The Mystery Pain Generator
Using Bone as Levers to Mobilize Muscles

by Erik Dalton.

As a fan of Vladimir Janda’s provocative body of work, I have highlighted his research throughout my teachings and hopefully integrated his wisdom into mainstream bodywork. I’ve written extensively on aberrant postural patterns associated with his infamous upper crossed syndrome, such as a protruding neck, rounded shoulders, kyphotic t-spine, jutted chin, hyperextended O-A joint, and internally rotated arms (Fig 1). Yet one overshadowed gem of Janda still exists- the humble pain generator deeply hidden within his upper crossed pattern –The Fixated First Rib.

Symptoms of a first rib fixation range from head, neck, jaw and shoulder pain, to breathing difficulties and arm numbness. The first rib is a relatively unstable structure that acts as the attachment site for several muscles including the scalenes. In the upper cross forward head carriage, the scalenes can often become hypertonic and exert an upward pull on the rib (Fig 2). In chronic cases, the first rib can become so “jacked up” (fixed in inhalation) that it is painfully frozen into inaction. Thus, the stage is set for possible brachial plexus compression and accompanying thoracic outlet syndrome that leads some naïve and pained individuals to opt for surgical removal of the first rib.

Assessment and Treatment Options

Ninety percent of fixated rib assessment can be determined from the client’s history. The palpation exam that follows will typically confirm the client’s history findings. Make it a routine to examine lifestyles leading to episodic injuries. Give full attention to the “mundane” such as sleeping habits, work demands, computer hours, posture, and all injuries from the innocent to the life-changers. Like family genetics or nurture vs. nature idiopathies, the body is literally....

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