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How To Test For Costochondritis Vs Slipped Rib

Dr. David Kulla  0:00 

How To Test For Costochondritis Vs Slipped Rib: So, this is an important video because a lot of you out there that are watching this video probably are wondering, “Do I have costochondritis?” There’s no test. There is no, zero, tests to show you have costochondritis. No X-ray will show that, no MRI will show that. It might show some inflammation in the chest wall, but nobody orders a chest wall MRI. It’s just rare, right? So, CAT scans won’t show it, there’s just no test to show that you have costochondritis. So, you have to go by your symptoms.

It can be the pain is out here towards the shoulder and to the front of the shoulder, but into the chest wall itself and the pec muscle area. But it can also radiate around here into the side. And typically, people with costochondritis have a lot of tension in between the shoulder blades and tightness that maybe comes and goes, but that’s not the main indicator. Usually, it’s the chest pain because you can have, obviously, upper back pain without chest pain, and you don’t have costochondritis. He had rib pain here on the side, didn’t have much rib pain on the front. Had a little bit in the front here, lower, on the lower ribs.

And he had a surfing accident, well, not an accident, but just was surfing every day, twice a day in a surf camp for, how many months?

Speaker 2  1:26 

Four weeks.

Dr. David Kulla  1:27

How To Test For Costochondritis Vs Slipped Rib diagnosis:

Four weeks. Okay. You got to look into your history, how it started, how did you first get it. And you didn’t get it until after the end of the four weeks, it started bothering you during the four weeks. So, if somebody told me it started a month before he surfed, and he had a really bad case of bronchitis, then I would say, okay, that can cause some inflammation in the chest wall or a bad bout a COVID, or something where you’re coughing a lot.

And then, overuse injury where you’re using your arms up here head level, where you’re lifting a lot of things, working in a warehouse. Or, somebody that drives a lot and has their arm up, and it’s an overuse of the pec muscle, and it causes inflammation in the chest. And then, it’s usually associated with problems in the back, but I hope that helps you guys figure out whether you have costochondritis. A lot of you are going to the heart doctor, to the hospital, and, I’ll tell you this; go, that’s fine. Rule out any heart conditions. Perfectly normal to do that. And you should do that. Get it checked out once, but don’t keep going back to the ER. I get people that have gone to the ER 3, 4, 5 times to have stress test, echocardiogram. Get it done once, if it’s negative, you’re good.

You probably have costochondritis if you have the symptoms that I just mentioned. For him, it was musculoskeletal and rib. He had a rib misalignment, we adjusted it once, I think, or twice.

Speaker 2  2:49


Dr. David Kulla  2:50

Twice. So far it’s held. How are you doing so far? How much improvement?

Speaker 2  2:54 

I only have 20% pain as opposed to 100 before.

Dr. David Kulla  2:56 

So, 80% improvement?

Speaker 2  2:58 


Dr. David Kulla  2:58 

Okay. So, we’re at 80% improvement. We’ve only treated you…

Speaker 2  3:03 

Five times.

Dr. David Kulla  3:04 

Five times. Yeah, so today’s… Actually, four times, right? Today’s our fifth. So, I’m going to show you. We’re probably not going to need to adjust the ribs again, but we’ll check it, and I’ll show you how I check the serratus. Now, we’re going to go ahead and test his serratus anterior, this is one of the things I do to check the ribs. You’re going to make a fist, you’re going to punch up, you’re going to go back halfway down. So, that’s all the way back. Sorry, keep the arm straight, and then punch all the way up, go halfway back, and resist. 1, 2, 3, resist. Good. So, that’s a good rib subluxation test serratus, and like that. Punch all the way up, come back halfway, and 1, 2, 3 resist. Good. So, that one was actually stronger on that side. So, that tells me — and it’s tender right there?

Speaker 2  3:46

A little bit.

Dr. David Kulla  3:47

It tells me that… And here.

Speaker 2  3:48 

It’s alright.

Dr. David Kulla  3:49 

Okay. Here?

Speaker 2  3:51

Mmm, okay as well.

Dr. David Kulla  3:51


Speaker 2  3:52


Dr. David Kulla  3:52 

And here?

Speaker 2  3:54 

Slightly tender there.

Dr. David Kulla  3:55

“How To Test For Costochondritis Vs Slipped Rib explained:”

Okay. So, I’m able to palpate in between his ribs, and some ribs, I can feel that they’re closer together. And that’s how I know.  And then I feel the top or the bottom of the rib, and that’s how I know whether or not it’s subluxated and which rib. Okay, now I want you to punch up in the air again. All the way up, halfway down, 1, 2, 3 resist. Much stronger. Okay. Go ahead and turn over on your stomach. Typically, I adjust the spine first. I’m not sure why I did it backwards today, maybe just because we’re doing a video and he happened to be in that position. But normally, I adjust the spine before I adjust the ribs.

And I want you to turn over on your back, and you’re going to cross your arms in front of you. A lot of you have seen me do this adjustment. This is a common adjustment we do a lot because we see it a lot. It’s a specific type of anterior subluxation where it shifts forward into the chest cavity a little bit, but not that far in. That would be like a dislocation. You’d have to get hit by a Mack truck for that to happen. Tuck your chin down, deep breath in, and come on up. And the rib moves on that as well, on that adjustment.

The ribs wrap around and attach to our thoracic spine, direct connection there. Relax yourself here. His neck really wasn’t a big problem. Five visits we’ve had here, we’ve adjusted, maybe, three out of the five here, the neck. Okay. It’s a very gentle adjustment there. And I’m also going to add he’s been doing some laser therapy over the rib area where it’s been painful and sore. Cold laser therapy. You guys have any questions about cold laser, feel free to comment below. Thanks for letting us use you as an example. And if you have any questions about whether you have costochondritis, make sure you watch the video. Rewind it.

Thanks for tuning in. Thank you guys so much. If you got anything from this video, or even if you just like this view of the Empire State Building and the Chrysler Building, give me a like, and don’t forget to subscribe. I appreciate you guys

[End Of Audio]

Dr. David Kulla, D.C.

Dr. David Kulla graduated from Life University in Atlanta, Georgia with a Doctorate in Chiropractic. He earned a Bachelor’s Degree from Hofstra University in New York.  Dr. Kulla was very fortunate to be under chiropractic care before he started his doctorate program. While attending college, he interned with his professional mentors, helping to gain a wide range of therapeutic tools he would later use in a clinical setting. Working as a fitness trainer gives him great insight into injury rehabilitation and working with the disabled population has given him the compassion needed to be a well-rounded, successful Chiropractor in New York City.

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