects the entire body, including the ligaments and muscles around the ribs. Maintaining rib alignment becomes crucial as your body adapts to these hormonal changes. Discomfort in the rib area often stems from the altered flexibility and stability in this region, allowing the ribs to be misaligned and restricted more easily. This widespread relaxation can lead to rib pain, especially when sitting or standing for extended periods.
5. Muscle and Ligament Strain
As the baby develops, the stomach muscles – rectus abdominis and transverse abdominis stretch as the abdomen grows. These two muscles attach between the Xiphoid process, Costal cartilages of ribs 5-7, located at the bottom of the ribs, and the Pubic Symphysis (pubic bone) at the front of the pelvis. So, as the abdomens grow, this stretching can place additional strain and pull on the lower ribs, diaphragm, and pubic symphysis, potentially resulting in decreased mobility of the ribs and pelvis.
Awareness of these muscle adjustments can help you understand the physical shifts occurring in your body. Many women notice a connection between their posture and the level of discomfort experienced, making posture awareness essential.
6. Stress and Breathing Patterns
Stress can significantly influence rib pain in pregnancy. When under stress, we can tend to adopt shallow breathing patterns, which primarily engage the chest and limit diaphragm movement. This can exacerbate feelings of tightness and discomfort in the rib area.
The connection between stress and rib pain is particularly noteworthy. Shallow breathing not only reduces the diaphragm’s natural movement but also diminishes the soothing effects of deep, restorative breaths. Incorporating stress-reducing techniques can help alleviate rib pain and improve overall well-being during pregnancy.
Relieving Rib Pain During Pregnancy
Finding relief from rib pain during pregnancy is essential for enjoying this transformative experience. Here are several effective strategies for managing discomfort.
1. Seek Professional Help
One of the most effective steps in managing rib pain during pregnancy is consulting with a healthcare professional, such as a chiropractor that specialises in prenatal care. They can provide targeted treatments and personalised advice.
2. Practice Proper Diaphragmatic Breathing
Proper diaphragmatic breathing is vital to reducing rib pain. This technique involves inhaling deeply, allowing your diaphragm to descend and move outward, which can help push the lower ribs outward and downward. This process not only encourages rib movement but also stabilizes your core. There is a link between the diaphragm and the pelvic floor muscles based on pressure. When the diaphragm descends, the pelvic floor descends. When the diaphragm is elevated, the pelvic floor is elevated.
Therefore, it’s crucial to ensure you’re not bearing down on your pelvic floor while practicing this technique. If you feel pressure in your pelvic area, consult a qualified professional for guidance on optimizing your breathing patterns.
3. Manual Therapy and Trigger Point Release
As mentioned earlier, Muscles and ligaments can become tight or lose mobility further into pregnancy. Manual therapy (chiropractic adjustments) or low-force adjustments, massage, and trigger point release can significantly improve rib joint movement and alleviate discomfort. These therapies can help address muscle tightness, improve rib joint restriction, and improve overall nervous system health by increasing brain and body communication and function.
4. Movement and Posture Modification
Maintaining good posture throughout the day is essential. Aim for a neutral spine with a slight natural curve in your lower back. This alignment helps keep the diaphragm moving optimally while stabilizing your lower back and core.
Engaging in gentle, supportive movements is also vital. Activities such as the Spinning Babies’ daily exercises, bird dogs, and thoracic rotations can promote mobility and relieve rib pain. Regular movement encourages flexibility and helps combat prolonged sitting or standing discomfort.
5. Incorporate Mindfulness Practices
Mindfulness techniques such as meditation or yoga can help activate the nervous system’s “rest and digest” response. This calming effect can enhance deep breathing, which, in turn, promotes rib expansion and relaxation.
Engaging in mindfulness can also help you process any stressors affecting your well-being. Finding a practice that resonates with you—quiet reflection, guided meditation, or gentle movement—can be incredibly beneficial.
6. Stay Active with Targeted Exercises
Incorporating targeted exercises into your routine can also help manage rib pain. Here are a few recommendations:
- Pectoral Mobility Stretch: Stretching your chest can help relieve tension in the upper body. To perform a doorway pec stretch, raise your arms so that your forearms and elbows rest against the door frame, creating approximately 90-degree angles at your elbows and shoulders. If you’re stretching both sides, step through the doorway. For a single-side stretch, simply turn your body away from the elbow you’re stretching
- Child’s Pose: This restorative yoga position can gently stretch the back and relieve rib discomfort. To perform the Child’s Pose stretch, start by kneeling in front of a stability ball. Place your hands on the ball, keeping them shoulder-width apart. Gently sit back onto your heels (or as far as is comfortable for you) while simultaneously pushing the ball away from your body.
- Triplanar Psoas Release: This exercise targets the psoas muscle, which often tightens during pregnancy, alleviating tension in the rib area.
- Side Planks: Strengthening your obliques can support your core and ribcage.
Rib pain during pregnancy, particularly in the third trimester, is a common issue many expectant mothers face. Understanding the causes—from diaphragm pressure and baby position to posture changes and hormonal shifts—can help you navigate this discomfort effectively.
Incorporating practical strategies for relief, such as seeking professional assistance, practicing proper breathing, maintaining good posture, and engaging in mindfulness, can significantly enhance your comfort. Remember that while rib pain can be a challenge, it doesn’t have to overshadow your pregnancy experience. Embrace the journey, prioritise your well-being, and look forward to the beautiful moments ahead with your little one.
