Dr. George 14.7

Rib Injury

Hey guys, what a day! Riding at Whistler was great … conditions were awesome, and the pipe was nicely shaped. We were fooling around a bit when I tried a McTwist and over-rotated, hitting the edge quite hard with my chest. I instantly knew something was wrong and the fun part of the day was over. When my breath slowly came back, I began to feel the pain. I tried hard to breathe, but couldn’t. I imagine that’s how it must be to drown. I managed to get down to the clinic, and the guys told me I broke my seventh rib. I had pain for more than six weeks and couldn’t even think of sneezing. It took me out for a while.-Deryl

Why do we have ribs?
We have twelve ribs on each side that form a cage around the lungs, heart, and main vessels to protect them against injury. We also need ribs to breathe. The rib cage is quite elastic, and the lungs are inflated within this space by a vacuum between each lung and the rib cage. The muscles connecting the ribs also help us breathe by supporting the inspiration and expiration movement of the chest.

What should be done when a chest injury occurs?
Rib fractures are the most common serious injury of the chest and can be found in approximately six percent of all snowboard injuries. They occur mostly in the middle and lower ribs with blunt trauma and also with direct force to a small area of the chest wall. A violent muscle contraction of the rib-bridging muscles can lead, in rare cases, to a fracture of the rib, too. Most chest injuries are from contusions or single-rib fractures and are more or less harmless, but all chest injuries should be taken seriously. A proper medical examination with an X-ray is a must because even with minor trauma, part of the lung can collapse and stop functioning (known as pneumothorax). Shortness of breath is a significant sign of pneumothorax, but it doesn’t always occur. This needs immediate medical attention! Symptoms worsen in high altitude, so the injured person should be brought to a lower altitude immediately.

How is a rib contusion or a fracture of one or two ribs treated?
Chest injuries in general can be quite painful, last up to several weeks, and are usually caused by a direct impact. The pain of having a broken rib or just a sprained one is almost the same, as is the treatment. Because of the inflammatory reaction of the surrounding tissue, usually the pain worsens the second day. The diagnosis of a broken or sprained rib is simple. The area is usually very sensitive against the applied pressure of a fingertip. As with most trauma, never put heat on the area. If you do, you won’t be able to move the next day. The best thing is to put ice on it, but don’t put ice directly on the skin-always put a towel or something similar between. Always apply cold intermittently, such as twenty minutes on, two hours off, et cetera.A rib belt also helps to limit the pain. The belt bridges the muscles in case you sneeze or cough by limiting the pull of the muscle on the sprained or broken rib. To reduce the pain, analgetics are extremely helpful. Always try to breathe normally, even if it hurts, to avoid pneumonia (lung infection). Healing should be well on its way before you return to snowboarding.

Dr. G. AhlbÃ'umer, better known as Dr. George, is an orthopedic surgeon at the well-known Klinik Gut in St. Moritz, Switzerland. Apart from surgery, he specializes in injury prevention. You can e-mail Dr. George directly at dr-george@biomex-protection.com.