Step 2 lower than Step 1

Ideally you want to trend upwards. This will be a red flag for some programs. If I were you I would apply to A LOT of programs and meet with your advisors about a backup plan. However, If you rotated well you still have a good chance at matching I would think. Scores aren't everything, but I wouldn't expect to have a lot of interviews.

I wouldn't be too overly nervous. I got a 240 on Step 1 and then followed that up with a real stellar 224 on Step 2. To make matters more nerve wracking, I took Step 2 in April of my third year to just get it out of the way (which also happened to be the week before my wedding, probably not advisable again).
Needless to say, I still got a lot of interviews and no one ever brought it up. To give you an idea of my whole picture for comparison, I did not go to a top 50 school, I was in the south, I honored one clinical rotation third and fourth year (surgery), I was nominated but did not get AOA, I had a lot of leadership stuff in medical school, I had two ortho publications (one in JBJS) and had an Academy presentation. I applied to 49 places because I was couples matching) and got 20 interviews including HSS, Brown, Jefferson, Duke, CMC, Pitt, Rush, Northwestern, Stanford, and UCSD and am now a PGY-3 at one of those places.
So, long story short, dropping down on Step 2 is not ideal, but also not the end of the world.

The Step 2 mean this year is 238 and the std deviation is 19.
Step 1 mean last year was 222 with a std deviation of 22.

So that's a pretty big drop lower in terms of relative performance.

Thanks for this, that is a little reassuring. I'll just be ready to answer any questions about it and do my best not to bring it up on my own.