RIB FRACTURE. Explanation. Causes. Symptoms. Diagnosis

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Daniel Simpson
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RIB FRACTURE Explanation The heart and lungs are encased by the chest wall, which is composed of the ribs. The ribs must be flexible in order to allow movement during expansion and contraction.

1 RIB FRACTURE Explanation The heart and lungs are encased by the chest wall, which is composed of the ribs. The ribs must be flexible in order to allow movement during expansion and contraction. This movement occurs when you breathe, as the chest wall expands when breathing in, and it contracts when breathing out. In addition to breathing, the flexibility of the ribs allows for greater resilience and protection of the heart and lungs in case you take a blow to the chest. Ribs form the external walls of the chest. A fracture occurs when a bone suffers a break or crack, which can occur in the ribs. You may have heard the expression, cracked rib, before, which is essentially a fractured rib, except that the broken ends of the rib maintain contact, meaning that a full break has not occurred. With cracked ribs, flexible movements of the chest (like those that occur from breathing) are still possible and the heart and lungs are in no apparent danger without subsequent injuries. Causes A cracked or fractured rib most commonly occurs as a result of a sudden, significantly forceful external blow or pressure against the chest wall. It is not uncommon that you may experience more than one cracked rib at a time; however, the fractures of cracked ribs are only partial and fail to make a full break, making this injury less severe. Cracked ribs commonly occur during games high-impact contact sports, such as football or rugby, and also with automobile accidents, in which a blow to the chest occurs. Cracked ribs rarely occur as a result of exertion force, such as with the force of powerful throwing that one might experience in sports such as baseball. Symptoms The most prominent symptom of a cracked rib is the experience of moderate to severe pain that occurs during inhalation (breathing in) and exhalation (breathing out). This pain is likely to increase greatly with deeper breathing. You may notice some discoloration or swelling on the chest on or around the area of the injury, and you may experience a grating sensation when breathing. This is known as crepitus, and it occurs when the two broken ends of the injured rib rub together. If bleeding, especially that of a foamy nature occurs at the injury site or issues from the mouth, the injury is much more severe than a cracked rib, and you will need to seek emergency medical attention immediately. Diagnosis Prompt and correct diagnosis depends greatly upon your present symptoms, along with those listed in the above section. In addition to these symptoms, though, your healthcare professional will most likely request a history of your injury as well as possible events leading to the injury. Diagnosis is made simpler if the injury can be determined as the result of an impact to the chest wall.

2 Your health care professional will also check for signs of breathing trouble or strained breathing, as well as palpate (feel) the injury site. This is done to identify levels of tenderness, possible further injury or deformity, and to note the presence of crepitus. He or she may also order that an x-ray be taken of the injury site to further examine the significance and severity of the fracture. Treatment During the first 48 hours following the incident, you should exercise the use of cold applications (ice packs) to the injury site at least 3-4 times daily, as this can greatly reduce swelling and inflammation. Heat application may also be helpful in minimizing the pain of your injury, though hot and cold applications should be alternated if both used. The primary extended treatment for a cracked rib is to relinquish activities that require active participation or forceful physical contact or that increase the depth and frequency of your breathing. This means that you should abandon any contact sports or rigorous exercise until the injury is healed. Your healthcare professional will likely prescribe non-steroidal anti-inflammatory drugs (NSAID s) to help reduce pain, swelling, and inflammation. Take these according to prescription. It is also possible that your healthcare professional may fit your chest wall with an elastic bandage in an effort to keep the fracture ends of the cracked ribs in constant contact, or he or she may even opt to splint the area. This involves compressing the injury site with a pillow while having you take a deep breath to ensure that your entire lung is still operational. The splinting makes pain manageable during this maneuver. As soon as physically possible (when pain has lessened), you should take deep, long breaths at least once every hour in order to maintain full and proper function of the lungs. Lasting Effects Recovery time for a cracked rib can vary depending upon the age of the patient and the severity of the injury. In children, the injury tends to heal faster, usually within around 4 weeks. In most cases, though, the fracture will heal within 5-6 weeks, though some discoloration may remain for up to 8 weeks. Healing Time and Return to Play As stated before, typical healing time for a cracked rib is 5-6 weeks, though return to activity may require extended time. You should not return to sport or activity until discoloration, tenderness, and pain dissipate entirely. If tenderness or pain still occurs with deep breathing, do not return to activity or sport. This is significant, especially if you intend to return to a contact sport, as a second injury to a rib that is not entirely healed could result in a much more serious injury. While it is generally accepted that you can return to non-contact sports within 4-6 weeks, you should wait at least 8 weeks before returning to contact sports. Prevention The preventative measure you can take is to wear protective gear and equipment while partaking in contact sports or activities; however, in most cases, cracked ribs occur as results of sudden, unpredictable events and cannot be prevented.

$Rehab Recommendations The simple approach in rehabilitating a fractured rib is to simply avoid any activity that feels strenuous to the midsection and core.$ Listed below are a few stretches and exercises that should be safe to perform during the healing time. BICEPS STRETCH 1.

Listed below are a few stretches and exercises that should be safe to perform during the healing time. BICEPS STRETCH 1.

Begin stretch by simultaneously moving both arms backward around you as far as your shoulders and biceps will comfortably allow. 3.

3 Rehab Recommendations The simple approach in rehabilitating a fractured rib is to simply avoid any activity that feels strenuous to the midsection and core. When you start feeling some relief you can then incorporate some deepbreathing stretches and exercise movements. Listed below are a few stretches and exercises that should be safe to perform during the healing time. BICEPS STRETCH 1. Stand with both arms extended out shoulder height in front of you or out to your sides (switch view). 2. Begin stretch by simultaneously moving both arms backward around you as far as your shoulders and biceps will comfortably allow. 3. From the fully stretched position slowly reverse the motion and bring hands back in front of you. 4. Repeat for prescribed number of reps. SIDE BEND STRETCH 1. Stand with your feet spread wide and arms held up to the side at shoulder height. 2. Begin stretch by leaning the trunk to one side as you exhale and reach down toward the foot with the hand on that side while reaching straight up with the opposite arm. Be sure to keep the knees straight. 3. Hold statically for 5-10 seconds, and then inhale as you slowly come up out of the stretch. 4. Repeat the same stretch by leaning to the opposite side. BALL CHOP 1. Set feet slightly wider than shoulder-width apart while holding a medicine ball overhead. 2. Begin Chop movement by flexing the hips, lowering the torso, and bringing the ball down between the feet while maintaining a flat, neutral back. Inhale during this phase. 3. From the bottom position, reverse the motion by lifting the torso, extending the hips, and raising the ball overhead as you exhale. 4. Repeat Steps 2 and 3 for the desired number of reps.

and knees. Your body should be in a straight line from your head to your knees. 2.

Once at the bottom, push up by extending the arms as you simultaneously exhale and come back up to the starting position. PULLOVER 1. Lie back on a bench with a curl bar held at your chest.

4 PUSH UP on knees 1. With knees on the floor, get into the starting position by leaning forward and placing your hands on the floor slightly wider than shoulder width apart and balancing your body weight on your hands and knees. Your body should be in a straight line from your head to your knees. 2. Begin the downward movement by bending your elbows as you inhale, and bringing the chest to the floor while maintaining the straight line position throughout the movement. 3. Once at the bottom, push up by extending the arms as you simultaneously exhale and come back up to the starting position. PULLOVER 1. Lie back on a bench with a curl bar held at your chest. (Preferably handed to you) 2. Gently press and push bar up and back over your face and down toward the floor, moving the arms in a semi-circle while keeping the elbows slightly bent. Breathe in deep and expand your chest during this phase. Go down as deep as your shoulders will comfortably allow. 3. Upon feeling a good stretch at the bottom, reverse the motion as you exhale and pull the bar up and over, following the opposite path from where you started. CHEST FLYE 1. Sit upright on a bench with a pair of dumbbells resting on your thighs. 2. Carefully roll back on bench and thrust dumbbells to the shoulders then lift bells above the chest at arm s length, held with palms facing each other. (Starting position). 3. Inhale as you prepare to Flye, then with elbows turned out and slightly bent, inhale as you slowly separate and lower bells in an arcing, steady and even motion. Go down to the point where you feel a good stretch in your pectorals (chest muscles). 4. Upon feeling the stretch at the bottom, exhale as you reverse the movement by lifting bells back up in the same arc motion, as when they were going down, and bring the bells back together (imagine hugging a large tree) to the starting position at the top, while maintaining that little flexion in the elbows.

5 INCLINE DUMBBELL PRESS 1. Sit upright on the seat of an incline bench with a pair of dumbbells resting on your thighs. 2. As you lie back on the bench, kick each dumbbell into position by individually thrusting each bell up with the thigh and hip to where both bells are up by the shoulders, with elbows flexed under each dumbbell and feet set flat on the floor. (Starting position). 3. Inhale as you prepare to press, then with bells by the chest, exhale as you press bells upward in a smooth, steady and even motion, as you straighten the arms and bring bells together at the top. Keep bells in the pronated grip. 4. With bells together at arm s length, slowly lower the bells by bending elbows, angled down and out, then gradually separate bells apart back down to the starting position with bells finishing at the sides of the chest. As the healing progresses, you can progress into more exercises. Most all chest exercises will help to strengthen and stabilize the rib structure. Incorporating upper back exercises, particularly overhead movements such as lat pulldowns and pull ups, as well as core and abdominal exercises, will also be beneficial.

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