Most people mistakenly assume that the rib cage is a large, stiff, bony structure that has very little to do with movement and mobility. And while these characteristics allow the rib cage to protect your heart and lungs, you’d be surprised to learn that it can develop problems of its own. Rib flare refers to an abnormal rib cage positioning that has a domino effect on movement, mobility, and posture. 

Although some rib cage problems occur from trauma — like a car accident or fall — rib flare usually develops over time. Understanding what rib flare is and how you can address it can go a long way toward improved breathing patterns, core strength, and standing posture. Rib flare can even play a role in neck, hip, and back pain!

So let’s break this down a bit and see if we can make sense of it.

What is rib flare?

Have you ever noticed your rib cage poking out during an overhead exercise? It may have occurred when you increased weight or learned a new exercise. Perhaps, you felt your ribs lifting from the exercise mat during a core workout.  

This is known as rib flare, and it’s usually a sign of core weakness, instability, or both. 

Compensating for either one by flaring the ribs may make the exercise feel easier, but it’s actually setting you up for injury.

Rib flare can also occur during and after pregnancy — especially in those with small torsos — to accommodate for the growing baby. As the baby grows, the ribs tip up and out (or open, depending on how you look at it). If you have a short torso, there’s a greater risk that the baby will push outwardly against the rib cage, causing it to expand in various directions. 

Aside from compromised form during exercise and pregnancy, there are a couple of other causes of rib flare. You may be genetically predisposed, have an abnormal breathing pattern, or maybe really stressed out. 

How to tell if you have rib flare

The confusing part about figuring out whether or not you have rib flare is that it actually refers to two potential problems. Rib flare can mean abnormal rib positioning or changes to the rib angle (also known as the ISA/infrasternal angle). 

Fortunately, rib flare is easy to identify.

If you’re dealing with abnormal rib positioning, then you may be able to see your ribs sticking out, especially when you reach your arms overhead. You’ll be able to see it clearly when you’re lying down, too. From the side, you’ll notice a significant space between the floor and your lower back. 

To determine if you have rib flare due to changes in your rib angle, place your thumbs along your ribs at the base of your breastbone (sternum). Your thumbs should form a 90 degree angle. If not, then you may have an abnormal rib angle that affects rib positioning. 

Other problems associated with rib flare

Although some are lucky enough to have their ribs return to normal after pregnancy, others are left with lingering issues. Others are unaware that the problem even exists, since rib flare does not always cause pain or discomfort, especially in that area.

But, regardless of the cause of your rib flare, here’s why you should fix it.

Aside from noticeable differences in the mirror, rib flare can cause inflammation and, in time, pain. But there are much more pertinent consequences at hand.

The biggest one is a change in breathing efficiency. When you have flared ribs, your abdominal muscles struggle to activate, and there’s minimal motivation for your diaphragm (the “breathing muscle”) to work properly. As a result, you end up inhaling more air than you’re able to exhale.

Rib flare may also negatively affect spinal alignment. Your upper back (or thoracic spine) is thrust into hyperextension, exacerbated by weak upper back muscles and poor sitting or standing posture. Without treatment, you may experience a plethora of other issues related to abnormal spinal alignment and rib flare.

If you have flared ribs and are looking for the culprit of your low back pain, you may have found it. Much like the thoracic spine, the lower spine is tilted forward when a rib flare is present. A common co-existing issue with rib flare is an anterior pelvic tilt, also known as a forward rotation of the hips/pelvis. This then leads to tightened hip flexors and back extensors, which causes the opposing muscles (abdominals, gluteals, and hamstrings) to weaken. Related: Exercises to Correct Anterior Pelvic Tilt

With rib flare related to pregnancy, your lumbar spine is usually the area that is affected. The bad news is, because of the length of a pregnancy, flared ribs typically hang around for a little while longer postpartum, too.

If you haven’t put two and two together yet, everything is connected. One anatomical shift can result in a dozen others. Because of this, it’s crucial to be aware of these anatomical shifts — rib flare being one of them.

How to fix rib flare

Two words: Core. Strengthening.

A strong core is the key to maintaining good rib health and treating rib flare. And we’re not talking about your “abs” — we’re talking about your inner core. Unfortunately, adding an ab circuit or challenging yourself to do 50 crunches every day isn’t going to fix the issue at hand.

If your rib flare is a result of pregnancy, treating it should be a priority in the early postpartum months. As with just about anything, the earlier you can correct the dysfunction, the better your odds for minimizing other issues. 

Learning how to properly engage your core is the first step for strengthening. Without this, you’ll train the wrong muscles and see limited progress. The most common cue for activating your core is “pull your belly button into your spine.” 

There are a handful of exercises that you can do once you’ve mastered the practice of engaging your inner core muscles. You can try any of the following:

• Dead Bugs
• Wall Angels
• Kneeling Pullovers
• 90/90 Bridge

Aside from treating your rib flare, strengthening your core will prevent further injury. This is especially important if you’re working toward a specific fitness goal. As your exercises progress with heavier weight and higher difficulty, the last thing you want to do is compromise your form.

Hopefully, the biggest takeaway is to not leave rib flare untreated. Find your way to your physical therapist if you have further questions or want to dig deeper into treatment for rib flare.