Rib Injury

What is a rib injury?

The 12 ribs on each side of your child's chest may be bruised, strained, broken, or separated. All of the ribs are attached to the vertebrae (backbone) in the rear. In the front, 10 of them are attached to the sternum (breastbone) by pieces of cartilage. Direct blows to the ribs may bruise or break the ribs or injure the rib cartilage. The ribs may tear away from the cartilage that attaches them to the breastbone. This tearing away from the cartilage is called a costochondral separation. If a rib cartilage gets inflamed it is called costochondritis.

How does it occur?

Rib injuries usually result from a direct blow to the chest wall. Breaks usually occur in the curved portion of the outer part of the rib cage. A costochondral separation may occur from an injury, when your child lands hard on the feet, or even when coughing or sneezing violently. Costochondritis may be caused by an infection, repeated coughing, or overuse, such as rowing or heavy lifting. Sometimes the cause is not known.

What are the symptoms?

A rib injury causes pain and tenderness over the place of injury. Your child may have pain when you breathe, move, laugh, or cough.

How is it diagnosed?

Your child's healthcare provider will review the symptoms, examine the rib cage, and listen to the lungs. He or she may order a chest X-ray to look for rib damage, lung damage, or bleeding around the lungs.

How is it treated?

To help your child's injury heal, your child's provider may recommend that your child:

• Rest.
• Put an ice pack over the injured rib for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away.
• Take an anti-inflammatory or other pain medicine.
• Wear a rib belt. This is sometimes used for very painful injuries. The belt works as a girdle for your child's chest and helps support the ribs. It limits movement when coughing, breathing, or moving the body in other ways. This helps decrease pain. If your child wears a rib belt, your child's provider will give them breathing exercises to help them avoid lung problems.

How long will the effects last?

Bruised ribs and a costochondral separation usually take 3 to 4 weeks to heal. Broken ribs take 6 to 8 weeks to heal.

When can my child I return to normal activities?

Everyone recovers from an injury at a different rate. Return to your child's activities will be determined by how soon their ribs recover, not by how many days or weeks it has been since the injury has occurred. The goal of rehabilitation is to return your child to normal activities as soon as is safely possible. If your child returns too soon they may worsen their injury.

Your child's healthcare provider may take an X-ray to see that the bone has healed before he or she allows your child to return to normal activities. Your child may participate in noncontact activities if they can do so without pain in the ribs and without pain when breathing.

How can my child prevent a rib injury?

Ribs are often injured in accidents that are not preventable. However, in contact sports such as football it is important to wear appropriate protective equipment. Always make sure children wear seatbelts in a car.

When should I call my child's health care provider?

Call immediately or go to the emergency room if:

• Your child has worsening pain.
• Your child has trouble breathing.