Healing a sprained ribcage.....the right way.

Do-it-yourself rehab for the non-severe sprained rib

By Matthew Colby, DC, MUAC

For most dedicated athletes, treating minor injuries means only occasional trips to a doctor or therapist.  For the Brazilian Jiu Jitsu athlete, minor sprains and strains are commonplace and self-rehabilitation for certain injuries is a valuable skill to master.  Rib sprains are some of the most common injuries I see in BJJ athletes and can often be self-managed.  In fact, proper self-treatment is a must with a sprung rib or ribs, since they have a tendency to heal improperly.

A forceful twist of your ribcage can result in a rib strain or sprain.  The rib may even pop out of place at the time of injury or click in and out repeatedly later on.  Rib sprains can easily become a far more miserable chronic issue called slipping rib syndrome.  Many BJJ athletes come in with this problem, which can leave you sidelined for months and plague your training indefinitely. It is important for the BJJ athlete to take rib injuries seriously to avoid slipping rib syndrome or re-injury. 

Unfortunately, time is a big factor for a sprained rib.  Three weeks off the mat is the minimum time you should allow for the injured connective tissue to heal to the point of being fairly stable.  Even now your likelihood of re-injury is still very high.  Preventing this from becoming a chronic problem should be your highest priority. Sprained ribs are notorious for re-injury.  BJJ athletes are notorious for returning to training too soon. Don’t underestimate the time required to heal.

When you return to the mat, a proper warm-up and cool down is crucial.  Be sure to:

1.       Heat the area for before training.  This will loosen up the intercostal muscles, giving the area more flexibility right from the start.

2.       Stretch the area for roughly 10 minutes before and after your overall warm-up. 

3.       Roll it out on the foam roller. This will ready your costovertebral joints for rolling. If this is too painful to perform or is already straining the injured area, you’ll have to return another day.

4.       Activate the muscles that hold your shaky rib in. Do these exercises a few times daily.

5.       Kinesiology tape or some type of compression wrap may be helpful. Proper application is tricky. Your doctor or therapist should show you how to do this for your particular injury.

6.       Avoid the MOI (mechanism of injury). Remember the position you were in when you got yourself injured? Avoid it for now.

7.       Cool the area after your workout with an ice pack. A few 20-minute doses of cold will limit the inflammation that is bound to happen from your return to training.

8.       Re-evaluate your level of recovery. If you are truly ready to return to training you may be able to start with drill techniques that are easy on your ribcage. But don’t be surprised if you find out you need some more time for full recovery and doctor-driven therapy is necessary.

4 SIGNS THAT A RIB INJURY MAY BE A MEDICAL EMERGENCY

·         Severe pain

·         Difficulty Breathing

·         Bruising or swelling

·         Blood in your urine  

References

1.       Brian E Udermann. Slipping Rib Syndrome in a Collegiate Swimmer: A Case Report. J Athl Train. 2005 Apr–Jun; 40(2): 120–122. Level 3B

2.       E M Scott and B B Scott. Painful rib syndrome--a review of 76 cases. Gut. 1993 July; 34(7): 1006–1008. Level 3A

3.       Heinz GJ, Zavala DC. Slipping rib syndrome. JAMA1977; 237(8): 794-5

4.       DeLisi N. Slipping rib syndrome: ’there’s an easier way’. Geriatrics1995; 50 (7): 7 level 5

5.       Gregory P.L., BISWAS A.C., Batt M.E.,Musculoskeletal problems of the chest wall in athletes, Sports Med., 2002;32(4):235-50. Level 3A

6.       Athl Train. 2005 Apr-Jun; 40(2): 120–122.

7.       The Lancet; Slipping Rib Syndrome; J.T. Wright; September 1980