Rib Flare SOLUTIONS (A Coach’s Guide) 

Welcome to my UPDATED Rib Flare guide for 2022. This article includes the latest and most relevant information on Rib Flare, and what you can do to fix it. 

I discuss the various types of Rib Flares, some of their dangers and consequences, and the insights they reveal on what strategies you use to breathe, move, and go through daily life. 

All the knowledge, strategies and exercises in this article are the exact same ones I use with my clients and on myself – so you know they ACTUALLY WORK.

I hold nothing back and share everything I have learned in this fascinating study of Rib Flares during my 15+ years experience as a coach and athlete. If you want to learn all the latest strategies and best products in fitness and wellness, be sure to look around my site when you finish with this guide.

Let’s dive right in. 

What is Rib Flare? 

Rib Flares are persistent, bony protrusions of the lower ribs that do not lay back down during exhalation, or when you put your arms overhead. 

They can easily be identified by visually inspecting yourself in the mirror. 

These bony protrusions can occur on the left, right, or both sides of your rib cage, and Rib Flares are associated with poor rib positioning, weak abdominal muscles, inactive obliques, and excessive extension of the lumbar spine. 

Each time you inhale, your rib cage naturally flares outwards to make room for the diaphragm to contract and come down. Exhalation reverses this process, and your rib cage should close back down. Check out this article for more information on how to test for rib flares.

If your rib cage protrudes in every activity and posture we take (sitting, standing, laying down, walking, squatting, bench pressing, etc), we are simply describing a Rib Cage that went into inhalation but didn’t come back. 

The origins and presentations of Rib Flare are varied, but there is strong evidence suggesting they are the direct result of natural human asymmetry and right-dominant patterns. The science of this is covered in full detail in the sections to follow.

Rib Flares are sometimes harmless, but flaring ribs will (in many cases) decrease trunk stability during exercise and daily life. The image below will show the most common hyperlordotic position associated with Rib Flare. 

If Rib Flare is unaddressed for long periods of time, it starts a feed forward chain reaction leading to postural issues, musculo-skeletal pain, and dysfunction of surrounding biological systems.  

To fix Rib Flare, you need to (1) acquire ideal positioning and alignment of your pelvis and rib cage, and (2) find your obliques to anchor the rib cage back to the pelvis. 

Traditional methods like stretching tight lats and hip flexors, or core exercises are limited in scope, and lead to temporary or no success. 

Successful solutions will need to integrate the complex systems of the human body to address the root cause, which are: human asymmetry, breathing dysfunction, and the brain’s role in movement. 

Our brains control our muscles, and one of the most difficult things to do is to reprogram a fixed pattern. 

Incorporating breathwork into your alignment practice and exercise will be extremely useful in this context, because breathing is one of the only ways you can consciously influence your autonomic nervous system.

These Rib Flare exercises are super effective because they respect the complexity of the human systems and integrate them into a simple activity. 

If you came here for the exercises, feel free to jump ahead to the most relevant section. 

1. Bilateral Rib Flare
2. Left Rib Flare 
3. Right Rib Flare

Sometimes Rib Flares are confused with a Wide Rib Cage, which can often occur together, but are not the same. Since the ribcage is one of the most malleable skeletal structures in the body, it will change many times throughout your life. 

For example, pregnant women will experience a widening of their rib cage angle (~68 degrees to 100+ degrees) to adjust to the changes in uterine pressure and new ventilation needs during pregnancy. This topic is covered in more detail in the section on Rib Flares during pregnancy.

Continue reading to learn about what exactly happens to your rib cage during breathing, what is human asymmetry, and what are some of the dangers and consequences of Rib Flare you should watch out for. 

Rib Cage & Diaphragm 

Your rib cage will typically consist of 12 ribs, which house the vital organs such as the heart, lungs and crucial blood pumping vessels. 

Flaring often occurs at the lower ribs (~Ribs 8-10) which are called False Ribs because they are only connected to the front by a flexible costal cartilage. Below these, the Floating Ribs have no connection to the front side of the body. 

Since the lower ribs have no solid connection to the front, their position is highly flexible, and you will experience a large degree of change in your rib cage throughout your life. 

The next section covers breathing, and how rib flares are simply a rib cage that went into inhalation, but never came back out. 

Breathing

The average human takes about 22,000 breaths each day. Each time we go into inhalation, our lungs fill up with air, and the respiratory diaphragm (the key muscle of respiration) contracts downwards. 

This will be easier to visualize in real time, and this video demonstrates the relationship of the diaphragm and rib cage during each inhale-exhale cycle.  

As you see in the video, when during Inhalation, your rib cage EXPANDS to make room for the diaphragm to contract and come downwards. That is to say, your ribs naturally flare upwards when you inhale, and tuck back down during exhalation.  

Seen this way, it makes it clear that a persistent Rib Flare is simply a Rib Cage that went INTO inhalation but DID NOT come back. 

The next section will cover one slice of human asymmetry, and how an overactive Left AIC chain can cause your Left Rib to get stuck into chronic inhalation. 

Asymmetry & Right-Dominance 

Walking and breathing are highly interdependent activities.

In walking, humans possess functional chains which turn on when we take a step, run, throw, etc. You are probably familiar with the Posterior Chain, which is involved every time we lift a heavy barbell off the ground.  

Due to an influx of pioneering coaches and physical therapists in recent years, you may have also heard of the Left Anterior Interior Chain (Left AIC). This is the chain most likely to get OVERACTIVE, and feeds directly into the right-dominance pattern many of us live by. 

The Left AIC are the primary muscles active during Left Swing Phase of Gait – that is, the stage where you pick up your left foot and put it back down again. This chain includes the left diaphragm, left psoas major, left iliacus, left tensor fasciae latae, left biceps femoris, and left vastus lateralis. 

Image taken from ‘PRI. A tri panar asymmetrical framework for understanding, assessing and treating scoliosis and other spinal dysfunctions.’ 

When this Left AIC chain is active, what is happening in the breathing system, is the following: the left front rib cage elevates and rotates outwards, as the left diaphragm flattens into an inhalation position. 

What this means is that the Left Rib will flare naturally while the Left AIC Chain is active. 

When the Left Rib flares chronically, this is a result of a chronic and overactive Left AIC Chain. 

Rib Flaring is a naturally occurring phenomenon, but the danger is when the rib cage goes into a chronic state of inhalation. Read on to learn how exactly this occurs, and what to look out for. 

Are Rib Flares Dangerous?

Rib Flares indicate a hyperinflation of the lung underlying it and can introduce a chain of events which can develop into deeper dysfunction and pain over time. 

The danger is when the rib cage goes into a chronic state of inhalation (that is, flared up over long periods of time). The sequence that will eventually follow is: 

1. When the ribs stay up; the diaphragm will also stay down in a descended state of inhalation. This means – eventually the diaphragm will lose its efficiency to act as the primary muscle for respiration

2. Your body starts to rely on the accessory (secondary) muscles for respiration, e.g. psoas (hip flexor), paraspinals, muscles of upper back, chest, and anterior neck (like the scalenes). Importantly, these accessory muscles are not designed to do this magnitude of work

3. Your diaphragm takes a back seat to these accessory muscles, and instead become an auxiliary muscle for postural extensor, which means it will pull the lumbar spine forward, and reinforces the hyperextended lumbar spine and rib flaring posture 

Good fitness and strength training programs should provide opportunities to balance our asymmetries and ensure you retain all of the available movement options of healthy human bodies. 

Rib Flare Consequences

Early detection is a huge advantage. Rib Flares suggest a hyperinflation of the underlying lung, and catalyzes a chain reaction leading to dysfunction of the diaphragm and related functional muscle chains. 

If your breathing muscles and structures are compromised, they can eventually become postural disorders, including lower back pain, slumped shoulders and upper back, forward head posture, and changes in rib position in scoliosis. These are often followed by issues in other biological functions like GERD, constipation, migraines, etc. 

Some of these postural disorders include what is described as Upper Crossed, Lower Crossed Syndrome, and Layer Syndrome. 

Chances are these folks started off with an innocent rib flare, and in compensation, their lumbar spine got pulled forward as a way to get more air into the body (into the belly), and started to feed the posture created above. 

Bilateral Rib Flare 

If your Ribs flare on both sides, there is a good chance you are also dealing with a hyperlordotic spine, characterized by an excessive arch of the lower back. Restoring this will be the first priority. 

‘Neutral’ Rib Positioning

The first step is to be mindful of your posture, and the positions of your ribcage and sternum. 

Follow these steps to restore ‘neutral rib positioning’. 

1. Keep your sternum down 
2. Pull your belt line up 
3. The resulting shape should be two parallel lines projecting straight ahead in front of you 

After you have passively found this ‘neutral’ position, you can try to dynamically achieve this by layering simple positions and specific breathing to synchronize the different systems of (1) skeletal positioning, with (2) muscle activity, and (3) respiration together. 

The simplest way is laying on the ground, in a modified bridge position. 

Test / Re-Test: Standing Toe Touch 

A simple test like the Standing Toe Touch, will tell you much more than the ‘neutral posture’ (shown again below) about your ability to contract the diaphragm and manage the pressure between your pelvis and rib cage.

• Reach down as far as you can and try to touch your toes
• At the bottom, inhale into your mid-upper back, between your shoulder blades

Try to sense and take note of how far you are able to reach down to your toes, and whether it is easy to breathe in that position. 

After doing a set of any of these breathing exercises like the Bridge with Ceiling Reach above, re-test with the Standing Toe Touch and see if it gets easier. 

If you can feel expansion through your upper back during the inhale, and compression down the front of your chest during the exhale – you’re good to go! 

How to Breathe during these Exercises 

The way you breathe during these exercises are critical to achieving the results you want. These are some key tips: 

1. Inhale gently with your nose (3-4 sec)
2. Exhale with your mouth with pursed lips for a full 5 seconds (as if blowing up a balloon) 
3. Pause for 2-3 seconds, and hold the ribs down position
4. Re-inhale through your nose on top of the new position, and repeat for 4-6 breath cycles 

Exhales should be long and complete. There should be little to no air left in the lungs. At this point, you will start to feel your obliques engage. That’s when you pause. 

This pause is where the magic happens. If you have exhaled all your air, the pressure inside the trunk cavity will drop and your ribcage (if flared) now has a chance to lay back down. 

The pause is also crucial for signaling to your autonomic nervous system that this new position is one you control, versus if your rushed back in desperation to intake more oxygen – which would perpetuate the problematic pre-programmed patterns you already have. 

Another important note is the feet. You want to be engaging the various parts of the feet (thumb joint + pinky joint + heel), and feel hamstrings. These additional layers are important as you aim to integrate this into movement when you stand back up. 

Exercises for Double Sided Rib Flares

The exercises below are super effective for reducing rib flare. 

Because these exercises integrate multiple systems of your body together during a single activity, they will be much more effective than stretching or core exercises, to address a condition as complex and multi-faceted as Rib Flare. 

Do each of these exercises for 4-6 breath cycles, and 2-3 sets before checking to see if your rib flare has reduced. 

Breathing with Reach Overhead

This exercise utilizes an overhead reach, which puts you in a position to better access your lower ribs during an exhale.

https://youtu.be/txlED5V1dao 

Quadruped with Breathing 

This exercise emphasizes alignment in a Quadruped position, which will challenge you a bit more to maintain the integrity of the ribcage and pelvis positions achieved in the previous exercise. 

These exercises are a great start to eliminating your Rib Flare and mitigate their deleterious consequences on your posture, movement, and functioning of other biological systems of your body. 

For lasting impact, you will need to continue doing these exercises, and try to avoid any aggressive positions. A good rule of thumb is to aim for ‘neutral’ postures in simple activities such as sitting, standing, and during exercise. 

Left Rib Flare

Left sided Rib Flare is one of the more common rib flares, and the cause can be tied directly to the underlying asymmetry of human bodies and right-dominance.

Visually, you will know you have a Left Rib Flare if the left lower rib cage is expanded, and the right rib cage is compressed. Look at the following image below, for example: 

These flares are often pronounced in individuals with scoliosis, but it’s important to note that a Left Rib Flare pattern may cause otherwise skeletally normal individuals to develop a functional scoliosis pattern as well. 

Solutions will include lowering the left side of your rib cage to enable your lateral abdominal muscles to do their job of anchoring the pelvis back to the rib cage. 

If you think you have anterior tilt, or a pronounced arch in your lower back, I would suggest first reading this quick section on restoring neutrality in your posture and a critically important guide on how to breathe during these exercises before coming back to do Left Rib Flare specific exercises below. 

Exercises for Left Rib Flare 

The exercise below integrates multiple systems of your body together during a single activity, so they will be much more effective than stretching or core exercises, to address a complex and multi-faceted condition, like Rib Flare. 

Do each of these exercises for 4-6 breath cycles, and 2-3 sets before checking to see if your rib flare has reduced. 

Cross Connect with Right Arm Reach 

This is one of my favorite exercises for bringing down your rib flare on the left. 

These exercises will help reduce your Rib Flare and prevent their negative effects on your posture, movement, and overall body function. 

You’ll need to keep doing these exercises and avoid any forceful postures for significant results. A good rule of thumb is to aim for ‘neutral’ postures in other aspects of your life. 

Right Rib Flare 

Right Rib Flare can occur in some body types, often as a progression to the more common Left Rib Flare, which we have discussed is the result of human asymmetry and right-dominance. 

In that model, the right Rib Cage is often compressed, which makes it hard to breathe into the right side of the body. To compensate, an individual might hyperextend the lower back to improve air flow by funneling air into the belly. 

Since this is still an inefficient method of breathing, the body will start to flare the right lower rib cage as an effort to draw even more air into the right chest cavity. 

Solutions for Right Rib Flare, are the same as the Left Rib Flare, except with one additional step: 

1. You’ll need to go after your right obliques first
2. Then, continue on to find your left obliques 

If you have Right Rib Flare, you will almost surely have anterior tilt (due to the reasons stated above). 

In this situation, the above exercises will help you decrease the excessive lumbar hyper-extension, but I recommend first reading the section on restoring neutrality in your posture and a critically important guide on how to breathe during these exercises before coming back to do Right Rib Flare specific exercises below.  

Exercises for Right Rib Flare 

The exercise below integrates multiple systems of your body together during a single activity, so they will be much more effective than stretching or core exercises, to address a complex and multi-faceted condition, like Rib Flare. 

Do each of these exercises for 4-6 breath cycles, and 2-3 sets before checking to see if your rib flare has reduced. 

Cross Connect with Left Arm Reach 

Cross Connect with Right Arm Reach 

These exercises will be helpful to reduce your Right Rib Flare and manage their deleterious consequences on your posture, movement, and functioning of other biological systems of your body. 

Try out these exercises and see if they help to reduce or eliminate your Rib Flare! 

Summary

• Which type do you have? If you’re experiencing Rib Flare, the first step is to figure out which type you have (Double, Left, or Right).
  
• What goes up, must come back down. Rib Flare (of any kind) can be thought of as ribs that entered a mode of inhalation, but never came back down. Reasons for this occurring varies, but Rib Flare solutions require exhalation in some form or another
  
• Ribs are the house for your diaphragm and internal organs. Dysfunction in this area has wide implications, including back pain, shoulder pain, indigestion, GERD, constipation, migraines, and more. If traditional treatments and medications haven’t helped, chances are these exercises will help
  
• Rib Flares are the symptom, not a root cause. The lower ribs are flexible, and as one of the most malleable areas of your skeleton – it will be the first sign you can perceive of a deeper underlying hyperextension or twist.
  
• Rib Flare signals underlying issues with your body’s ALIGNMENT and overall FUNCTION. Solutions will require improving ideal rib positioning for your obliques / lateral abdominal muscles to reach up and anchor your pelvis to your rib cage.
  
• Rib flare can exist, for some time, with no pain or loss in performance. However, early detection is a key advantage to maximizing chance of success in preventing eventual issues related to pathological posture, and maximizing current quality of life.
   

• Rib Flares are often accompanied by loss in performance and stability, musculo-skeletal pain in lower back pain and neck, and even cause issues with digestion, bowel movements and migraines. If traditional treatment methods have not worked for you, you can consider increasing the quality of your rib cage positioning and overall posture, which directly house your valuable internal organs. Many individuals who have traditionally used medications have reported to find exercise and conscious posture and movement to be much more effective and sustainable in addressing their symptoms.
  
• Rib Flares that are accompanied with Musculo-skeletal pain, loss of performance, and even digestion, bowel movement, and even headache related issues, CAN and SHOULD BE addressed.
  
• Human bodies and each Rib Flare is complex, but share a common root cause. Solutions can start with the general, but lasting results will require individualization.

FAQ

What is Rib Flare?

Rib Flare can be identified easily by inspecting yourself in the mirror and seeing if your lower rib cage protrudes upwards. Rib Flare can present in three basic shapes (1) Bi-lateral, (2) Left Side, (3) or Right Side. These flares become more prominent when you reach your arms over your head and take a big breath in. Your lower ribs inflate with air, making Rib Flare easier to see and feel. 

The majority of cases are Left Rib Flare and Bi-Lateral Rib Flares. The visible part of these Rib Flares will be between the eight and tenth rib, due to their lack of a fixed attachment to the sternum, and instead being held in place by flexible costal cartilage. 

When you have a Rib Flare, this will usually signal that your trunk stability is compromised. Since this new rib position increases the distance from rib cage to the pelvis, it makes it much more difficult for the lateral obliques to reach up and anchor the rib cage down to the pelvis – which is integral for pressurizing the trunk during daily and more strenuous activities. 

What Causes Rib Flaring?

In general, Rib Flares are the body’s way to direct more air into your body. Your ribs naturally flare upwards and out when breathing inwards. Sometimes, your rib cage gets stuck in a state of chronic inhalation and is unable to come back down into exhalation. 

The largest contributor to Left Rib Flare is due to the extremely common pattern of right-hand dominance in our lives. Those who have a left Rib Flare also have a collapsed Right Rib Cage, which causes the body to depend more heavily on the left Rib for inhalation processes. 

Right Rib Flare can be an additional consequence of the same right-dominant pattern. In this case, there is often a hyperextended lower back which helps to draw air into the belly. Over time, the Right rib cage lifts and turns out in effort to direct more air into the compressed Right Lung. 

Is Rib Flare Harmful?

Since our rib cage is the house for your diaphragm and internal organs, dysfunction in this area has wide implications. Many who present with the following symptoms will also show signs of rib flaring and poor postural control. 

• Back pain
• Shoulder pain
• Chest Pain
• Neck pain
• Indigestion
• GERD or Acid Reflux
• Constipation
• Incontinence
• Migraines, and more. 

When the rib cage goes into a chronic state of inhalation (that is, flared up), the diaphragm will also stay down in a descended state of inhalation as well. This means – eventually the diaphragm will no longer be an effective muscle for respiration. 

Because the diaphragm is no longer an effective muscle for breathing, it will often instead become an auxiliary muscle for postural extension, and over time pull the lumbar spine forward. 

To help you breathe, your body starts to rely on the accessory (secondary) muscles for respiration, like the psoas (hip flexor), paraspinals, muscles of upper back, chest, and anterior neck (like the scalenes). 

This is why people often describe feeling pain during breathing, in the front sides of their neck, shoulders, back, chest, and lumbar spine. We are likely describing an individual who experiences some kind of Rib Flare, and would benefit greatly by bringing some of their ribs back into exhalation. 

How Do You Fix Rib Flare?

Once you have identified the type of Rib Flare you have, solutions require improving rib cage positioning and restoring obliques. These lateral abdominal muscles reach up and anchor your pelvis to your rib cage, and are crucial to trunk stability. 

Check out the sections (Both Ribs Flare, Left Rib Flare, Right Rib Flare), which are some of my favorite exercises targeting your obliques and maximize your chances of getting your lower ribs to lay back down.

Can Rib Flare Cause GERD?

Posture, rib positioning and underlying diaphragm function has also been strongly tied to carrying out necessary biological functions. In the case of a 35 year old with GERD, experiencing pain in the upper back, neck, and sternum – addressing her postural symptoms were key to treatment, and restoration of normal spine mechanics were concurrent with the complete reduction of her symptoms. 

Rib Flare and Scoliosis

Early detection is a HUGE advantage, and will significantly increase the success of addressing issues before they become serious and pathological. I hear too often of someone who went to get something checked out and was given the guidance to ‘wait and see’. 

Most of the time, we wait too long, and may not know what we are looking for. In Rib Flare – we risk the whole list of symptoms above, as well as functional scoliosis (like in the picture below). 

Try the exercises below, and see if you can feel the difference in your Rib Flare. I’m certain they will. 

Pregnancy and Postpartum Rib Flares, Diastasis Recti, and Wide Ribs in Women

During pregnancy, women will often experience a widening of their infrasternal angle from 68 degrees to 100+ degrees, to adjust for the new ventilation needs of the pregnant individual. 

Another closely related condition is Diastasis Recti, a partial or complete separation of the rectus abdominis, or “six-pack” muscles, which meet at the midline of your stomach. 

100% of pregnancies include Diastasis Recti by the third trimester, with 2 out of 3 cases occurring earlier in the pregnancy. About 30% of women continue to experience the symptoms of Diastasis following pregnancy. 

Newborns and men can also experience this as well. For men, it’s often after heavy lifting with Rib Flared or ‘Crossed Syndrome’ postures. 

Symptoms generally include visible bulge in the abdomen area, constipation, lower back pain, incontinence, trouble breathing, and hernias. 

If you have persistently wider ribs postpartum, use the exercise below to direct your rib cage and pelvis back to their normal position. 

I would suggest first reading this quick section on restoring neutrality in your posture, and a critically important guide on how to breathe during these exercises, for best results. 

Bridge with Reach Overhead 

These exercises are a great start to eliminating your Rib Flare and mitigate their deleterious consequences on your posture, movement, and functioning of other biological systems of your body. 

Are Wide Ribs the Same As Rib Flares? 

No, Wide Ribs are not the same as Rib Flares. A Wide Rib Cage simply refers to the angle in which the rib cage spans out, and wide ribs do not need to be flared to be classified as Wide. 

They can often occur together, and can exasperate the wide appearance. I discuss this in much more detail in the following post about wide ribs.

Your lower ribs (8-12) are one of the most malleable skeletal structures in your body, and can shift into different shapes and sizes throughout a normal life. 

For example, pregnant women often report a widening of their rib cage, which naturally occurs to create space for a growing fetus and accommodate the new ventilation needs of pregnancy. I discuss these in more detail and what can be done to reduce wide ribs, in the section of pregnancy and postpartum rib flares. 

The angle of how wide (and narrow) your ribs are, is also referred to as the Infrasternal Angle. This angle is measured from the lowest point of your sternum (Xiphoid Process) to the lowest perceivable point of your ribcage when viewed from the front. 

In the example above, this individual has a wide infrasternal angle (i.e. excess of 110 degrees), with a classic flaring Left Rib, with the naturally accompanying compressed right Rib cage. 

Your infrasternal angle can reveal valuable information about your respiratory strategies and available movement strategies, and may explain why certain movements are easy for you, while others are not and feel inaccessible.

For the purpose of this article, simply perform a visual inspection to ensure that you are within normal ranges, which various sources have placed between 90-110 degrees. If your Infrasternal Angle is on the wider side, try the following exercise which will help you close down your ribs. 

Bridge with Reach Overhead 

These exercises are a great start to eliminating your Rib Flare and mitigate their deleterious consequences on your posture, movement, and functioning of other biological systems of your body. 

Try them out and see if they help to reduce or eliminate your Rib Flare!

If you’ve been looking for a balanced and personalized fitness program that integrates the complexity of your human body on a individualized level, reach out out to me at danny@dannychois.com for a free consultation today!