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A direct blow to the chest can result in rib trauma. This may include anything from bone bruising to a fracture in one or more of the ribs. Rib fractures most commonly occur on the curved portion of the ribs. The ribs can also tear away from the cartilage on their attachment on the breastbone. This is known has a costochondral separation as it occurs at the costochondral (rib to breastbone) joint. Costochondral separation can occur with violent coughing, sneezing or when landing on your feet from a height.

There are 12 pairs of ribs in the human skeleton that protect the lungs, heart and abdominal organs from damage. All the ribs have an attachment posteriorly into the spine. The first 10 pairs of ribs also attach anteriorly into the breast bone with the last 2 pairs of ribs being floating ribs due to them having no attachment anteriorly.

Symptoms of Rib trauma

There will be pain in the area of injury. The pain is usually worsened with deep breathing or coughing as this causes movement of the ribs. If there has been a direct blow to the chest wall then there will also be bruising and swelling. There will also be local tenderness of the involved ribs and muscle spasm in the area of pain.

Diagnosis and treatment

An x-ray will be done to confirm the presence of a rib fracture. Your doctor will also asses your lung function and the integrity of your abdominal organs as occasionally the ribs can pierce them when a rib fracture has occurred. In the cases of a rib fracture they are usually left to heal on their own provided no further damage will occur.

Your physiotherapist will be able to help to reduce pain and maintain optimal lung function. Treatment may include the use of electrotherapeutic modalities, ice, heat, gentle soft tissue therapy and breathing exercises. Rib fractures and rib bruising in most cases remains painful and tender for 3-4 weeks. In the case of a rib fracture sport should be avoided until healing of the fracture has occurred. Your physiotherapist will be able to help in your return to sport. If you are involved in contact sports then protective padding may be necessary to protect the ribs.