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Home > Health & Wellness > Rib fractures

Rib fractures

Simple rib fractures usually occur as a result of blunt trauma and in the yachting community are often due to a fall onto a winch or stanchion. They are also caused by contact sports such as rugby and is a common cycling injury or road traffic accident when the chest wall makes contact with the handle bars or steering wheel.

Other causes of rib fractures are pathological in nature such as a cancer lesion or osteoporosis in older patients which, when combined with a bad cough, can cause a rib fracture.

Signs and Symptoms of a Rib Fracture

Pain on deep breathing. Sneezing and coughing will feel very painful and a bit frightening to perform.

Pain on palpation of the rib cage possibly inducing nausea and vomiting.

There may be bruising at the site of the impact.

Bending or rotating the body will be uncomfortable and cause breathlessness.

The rib cage comprises of the spinal column at the back, the ribs and the sternum at the front. Together they perform several functions which include muscular attachments for the back, abdomen, diaphragm, and muscles of respiration. The ribs also serve as a protective cage around vital organs such as the heart, lungs, and bronchi. The lower “floating” ribs offer some protection to the liver, spleen, pancreas and kidneys.

While it is rare for the lower “floaters” to be fractured (due to their flexibility) any suspected rib fracture should be taken to A and E as soon as possible to evaluate any possible organ damage.

Immediate Care

Ice pack should be the first aid of choice to help reduce bruising, swelling and relieve pain.

Any suspected rib fracture must be checked at the nearest clinic as when ribs break they can leave very sharp edges. Any organ or soft tissue damage may not be evident at the time of injury.

 Bandaging around the torso is helpful to support the rib cage when transferring to the A and E however this may well not be advised long term as the restriction will inhibit deep breathing and could give rise to a chest infection and even pneumonia.


Physiotherapy is not always a requirement for the recovery of a simple rib fracture however if there are more than one rib broken, you will certainly find relief from an appointment or two.

Your Physio will likely use cold therapy techniques and ultra sound to help any heamatoma. If after 6 to 8 weeks there is still difficulty in breathing, then gentle mobilisation techniques can be used to loosen up the rib articulations (with the spine) and which often become a bit “sticky” due to the lack of deep inspiration during the healing period.

Flail Rib

Flail rib fractures are when there is more than one break in multiple ribs such that there exists no connection in a portion of the rib cage.

Usually our chests inflate when we breathe in and deflate when breathing out however when a section of the rib cage is broken it will do the opposite due to a change in the stability of the respiratory vacuum.

Flail Ribs (also known as flail chest) is a serious condition and medical help should be sought immediately as this can cause a pneumothorax (collapsed lung) or heart insufficiency with severe consequences if not quickly attended.

Tracey Evans

The Physiotherapy Centre


+34 609 353 805