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Principles of Manual Medicine

Treatment - Rib Raising

The rib raising technique is a direct action, soft tissue technique which has multiple functions. It helps to decrease soft tissue and muscle tone of the thoracic spine. It also helps to restore normal rib cage motion which facilitates venous return and lymphatic drainage.

  • The patient should be lying in a supine position on the table and I will position myself so that I am seated at the patient's side.
  • The hands are positioned so that the finger pads are placed at the position of the rib angles. Having the fingers at the rib angles is important because the rib heads approximate the thoracic chain ganglia. By effecting the thoracic chain ganglia, we can help restore homeostasis of the sympathetic nervous system.
  • With the fingers placed at the rib angles, the operator's wrists are placed onto the table such that pressure can be applied through the shoulders and the elbows into the wrists. This helps to traction the fingers upward.
  • In addition, the fingers are tractioned a small amount in the lateral position.
  • This position is held while we wait for the soft tissues to release. This may take as little as 15 seconds, or as much as 1 or 2 minutes.
  • Once soft tissue release is appreciated, the hands are repositioned to subsequent ribs.
  • Typically, one should be able to treat approximately 5 ribs to 6 ribs at a time.

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