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Hello Laurie!

I have attended 2 courses with you in Vienna, Austria some years ago and i am using so many of the techniques you showed us, also on horses
A great technique you taught us was treating the first rib, even finding pain and the origin of lameness there has improved my diagnostic tools a lot.
Since i see pain in the 1. rib often, i wonder if you have a theory, on what is causing pain and „subluxation“ there?
I tend to see it more often in bigger dogs, in IPO (protection) dogs, and labradors. Do you have an explanation why these dogs have, sometimes even recurring, problems in this area? And do you have had success with specific training/stretching etc of that area to prevent reinjury?

Thank you very much,
L

Hi L,

Great questions!

I ‘THINK’ that the problems at rib one are related to how the dogs use their bodies. Dogs that pounce on things or make hard stops, or dogs that jump down lots are common to have 1st rib issues. I see it more in sporting dogs than pet dogs. In pet dogs I see it more in small ones that jump off the bed or couch.

So the real question is a bit about ‘what is actually going on’. Is it actually a subluxation? (Human research is telling us that joints don’t so much ‘sublux’, but rather that there is a change in pressure within the joint and subsequently the tone in the adjacent soft tissues / muscles.) So the question might actually be about the Scalenes muscle, and what action / activities cause the dog to excessively use the Scalenes or stretch it, etc… and subsequently pull on the costvertebral / costotransverse joints, causing ‘pressure’ in the joints.

So… stretch scalenes. Routinely. Maybe add massage to scalenes. Maybe check for fascial dysfunctions along the entire cervico-thoracic-shoulder region.

I hope this helps!

Cheers,

Laurie

To add to Laurie's comments, I would also check pectorals.

Also (and I know I've stood on this soapbox before), I have a 3 stikes rule for 1st rib issues. If it comes back a 3rd time then I recommend imaging (combo rads/ultrasound or alternatively MRI) the shoulder, irregard of whether or not I find shoulder pain on exam. I've only had to do it a 1/2 dozen times or so, but every single case that progressed to imaging showed a shocking amount of glenohumeral inflammation and/or soft tissue damage despite the normal physical exam.

This, I assume, goes back to Laurie's comment about how the dogs use their bodies. Perhaps they repetitively engage in activity that is hard on the shoulder region, or perhaps in some cases there is underlying shoulder pain causing abnormal compensatory overuse of other muscles (eg scalenes or pectorals).

Another also is that in the same spirit that we recognize "Shelbow", I think we should talk about Shneck"... The shoulder and neck base are so interconnected that if is experiencing difficulty, there is a good chance that the other will eventually get drawn into the drama.

David Lane DVM
ACVSMR