Fractured ribs

The ribs are an important part of the chest wall that protect underlying internal organs. Rib fractures commonly occur in the seventh and tenth ribs. The first rib is normally protected by the clavicle or collarbone, while a lower rib fracture can injure the diaphragm, resulting in a diaphragmatic hernia. Fractures usually occur from direct blows or from indirect crushing injuries. Simple rib fractures are not life-threatening, but can be painful and lead to severe injury inside the abdomen and chest.

In young people, rib fractures may be sustained during sports or recreational activities. In adults and the elderly, they may be the result of a vehicular accident or falling from a height. However, ribs can be fractured by means other than direct trauma. Prolonged coughing, cancer or infection, osteoporosis or diseased bones can all lead to fractured ribs.

The most common indicator is pain during breathing. There may be a grating sound with breathing or movement and the chest wall may flail. This is a potentially fatal condition in which multiple adjacent ribs break in a number of places, causing a portion of the chest wall to move separately from the rest of the chest. The flail segment moves in while the rest of the chest moves out.

Pain from simple rib fractures can make movement and breathing difficult. The person may also try to suppress coughing, which can lead to infection. Early mobilisation is important to prevent infection, pneumonia, constipation and deep vein thrombosis (DVT).

Physiotherapy can help in a number of ways:

• Assist you to walk, while heeding necessary precautions
• Train you in safe transfer methods
• Manage co-morbidities. Osteoporosis, diabetes and cardiovascular disease can all be safely managed during physiotherapy
• Strengthening and/or flexibility exercises to prevent falls

Even though there is no specific treatment for broken ribs, the potential danger that this injury poses and the conditions that may cause the fracture, make physiotherapy for rib fracture victims a necessity. Patients may emerge from therapy much better off than they were before the incident.