Definition

A rib fracture is a break in a rib bone. Bruised muscles and ligaments often happen with a rib fracture. With a rib fracture, the lungs and other organs can be injured. More than one rib fracture after a trauma can indicate serious internal injury.

Multiple Rib Fractures with Damage to Lung

broken ribs resized

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Causes

Rib fractures are caused by:

    
  • A direct blow to the rib
  • Crushing of the chest, such as in contact sports or a car accident
  • Severe coughing incidents that can occur with lung problems or at high altitude
  • Rib fractures in young children are often a sign of abuse
  • Risk Factors

    Factors that may increase your risk of breaking a rib include:

        
  • Age: 65 years and older
  • Difficulty doing activities of daily living
  • Playing contact sports
  • Having weak bones
  • Having a chronic cough
  • Extreme repetitive upper body activity, such as in:     
  • Throwing athletes
  • Basketball players
  • Golfers
  • Rowers
  • Weight lifters
  • Having an occupation involving a lot of overhead lifting
  • Having a history of rib or chest fracture
  • Symptoms

    Symptoms include:

        
  • Pain in the ribs or upper chest area
  • Pain when coughing
  • Swelling and bruising in the fracture area
  • Severe local tenderness in the fracture area
  • Internal bleeding
  • Pain while breathing
  • Diagnosis

    The doctor will ask about your symptoms and how the injury occurred. Your chest, lungs, and back will be examined.

    Images may be taken of your bodily structures. This can be done with:

        
  • Chest x-ray
  • CT scan
  • MRI scan
  • Treatment

    Treatment includes:

    Rest

    Rest and do not do physical activity until the pain has gone away.

    Protection

    Your doctor may suggest wearing a chest binder around your ribs to protect them. The binder will also help you breathe properly. It is important to take some good breaths so that the lungs remain clear. Pneumonia can develop after rib fractures if you are not breathing deeply enough. If you play contact sports, you may need to wear a rib cage protector for 6-8 weeks when you return to playing.

    Medication

    Your doctor may recommend that you take over-the-counter medication to help reduce inflammation and pain, such as ibuprofen.

    Physical Therapy

    As your ribs heal, a physical therapist can teach you breathing exercises. The therapist can also help you maintain range of motion in arm and shoulder joints.

    Intercostal Nerve Blocks

    Special injections with local anesthetic can temporarily relieve pain.

    Epidural Anesthesia

    Sometimes, a temporary epidural catheter is used to place anesthetic near the spinal cord and nerves. This can help severe cases where the injury requires hospitalization.

    Hospitalization

    Hospitalization is usually only needed if there are complications such as damage to organs in the chest.

    Prevention

    Sometimes rib fractures cannot be prevented. To reduce your chance of fracturing a rib:

        
  • Wear protective equipment, such as rib pads, when playing contact sports.
  • Avoid over-training.
  • Learn the proper technique for exercise and sporting activities.
  • Maintain strong bones by:     
  • Getting plenty of calcium in your diet
  • Doing weight-bearing exercise
  • Not smoking