UKC

Hi all,

Im looking for some advice about a rib injury and thought this might get the most informative  reply from people who have had them.

In short I had pneumonia, 2 weeks of coughing so hard my chest was throbbing, then one day I “heard” a crack while coughing and felt an intense stabbing pain. X-rays don’t show a break but the rib that hurts is now sunken about a cm below the others. It’s not sure to touch except if you follow it along so there it changes from bone to cartilage, it’s not a true rib. At that point I can feel a gap and a LOT of pain. Coughing even lightly makes me involuntarily shield my chest, I can’t carry much weight, walk or move easily, same with sitting up. 
 

The break happened 15 days ago now and the advice was to do normal activities but don’t go till it’s really sore. 
 

how long do these things typically take to feel improvement as it not easing up. 
 

im usually very active but i can barley go 30m a day until im in throbbing pain. I’ve got codeine as a painkiller but while I can move while taking it, it hurts so much more the next day, so im trying to stick to over the counter where possible, although some days im struggling to inhale after doing light tasks.

there is no blood, bruising, swelling or extrnal marks, and it’s not stuck in my lung, just hurts like hell and apparently can take a year to heal… not optimistic 

anyone damaged a rib like this and have experience to share?

In reply to OJ102:

I damaged ribs by leaning on my chest pulling onto a ledge. No break but probably tore intercostal muscles or something like that. It was about 5 months before I was pain free although after about 2 or 3 months I was mostly back to regular activity and just putting up with it!

In reply to OJ102:

I fell off my bike a few years ago, after hitting a pothole.  Landed heavily on my side.  My friend 'diagnosed' it as he'd bust a rib a few months before.   He was quite amused...

Yes it's a bit of a bugger.  The medics will just let it heal and it will.  After 2 or 3 months....

You want to avoid activities that make you breathe deeply or twist your upper body.  Oh, and your friends will take the p*ss, to make you laugh.  Laughing and coughing are definitely off the menu for a while.  Ditto climbing, unfortunately.

Best wishes

Dave

In reply to OJ102:

Ive broken two, both cycling related, I avoided coughing and laughing, otherwise pretty much carried on as normal, took about 4 weeks for it to no longer be noticeable 

In reply to OJ102:

Depends on your age. I'm mid-30s and it took ~4 weeks to recover from what was probably a less serious injury by the sounds of things. I took lots of painkillers for the first week or so in order to sleep (lay off the codeine btw - v addictive).

I found that if I aggravated the injury it felt significantly worse for a few days so I stopped all activities, including picking up children / shopping / laptop bag. Driving also hurt so I tried to avoid driving. I also made an effort to sleep more, eat well etc.

Bad luck!

In reply to OJ102:

I broke a rib a week ago. One piece of advice which I found helpful was to make sure to take, and hold, 5x deep breaths every hour when awake. Otherwise there can be a risk, with shallow breathing because of the pain, that air-sacks (alveoli) don't inflate and that can lead to chest infections. 

In reply to OJ102:

I injured my ribs bouldering once - fell off sideways and landed with my arm between my ribs and the matting.

Thought it was broken as it was intesely painful to move, but was diagnosed as just tearing and damage to the tissue between the ribs.

Unfortunately (I was told), this tissue is incredibly dense, and so when damaged takes a long time to heal. I think it was at least 2-3 months for me to get back into light bouldering again.

Good luck - hope it heals up okay and you don't go too crazy waiting to recover!

In reply to OJ102:

I fell off my bike in November, think it took a couple of months to completely heal. I went climbing 2 weeks after the fall and it felt OK, but the following day it was pretty sore. I could do hangboarding but certain movements like mantling or push ups were painful. I remember an initial improvement then a plateau where the recovery really slows down, then it's fine. 

In reply to OJ102:

I broke all twelve on my right side, several in several places, resulting in a flail segment and a punctured lung, in a bad ground fall at Rivelin years ago. A doc on the Edale MRT probably saved my life by getting me breathing again at the crag. Luckily I had a brilliant and innovative surgeon at NGH Sheffield who rebuilt me in a pioneering operation. When I asked him what I should do in terms of getting back to climbing, his reply was essentially do what you like as long as you can stand the pain. I was back bouldering in four months and back on long days in the Alps in seven. Thank god for MRTs and the NHS.

In reply to Leonard Tedd:

Never broken a rib, but when I had abdominal surgery I was told to use painkillers to allow diaphragm breathing, because it's not good to only breathe with the top part of your lungs. Yes Codeine is addictive long term, but it's also very effective.

Thanks for all the fast responses!

I think I’m sat at the healing plateau, the pain has localised right on the break, tho when I push it, the area around swells up so no so great, and the next day I feel like I’ve been on a mountain hike with a backpack full of rocks.

im mid 30s but never had the joy of a broken bone. Even after having my appendix out I was recovering far faster than this.

Thankfully I don’t seem to have an issue with the addictive nature of the painkillers, I was left on dihydrocodeine for almost a year when I was suffering chronic migraine, when I dr changed the new one raised a flag on that! Tho by then I was only using them once a month at most when my head felt like it was melting. Also learnt that you build a tolerance to them fast if taken frequently so I saved them for when I really needed the numbing effect. Doing the same thing now, only taking them in the evening to help me go to sleep or if I push it too much. I don’t like sitting around so this keeps happening!

My main concern was a misaligned heal as my rib is noticeably not in the right place but sounds like it will usually sort itself out over time.

In reply to OJ102:

This could read as 'do whatever you would normally do' which would be fine if that only involves driving to work, cooking, etc.

I broke a rib a while ago. Laughing is certainly to be avoided. I'd say it was 6 weeks before I could start to gingerly do my normal activities and about another 6 until I was 'back to normal' albeit I used to get the occasional twinge of pain up to a couple of years afterwards.

In reply to WastelandBilly:

Yes, that's why eating spare ribs is tasty. There's a lot of solid meat in there!! (pork and lamb I mean, never tried the Hannibal Lecter approach, but should be the same as pork)

Incidentally some people have an extra rib ~1% of people (lumbar), about 0.5% of people (mainly women) have an extra one higher up (cervical).

In reply to OJ102:

Hi

wait 10 weeks in total, first 6 for bone healing if there is a fracture, total 10 weeks to stabilise, then if any painful or functional restriction remains go and see a physio or osteopath who knows how to treat rib dysfunctions.

good luck

In reply to OJ102:

I'm afraid this isn't going to help much, but it may be good for a (painful) chuckle or two.  It was written, by me, in the style of the American Alpine Club's Accidents in North American Mountaineering.

ACCIDENTS IN NORTH AMERICAN MOUNTAINEERING 2021

FALL ON FRONT STEPS—INADEQUATE INTELLIGENCE, POOR EQUIPMENT, VOCAL INCOMPETENCE.

On February 15, the victim, RG, a 77-year-old homeowner with 77 years of experience, embarked on a solo expedition to his driveway.  The weather was clear and temperatures were above freezing, but a hard freeze overnight had left a glaze of ice on the second of three front steps.

It is the Editor’s experience that even experienced homeowners frequently underestimate their front yard.  RG was shod in bedroom slippers, had no microspikes or crampons, was not wearing a helmet, and had no self-rescue equipment with him, even though all these items were a scant twenty feet or less from the Steppes.  Whether RG was negligent in his selection of equipment, simply oblivious to the dangers of the homestead environment, or supremely overconfident in the face of significant risks, his poor preparation for the excursion was a significant factor in the adverse outcome.

The verglas on the Second Step was almost invisible, and RG’s foot shot straight off at the moment of contact, pitching him backward and slamming his back onto the sharp upper edge of the Third Step, resulting in an involuntary scream that no one in the neighborhood paid the least attention to, and what RG described as excruciating pain.

Semi-incapacitated and lying in agony on the Steppes, RG reports considering a helicopter extraction, but was dissuaded from making the call for fear of the prop wash damaging the daffodil shoots just popping up in the yard.  And so he opted for an epic self-rescue which involved a painful and laborious ascent of the Third Step, followed by several feet of crawling up to and over the threshold, where he was greeted cheerfully by his wife, who had heard the scream but thought it was cats meowing.

X-rays showed no displaced rib fracture, but the pain level suggested the diagnosis of cracked ribs.  The latest treatment, using the HUS Protocols (Harden Up Snowflake), was prescribed and carried out, with medication amounts that caused ibuprofen stocks to set records on Wall Street.

It was difficult to manage any kind of exercise during the healing process, and unable to perambulate properly, RG was forced to stay home and take pictures of kitchen utensil shadows.

Nurse Dana provided valuable medical knowledge and encouragement, and revealed that when The ex-president said, “One day—it's like a miracle—it will just go away,” he was referring not to Covid 19 but rib injuries, which are easily confused with Covid 19.  And so it was.  After six and a half weeks, one day the pain was gone.  Of course, it is now understood that many victims will have to grapple with PSRD (post-stupidity recrimination disorder) and that a return to normal may be delayed.

ANALYSIS.  The multiple errors made by RG in sallying forth from his home with inadequate preparation and equipment are too obvious to repeat.  Perhaps the most critical adjustment going forward would be to learn an agonized scream that does not sound like a cat’s meow.

In reply to OJ102:

From many rugby injuries over the years, recovery takes 4 weeks plus 1 week for every decade over 23 years of age.

Also stop playing rugby before you get to your late 40s.

In reply to OJ102:

I have done a few ribs over the years, park skiing, mountain biking etc. Generally takes 6-8 weeks to get back to some level of normal activity. Don't expect to be fully pain free though and painkillers probably will help for a while after this. Good thing with this injury is that generally it doesn't set you back too much as long as you stop whatever you are doing when it starts hurting unlike some other injuries where getting to that point can often set your recovery back several weeks. Anyway good luck, the body is amazing at healing itself if you give it decent food and sleep well. 

In reply to OJ102:

Are you icing it?  I've been told this is a good idea but maybe only if there's swelling?
I'm writing this with an ice-pack nestled against my injured ribs which I hope is speeding up the healing process but it's hard to tell - improvement is frustratingly slow!  You have my sympathy...

Did mine trying a boulder problem with a graunchy beached whale style top out 2.5 weeks ago.  Felt something give and pop on the right hand side of my rib cage and immediately thought that's not good.  I dropped off expecting pain to imminently rush in but strangely it never did.  The discomfort and pain seemed to get progressively worse for a week or so despite just resting it, stayed the same for another week (I have to roll out of bed carefully, can't sit up) and then hopefully slightly improving the last few days.  Confident nothing's broken but the right side of rib cage looks worryingly sunken and out of place compared to my left where the bottom rib protrudes significantly more - no idea if there was an asymmetry there before the incident!  Like you, no external marks or bruising.  Can't climb at all but count myself lucky that sleeping, deep breaths (most of the time), walking and road cycling aren't too painful and don't seem to be aggravating it.  Remember doing something similar on the top out of the tube at back bowden but think that was days rather than weeks to recover from.  

In reply to Ram MkiV: Ice for the first 2-3 days max then move to heat to improve blood flow. 

In reply to OJ102:

Bad luck ! You’ve probably damaged your costochondral junction where the front of the ribs meet your breast bone ( sternum ). Not uncommon in blunt trauma and very painful. Keep deep breathing and being gently active. Some people develop a permanent clicking feeling if it does not heal properly but in 4-8 weeks it will be much improved. From my own personal experience it took ages to heal damaged ribs from either fracture or intercostal muscle tears . Ibuprofen ( if tolerated) and keep active. 

The healing time for an injury doesn’t worry me as it’s finite generally, what is nagging at me is the rib that’s damaged is indented about a cm into my chest.

It appears to be one of the false ribs so cartilage break as opposed to bone, though it hurts like hell even if it’s not bone. 

when I run my fingers down the ribs on each side, the left side is curved slightly as it normally is, the right follows the same curve except one rib isn’t there, and when you go to the gap and press, it’s hiding! And then hurts like hell!
 

I have a smart watch and it’s turned into a mini game of seeing how upset the vitals get as I’m trying to do house work, actual work isn’t really happening as that takes a lot more activity.

I went for 1 afternoon of work to test the waters and got a high score HR of 160 for 2 hours. I spent the next day feeling like my chest was imploding. The more my HR rises the more it hurts, which makes me breathe deeper leading to Me coughing which hurts more and further increases me HR… it’s like a catch 22…

Ive read about rib dislocation and such but the prognosis isn’t informative, then can’t put a plate over cartilage to repair it can they else it would t flex!

do cartilage breaks in ribs go back to their home after a while? If I could grip the damn thing and pull it up as I’m sure it’s why it’s hurting more…

In reply to Ram MkiV:

No swelling so the ice just makes me cold. I’ve always favoured heat anyway and when it’s sore I’ll lay a hot water bottle across it and the pain stops. Tho I think it’s more of a pain displacement therapy by overloaded stimulus but it works. I use the same trick when I have a migraine coming on, only I’ll put it right down my spinal cord, skin goes a charming crimson colour for a good day or so but it helps with the pain.

in regards to the rib the sunken thing is defiantly a common denominator between us, I have to get out of bed sideways too as I can’t sit up unaided, and when I do, it’s very sore for a few minutes like my organs are pulling on the rib. 
 

I’ve always been bad for overdoing physical work, I dont tend to feel fatigue while busy, but once I stop it comes in a wave. This hits like a tsunami the moment I step too far, without any warning… hope your recovery is going well tho!