Brief Outline of Broken (Fractured) Ribs
Contact sports such as football and hockey, or sports that may result in falls or blunt trauma to the chest have a higher incidence of rib fractures than other sports. Extreme sports, horseback riding, and martial arts are other examples of activities that may result in this injury. Pain and tenderness over the rib cage after blunt trauma or a fall, especially with difficulty breathing, should always be treated as potentially broken ribs, and medical help sought.
Anatomy and physiology
There are twelve pairs of ribs, comprising true, false, and floating ribs. The first seven pairs are known as true ribs, and attach by costal cartilage directly to the sternum. The next three pairs are known as the false ribs, and attach to costal cartilage but not directly to the sternum. The final two pairs of ribs are known as floating ribs, and lack attachment either to costal cartilage or to the sternum.
The ribs protect the organs inside the chest (thoracic) cavity, and are also essential in the breathing mechanism. The muscles responsible for opening up the chest cavity, to allow air to enter the lungs, attach to the ribs. The ribs are more flexible than many other bones due to their cartilaginous attachments. When the ribs or the cartilage attachments fracture or break, they weaken the support and protection of the chest cavity. This also interferes with the muscles’ ability to open the chest cavity effectively to allow for adequate ventilation, which results in poor air intake and oxygen exchange. Any of the ribs may fracture, and often more than one ribs is involved in the injury.
Cause of Broken Ribs
Hard blow to the chest, side or back. Fall, landing on the chest, back or side. Forceful coughing – most common in people with impaired bone health e.g. osteoporosis.
Signs and symptoms
Pain and tenderness over the fracture site, which may be noted also when pressing on the sternum or compressing the rib cage. Pain and difficulty breathing, especially on inhalation. Depending on the number of ribs involved, irregular movement of the chest during respiration may be noted, as well as some swelling.
Complications if left broken ribs unattended
Fractured ribs that are left unattended will be painful and could lead to infections in the lungs due to shallow breathing. Reduce oxygen levels may result from the lower volume of air taken in. The bone ends may separate and cause damage to the delicate lung tissue underneath, causing a punctured lung or other damage; possibly even to the heart. Overall stability of the chest cavity will be affected also.
If a rib fracture is suspected, seek medical attention.
Rehabilitation and prevention
Rest is essential for recovery and repair of fractured ribs. It is important to take at least one deep, lung expanding breath each hour to ensure adequate lung tissue involvement and avoid infections in the lungs. Protecting the injured area until it is completely healed is important. Due to the inability to totally rest this area because of its constant movement during respirations, it takes longer to heal, usually 6-8 weeks. When returning to activity, this area should be padded and protected for an additional week or two.
Building muscle mass in the chest and back will help protect the ribs from injury. Using properly fitting and appropriate protective equipment will help to protect the ribs also. Avoiding trauma to the rib cage is the most important step in preventing rib fractures.