Is Rib Flare Dangerous? Here’s Why You Should Care

Rib flare, also known as rib flaring deformity, is a chest deformity condition that occurs when the lower ribs protrude from the rest of the chest. This generally occurs when the cartilage that connects these ribs to the breastbone pulls the ribs further upward and outward from the chest than usual. 

An easy way to check if you have rib flare is to examine whether your lower ribs protrude from the rest of the chest when you lie down on your back. A significant amount of space between the floor and your lower back arch may be another sign of flared ribs. Any flaring will become more prominent when standing upright and raising your arms over your head. Some people with a flared rib cage may also show flattening or slight depression of the other ribs in the upper region of the chest. Finally, people suffering from rib flare will often have more flaring on their left side compared to the right side. However, some people will show an equal level of flaring on both sides. 

But what causes this condition? And is it dangerous? To find out more, read on! 

Causes of Rib Flare (Why Does My Ribcage Stick Out?)

As previously mentioned, rib flare usually occurs due to the connecting cartilage pulling the lower ribs upward and outward from the chest. This may be caused by a structural chest deformity or muscular imbalance and associated conditions.

Structural chest deformities causing rib flare are congenital (present from birth) and often have a genetic link. Most commonly, congenital rib flare is associated with chest conditions such as pectus excavatum or pectus carinatum.[1] These conditions result in improper growth of the breastbone cartilage, which can either pull the ribs further into the chest (pectus excavatum) or push the ribs out from the center of the chest (pectus carinatum). Rare cases of congenital rib flare may occur in some people. Congenital cases of rib flare worsen during puberty, as the breastbone is growing rapidly during this time. 

The second category of rib flare is non-congenital causes, which occur later in life. These most often occur due to muscle weakness resulting from injury or an imbalance in the chest/abdominal muscles. An example of muscle injury may occur in postpartum women, where the baby can push against the lower ribcage as it grows and weaken the abdominal muscles. On the other hand, muscular imbalance may arise from poor breathing habits, where the diaphragm is not fully utilized in breathing, and the person over-compensates by using their lower chest muscles in breathing. Poor posture - including a sideways curved spine (scoliosis) or excessively curved spine (hyperlordosis for front-to-back curvature) can cause rib flaring. 

Rib Flare vs. Pectus Excavatum

As previously mentioned, rib flare is a general condition where the lower ribs protrude from the rest of the chest. It may occur in conjunction with other congenital chest deformities, or it may result from muscle weakness/injury. Depending on the severity, it can be typically treated with either orthotic bracing or physiotherapy exercises. 

On the other hand, pectus excavatum is a genetic, congenital condition in which the upper chest has a sunken ("funnel") appearance due to the breastbone growing further inward [2]. Although it may occur in conjunction with rib flare in some cases, it is a much more serious condition. The main treatment for pectus excavatum is surgery [3]. 

Anatomy of Flared Ribs

So what exactly happens with flared ribs? One of the principal problems associated with rib flare is the loss of the zone of apposition (ZOA). When you have good rib posture, part of the diaphragm runs vertically along the inside of the chest, reaching from the lowest ribs down to the top of the diaphragm in the abdomen. This is known as the ZOA and is highly important as it controls the tension of the diaphragm. 

When the ribs are flared, the topmost part of the diaphragm is pulled higher into the chest, causing loss of the ZOA. This means that the diaphragm cannot work as effectively, making it challenging to maintain proper breathing. Another issue caused by loss of the ZOA is activation of the sympathetic nervous system, which results in a "fight or flight" response and increases chronic stress levels. 

Rib Flare and Breathing

Unsurprisingly, one common problem associated with rib flare is poor breathing habits. Having flared ribs (i.e., loss of the ZOA) means that the diaphragm and other abdominal muscles must work harder to breathe. Consequently, many people compensate by using their lower chest muscles to help them breathe. However, this results in a shallow, inefficient breathing process that does not fully recycle all of the air in the chest cavity, in contrast to deeper breathing which uses the diaphragm and abdominal muscles. 

Is Rib Flare Dangerous?

The good news is that rib flare is not intrinsically dangerous. Aside from inefficient breathing, it is primarily considered an aesthetic condition; however, some problems with rib flare can exacerbate existing ailments or potentially increase the risk of back or shoulder problems. This is because rib flare tilts the pelvis backwards (known as "anterior pelvis tilt") and pulls the shoulders forward. This causes muscle tightness and back soreness, which can lead to future injury. 

Hence it is important not just to ignore this condition, as it will not go away by itself. By talking to your healthcare professional and understanding the cause of your rib flare, it is now easier to treat effectively. 

Fixing Rib Flare Is Possible With Dakota Brace Solutions

There are two main approaches to solving rib flare: physiotherapy exercises and orthotic bracing. Both have their place in solving this condition; however, physiotherapy exercises are generally more suited to mild cases of rib flare. 

At Dakota Brace, we provide custom-made chest braces to suit rib flare alone or in combination with pectus carinatum. These work by applying front-to-back pressure to the lower chest, pushing the flared ribs back to their optimal position. A brace must be worn regularly to be effective and may take several months for optimal results. However, in the long term, it helps restore the optimal breastbone shape and retrain the diaphragm/abdominal muscles to hold the ribs in the correct location, thus helping solve your rib flare. 

Conclusion

Contrary to what many people may think, rib flare is a surprisingly common condition. Although it is not dangerous, treatment is recommended to reduce the risk of future injury or muscle strain. Fortunately, flared ribs can be successfully treated by using an orthotic brace by Dakota Brace.

Are you ready to restore your health and confidence? Get a free consultation with Dakota Brace today and $75 off your first order, and get evaluated for either our Custom Rib Flare Brace (The Rider Brace) or our Custom Pectus & Two Rib Flare Brace (The Bison Brace).

References:

1. Haleem, A., Hanif, M. S., Majeed, F. A., Wyne, A., & Rahim, K. (2015). Frequency of anomalies associated with chest deformity in physically fit male candidates reporting for military recruitment. PAFMJ, 65(2), 170-174.
2. Croitoru, D., & Nuss, D. (2004). Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med, 15, 455-471.
3. Jaroszewski, D., Notrica, D., McMahon, L., Steidley, D. E., & Deschamps, C. (2010). Current management of pectus excavatum: a review and update of therapy and treatment recommendations. The Journal of the American Board of Family Medicine, 23(2), 230-239.