Six weeks post surgery, Parker Linkous is pain free and ready to resume his active high school life.
Parker Linkous,16, was a typical, active, happy high school student, juggling classes and three sports at Minerva High School.
But life changed in November 2024 rather suddenly when he began experiencing a mysterious pain in his torso while playing basketball.
Before long, the pain began to consume his every waking moment.
Parker was an active, multi-sport athlete before being diagnosed with slipping rib syndrome.
“It felt like a knife going into my back, and into my front on my right side,” said Parker. “It was pretty bad.”
His mother, Maggie, who works in health care as an occupational therapy assistant, knew to ask him to rate his pain. When he rated his pain 9/10, she started making appointments.
“You assume pain in that area is related to an organ,” said Maggie, “So we started looking at his gallbladder, kidney stones, all types of GI issues. We did scopes, an MRI and everything kept coming back ‘unremarkable.’ ”
At one point when they began to “run out of possible serious diagnoses,” Maggie’s mom suggested the problem could be the ribs themselves.
“I started palpating on his ribs and could make his pain worse,” she said.
The Linkous family outside of Ohio Stadium before the Youngstown State game in 2024.
Interestingly, Maggie and her mom remembered that her younger sister, Claire, had experienced something similar as a teen (Maggie was away at college at the time) and was eventually diagnosed with slipping rib syndrome.
Maggie shared her idea with Parker’s pediatrician, Dr. Marcia Marhefka, “an open ear and constant advocate” for Parker, and began searching for pediatric surgeons with experience in slipping rib syndrome. She found long waits and the potential for extensive travel to find a provider. But she noticed that Dr. Joseph Iocono, a pediatric general surgeon at Akron Children’s, had noted on his website surgical expertise in the thoracic cavity. More importantly, his front-office staff seemed to really listen to Maggie’s concern about her son’s level of pain and were willing to change his schedule to get Parker in quickly for a first consult from initially two weeks out to the next day.
“I already loved him for that,” she said.
With CT images in hand, Dr. Iocono took a complete medical history on Parker and a key part in confirming his diagnosis of slipping rib syndrome was a physical exam technique called the hooking maneuver.
“You palpate the area of maximal tenderness and see if it corresponds to an unstable rib tip that slides underneath the rib above it,” Dr. Iocono said. “With your fingers, you hook the lower rib and pull out to see if the lower rib is unstable and moves past the upper rib nerve bundle, causing pain. It is a sign that the lower rib is unstable and is migrating below the upper rib, causing pressure on the nerve bundle and constant pain.”
Surgery – a partial rib resection and chest wall stabilization – was quickly scheduled for Parker.
In the surgery, Dr. Iocono’s first step was to remove the portion of the ribs that were sliding under the rib above it, and causing the nerve pain. In his case, two rib tips were removed. The second portion of the surgery was to stabilize the ribs by re-attaching the cartilaginous ligaments between them so slipping does not reoccur.
Six weeks out of surgery, Parker is pain free. He is set to begin physical therapy and will wait for clearance to ease back into his sports, beginning with golf. Then, he’ll be back to basketball and baseball for his junior and senior years.
Parker plans to return to golf, then other sports when he gets PT clearance.
Despite the connection with his aunt having slipping rib syndrome in her teens, Dr. Iocono says research has not confirmed a genetic association. “But,” he says, “patients who have inherited soft tissue disease may be at some increased risk.”
He said it was a very good catch on part of the family and Parker’s pediatrician to consider slipping rib syndrome as many people go years, if not decades, experiencing pain and assuming it is related to their gallbladder, kidneys, or GI systems.
The Linkous family hopes to raise awareness about Slipping Rib Syndrome, which has sidelined Parker since fall.
“Thankfully, there is increased awareness and acceptance of this condition,” said Dr. Iocono. “Operative treatment is still evolving. The second part of the operation to stabilize the ribs has been added within the last five years. There is a large series of adult patients from West Virginia with great results, but this condition occurs more than we realize in teens. We need to identify patients who may have this, so they don’t suffer. The workup is straightforward, and the surgery can have a life-long impact on pain and mobility.”
Maggie and Parker’s father, Chad, are thrilled to have their son back – they could see the constant pain taking a toll not only on him physically but mentally as he began to withdraw from the things he loved.
“I am feeling one hundred times better,” said Parker. “My life is back to normal. I’m not yet back to sports but willing to take the six to eight weeks [post surgical] rest required to get back to my sports over the pain I had.”
Linkous family: Grant, Nate, Maggie, Chad, Mallory and Parker.
