(Broken Rib; Fracture, Rib)
A rib fracture is a break in a rib bone. Bruised muscles and damaged 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
Rib fractures are caused by:
- A direct blow to the rib
- Crushing of the chest, such as in contact sports, a car accident, or having CPR
- Severe coughing incidents that can occur with lung problems or at high altitude
- Rib fractures in young children are often a sign of abuse
Rib fractures are common in people 65 years and older. Other factors that may increase your chance of a rib fracture include:
- Difficulty doing activities of daily living—generally with eldery people
- Playing contact sports
- Weak bones
- Chronic cough
Extreme repetitive upper body activity, such as in:
- Weight lifting
- Occupations involving a lot of overhead lifting
- History of rib or chest fracture
Rib fracture may cause:
- Pain in the ribs or upper chest area
- Pain when breathing or coughing
- Swelling and bruising in the fracture area
- Severe local tenderness in the fracture area
- Shortness of breath
- Internal bleeding
The doctor will ask about your symptoms and how the injury occurred. Your chest, lungs, and back will be examined.
Imaging tests can evaluate your chest and surrounding structures. These may include:
Treatment may include:
Your doctor may suggest wearing a chest binder around your ribs to protect them. The binder may help you breathe properly. It is important to take deep 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.
Your doctor may recommend that you take over-the-counter medication to help reduce inflammation and pain, such as ibuprofen.
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.
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.
Sometimes rib fractures cannot be prevented. To help reduce your chance of a rib fracture:
- Wear seat belts with shoulder strap.
- 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
Ortho Info—American Academy of Orthopaedic Surgeons
Trauma—Care of the Injured
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
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Broken or bruised ribs. NHS Choices website. Available at: http://www.nhs.uk/conditions/rib-injuries/Pages/Introduction.aspx. Updated April 29, 2015. Accessed August 4, 2015.
Fractures (broken bones). American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00139. Updated October 2012. Accessed August 4, 2015.
Gregoretti C, et al. Regional anesthesia in trauma patients. Anesthesiol Clin. 2007;25(1):99-116.
Rib fracture. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries-poisoning/thoracic-trauma/rib-fracture. Updated August 2014. Accessed August 4, 2015.
Rib fracture—emergency management. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Accessed August 4, 2015.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Barrett-Connor E, Nielson CM, Orwoll E, et al. Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study. BMJ. 2010;340:c1069.
Last reviewed August 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.