Yes, the first rib moves, but its movement is limited compared to other ribs. While not as mobile as ribs 5-10 (the "bucket handle ribs" which move significantly up and down during breathing), the first rib does participate in subtle movements.
Types of First Rib Movement
Several sources describe the limited but present movement of the first rib:
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Superior/Inferior Movement: While the first rib moves minimally up and down with the rest of the upper rib cage, this movement is less pronounced than in lower ribs. ([Ribs 1 to 4 on their anterior articulations move up and down](Reference information)). The first rib's articulation with the sternum and vertebrae restricts its range of motion. ([It hardly permits any movement, so the two first ribs, together with the manubrium, move up and down together as one solid arch](Reference information)).
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Posterior/Anterior Movement: The first rib can exhibit posterior (backward) and anterior (forward) movement, particularly during neck rotation. This movement is facilitated by the action of muscles like the scalenes. ([Using T1 as reference, rotate the patient's head to the side being tested. This allows the first rib to move posteriorly and become more accessible for…](Reference information)). ([Postero-anterior accessory movement of first rib…](Reference information))
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Elevation/Depression: The scalene muscles, which attach to the first rib, can pull it superiorly (upwards), particularly if they are tight. ([The scalene muscles are very strong and they have the ability to pull the first rib up if they shorten for any reason](Reference information)). Conversely, other muscular actions can cause depression (downward movement). ([The first rib is most likely to move superiorly; however… can position the first rib relatively anteriorly as well](Reference information)).
Clinical Significance of First Rib Movement
Restrictions in first rib movement can contribute to various conditions, including neck and shoulder pain and thoracic outlet syndrome. Manual therapy techniques may be used to address first rib dysfunction. ([Mobilizations of costotransverse and costovertebral joints can restore first rib…](Reference information)). ([Manual Therapy for First-Rib Dysfunction](Reference information)). In severe cases, surgical intervention might involve removing the first rib. ([Surgery can involve cutting small muscles of the neck (anterior and middle scalene) and removing the cervical or first rib](Reference information)).
In summary, while the first rib's movement is limited compared to other ribs, it does move subtly. Understanding its mechanics is crucial for diagnosing and treating certain musculoskeletal conditions.
