Rib Strain

Injury to any of the muscles or tendons that attach to the ribs. A muscle, tendon and rib comprise a unit. The units stabilize the chest, breastbone and upper spine and allow their motion. A strain occurs at the weakest part of a unit. Strains are of 3 types:

• Mild (Grade I)- Slightly pulled muscle without tearing of muscle or tendon fibers. There is no loss of strength.
• Moderate (Grade II)- Tearing of fibers in a muscle, tendon or at the attachment to a rib. Strength is diminished.
• Severe (Grade III)- Rupture of the muscle-tendon-rib attachment with separation of fibers. Severe strain requires surgical repair. Chronic strains are caused by overuse. Acute strains are caused by direct injury or overstress.

Body Parts Involved

• Tendons and muscles of the chest, back and abdomen that attach to any of the ribs.
• Ribs.
• Soft tissue surrounding the strain, including nerves, periosteum (covering to bone), blood vessels and lymph vessels.

Causes

• Prolonged overuse of muscle-tendon units that attach to the ribs.
• Single violent injury or force applied to the muscle-tendon units in the chest.

Signs & Symptoms

• Pain with motion, breathing or stretching.
• Muscle spasm.
• Tenderness to the touch.
• Swelling.
• Crepitation ("crackling") feeling and sound when the injured area is pressed with fingers.
• Calcification of the muscle or tendon (visible with X-rays).
• Loss of strength (moderate or severe strain).

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

Follow instructions for R.I.C.E., the first of rest, ice, compression and elevation (If possible).

Continuing Care

• Continue ice massage 3 or 4 times a day for 15 minutes at a time. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
• After the first 24 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments
  and ointments.
• Take whirlpool treatments, if available.
• Wrap the injured chest cage with an elasticized bandage or rib belt between treatments.
• Massage gently and often to provide comfort and decrease swelling.

Medication

• For minor discomfort, you may use:

Aspirin, acetaminophen or ibuprofen.

Topical liniments and ointments.

• Your doctor may prescribe:

Stronger pain relievers.

Injection of a long-acting local anesthetic to reduce pain (rare).

Injection of corticosteroids, such as triamcinolone, to reduce inflammation (rare).

Home Diet

Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry,
cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Diagnostic Measures

• Your Own observation of symptoms:
• Medical history and exam by a doctor.
• X-rays of the chest to rule out fractures.

Prevention Tips

• Participate in a strengthening and conditioning program appropriate for your sport.
• Warm up before practice or competition.
• To prevent a recurrence, tape the rib area before practice or competition.