Rib Flare: Why It Happens and How to Fix It

Rib Flare is a very common yet often overlooked issue. Many people perceive it as a purely aesthetic problem, but in reality, it has a direct impact on breathing, core stability, posture, and back pain.

What Is Rib Flare?

Rib Flare describes a condition in which the lower ribs rotate outward and forward instead of being gently “pulled down” and stacked over the pelvis. It is most noticeable in standing or lying on the back, where the lower ribs visibly protrude and create a pronounced angle between the rib cage and the abdomen.

Rib Flare is a sign of disrupted coordination between breathing, posture, and overall trunk stability.

What Causes Rib Flare?

Rib Flare is primarily the result of an altered breathing pattern—specifically, an ineffective exhalation.

When a person is unable to fully exhale, the lower ribs remain chronically positioned in an inhaled state. As a result, they fail to move naturally downward and inward, which should occur during a proper exhalation.

Over time, the ribs become “fixed” in this position, and the body begins to perceive it as normal.

In addition to Rib Flare, other related issues often appear, such as reduced trunk stability, excessive loading of the lumbar spine, and the development of postural asymmetries. The postural asymmetries are especially noticeable when Rib Flare is present only on one side of the body—most commonly on the left side.

How to Fix Rib Flare

If we want to fix the Rib Flare long term, there is only one effective approach which is correcting the breathing pattern and restoring a proper exhalation.

There are many myths and ineffective approaches related to breathing, which will be addressed in separate articles. Here, we will focus on the basic principles of proper breathing according to the Postural Restoration Institute (PRI), which are essential for bringing the ribs back into a neutral position.

PROPER BREATHING

1. Inhale through the nose, followed by a slow and relaxed exhale through the mouth.

2. Aim to exhale as much air as possible while avoiding engagement of the neck muscles.

3. During the exhale, the oblique abdominal muscles should activate slightly. If you do not feel them, the exhale is either too short or you are not releasing all the air.

4. Avoid trying to breathe only into the belly, as is often taught. Instead, the chest and torso should expand evenly in all directions during the inhale.

5. You can also try pressing the tongue gently against the roof of the mouth during inhalation—this further supports correct activation of the respiratory muscles.

Which Exercises to Start With?

The best first step is to simplify the body position and create optimal conditions for a high-quality exhalation. The most suitable starting position is sidelying, which facilitates activation of the oblique abdominal muscles and allows better awareness of breathing.

SIDELYING BREATHING

Starting position:

Lie on your side with the hips and knees flexed between 60 and 90 degrees. Support your head with your hand, a block, or a pillow so that the cervical spine remains in a neutral position. The ribs are gently pulled down and stacked under the rib cage.

Execution:

Exhale through the mouth, aiming to release as much air as possible. The exhalation lasts approximately 5–10 seconds, with a light activation of the oblique abdominal muscles at the end. This is followed by a quiet nasal inhalation, ideally with the tongue resting on the roof of the mouth, while maintaining gentle oblique activation. During inhalation, you should feel the ribs expand softly to the sides.

Perform 5–8 breathing cycles.

How to Progress Further?

Once proper breathing is mastered in the sidelying position, it is important to gradually progress to more demanding positions. Begin with supine (lying on the back), then move to seated positions, and finally to standing.

These positions place greater demands on coordination between the ribs, pelvis, and abdominal wall, while also more closely resembling the functional postures used in everyday life.

What If You Struggle to Achieve Proper Exhalation and Oblique Activation?

A very effective tool that can help improve breathing quality is exhaling into a balloon. The balloon creates optimal resistance for the diaphragm and supports activation of the oblique abdominal muscles.

The balloon can be used in any position. However, it is important to remember that it is only a tool to facilitate the return to an effective exhalation—not a solution on its own.

Image source: Postural Restoration Institute