Slipping Rib Syndrome: The Hidden Cause of Chest and Side Pain You’ve Never Heard Of
Have you ever felt a strange, sharp, or poking pain under your ribs—especially when bending, twisting, or breathing deeply? You’re not imagining things. You might be dealing with a condition called Slipping Rib Syndrome, also known as Rib Tip Syndrome or Costal Margin Syndrome.
While it’s not the most common diagnosis, it’s more frequent than many realise—often misdiagnosed as anxiety, digestive issues, or even heart problems due to where and how the pain shows up.
At Life is Movement Clinic, we’ve helped a number of patients with this unusual but very treatable condition. Let’s break it down in plain English.
What Is Slipping Rib Syndrome?
Imagine your ribs as a flexible cage made of bones and cartilage that protect your heart and lungs, but also move with your breath. The lower ribs—especially ribs 8 to 12—are a little different. Instead of connecting directly to the breastbone (sternum), they’re attached by softer tissue (cartilage or ligaments).
In some people, this connection becomes too loose, often due to injury, overuse, or hypermobility. When that happens, the rib can “slip” or move too much, irritating nearby nerves or tissues. This slipping is what causes that strange, often sharp or catching pain.
Think of it like a loose hinge on a door—it still works, but every time it shifts too far, it catches or pinches something, causing discomfort.
Common Symptoms
A sharp, stabbing, or clicking pain under the lower ribs (often on one side)
Pain that worsens with movement: twisting, bending, stretching, or deep breathing
A sensation of the rib “moving” or “popping out”
Pain triggered by pressure on the ribs or certain exercises
Sometimes mistaken for gallbladder issues, muscle strain, or even anxiety
How Is It Diagnosed?
Slipping Rib Syndrome doesn’t usually show up on scans like X-rays or MRIs. Instead, it’s diagnosed through physical examination—where a clinician applies pressure or moves the rib in a specific way (called the Hooking Maneuver) to see if it replicates your symptoms.
If we suspect Slipping Rib Syndrome at Life is Movement, we’ll also assess posture, breathing, and core control to see if there are movement patterns that may be contributing to the issue.
What Can Be Done About It?
Medical Options
Reassurance: First and foremost, knowing what’s going on is a relief for many.
Pain Relief: Anti-inflammatories or nerve-pain medications can help settle things.
Injections: Occasionally, corticosteroid or nerve-block injections are used.
Surgery: Very rare, but sometimes performed if the condition is severe and unresponsive to other treatments.
Physiotherapy for Slipping Rib Syndrome
This is where we shine.
Physiotherapy focuses on restoring core control, posture, and rib stability so that the rib doesn't continue to slip and irritate nearby structures.
Here’s what that might look like:
Helpful Exercises
1. Diaphragmatic Breathing
Why: Reduces tension in accessory breathing muscles and restores natural rib movement.
How to do it:
Lie on your back with knees bent.
Place one hand on your belly, one on your chest.
Inhale through your nose, letting your belly rise.
Exhale slowly through pursed lips, letting belly fall.
Do this for 5 minutes, 2–3 times per day.
2. Side-Lying Rib Mobility Stretch
Why: Gently encourages normal movement of the rib cage.
How to do it:
Lie on your pain-free side.
Reach your top arm overhead and gently rotate your upper body back.
Hold for 20–30 seconds and breathe deeply.
Repeat 3–5 times.
3. Dead Bug Core Activation
Why: Builds deep abdominal control, key for stabilising ribs.
How to do it:
Lie on your back with arms pointing up and knees at 90°.
Slowly lower opposite arm and leg toward the floor while keeping your back flat.
Return to start and switch sides.
Do 2 sets of 8–10 reps.
4. Bird Dog (Modified)
Why: Builds core and spinal stability without overloading the ribs.
How to do it:
On all fours, lift one arm and opposite leg.
Hold for 5 seconds, keeping hips level.
Return and switch sides.
Do 2 sets of 6–8 reps.
The Importance of Thoracic Mobility in Slipping Rib Syndrome
When the mid-back (thoracic spine) is stiff or restricted — often due to prolonged sitting, poor posture, or lack of rotation in our daily movement — it forces the body to compensate elsewhere. In the case of Slipping Rib Syndrome, that “elsewhere” is often the lower ribs, which are more mobile and more vulnerable to hypermobility-related issues.
Improving thoracic mobility helps:
Reduce the excessive strain on the costal cartilage
Improve rib mechanics during breathing and movement
Support proper posture and alignment
Decrease compensatory stress on the abdomen and lower ribs
Try These Thoracic Mobility Exercises:
Foam Roller Extensions: Lie on a foam roller placed horizontally across your upper back. Gently extend backward over the roller, supporting your head if needed.
Thread the Needle Stretch: From an all-fours position, rotate one arm underneath the other, letting the shoulder drop toward the floor to increase rotation.
Wall Angels: Stand with your back against a wall, arms in a goalpost shape. Slowly slide them up and down while keeping your ribs and back flat.
Aim to do these 3–4 times a week for 5–10 minutes. Gentle, regular work is more effective than intense or sporadic stretching.
What to Avoid
Heavy twisting or side bends
High-impact activities like sprinting or jumping in early stages
Overstretching or overbreathing (especially with shallow chest breathing)
Crunches and sit-ups: These can increase pressure on the lower ribs
Final Thoughts
Slipping Rib Syndrome can be frustrating—but with the right diagnosis, support, and rehab, most people get back to pain-free movement without surgery or long-term medication.
At Life is Movement Clinic in Brighton & Hove, we take a whole-person approach to rib and thoracic pain. If you’re experiencing mysterious side pain, popping sensations, or discomfort during movement or breathing, don’t suffer in silence.
Ready to Move Without Pain?
📞 Get in touch with us at Life is Movement
Whether it’s a slipped rib or something else entirely, we’ll help you figure it out. Book your consultation today and start your recovery the right way.
