Initial Phase – immediately after diagnosis or injury
It is important to rest the ribs and modify your activity level so you do not place undue stress on the ribs. This may cause re-fracture, or worse, nonunion of the bones. If the rib fracture is high, you may need to hold your arm in a sling to avoid strain and pulling on the ribcage.
Latent phase – when pain is diminished and an X-Ray shows rehealing of the bone
Make sure to return to activity gradually for soft tissue and bony tissue to adapt to the strains of your sport. Focus at this stage should be on strengthening supporting muscles of the arm and torso, to prevent further strain on the newly-healed rib bone. For e.g. bicep strengthening through bicep curls can take some weight and pressure of your ribs when performing certain activities like throwing or swinging a racket. Core exercises shown by a physical therapist can help gradually strengthen your back and abdominal muscles to strengthen the torso, especially needed on contact sports.
Gentle stretching to the shoulder and trunk can help expand your chest cavity and may make breathing and moving easier. Stretching may also alleviate pain that is referred to the back or shoulders from the rib fracture, or pain from wearing an arm sling.
For patients who are frail and elderly, physical therapy can help the patient walk and normalize some function with a rib fracture. A physical therapist can train the patient to transfer between bed and chairs safely, while observing precautions that make the rib pain worse. A PT can also help with managing comorbidities like osteoporosis, diabetes, that may have indirectly caused the rib fracture in the first place via a fall or accident. To counteract the frailty, strengthening and balance exercises can be prescribed in physical therapy so re-injury does not occur.
Fractures of bones take at least six weeks to repair themselves, so exercise patience. Pain modulation is important for comfort, and your physical therapist can choose to do TENS electric stimulation to help modulate the pain non-narcotically. Consult with your physician if you wish to have prescribed medications for the broken rib pain.
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