Sports Injuries: Stress Fractures to the Ribs

Stress fractures to the ribs occur in rowers, golfer, canoeists, lacrosse players, and baseball pitchers. More common in sports involving an element of trunk rotation with scapula movement across the rib cage.

A stress fracture described as an overload of the bone caused by repetitive loading due to a particular movement. Any load on the bone will create a stress in the bone. However, given enough recovery time the bone heals and ends up stronger. Known as Wolfe’s law. But, if the bone load is too high or too frequent, then the bone does not repair quickly enough, a stress response occurs, and a fracture follows.

In rowing, repetitive loading muscles such as the serratus anterior and abdominals that directly attach to the ribs can lead to packing on the ribcage due to contraction. Improper rowing technique, perhaps caused by poor hip flexibility, which then requires an excessive compensatory thoracic rotation, may then lead to rib breakdown.

Other causes include equipment issues such as the oar type (lighter carbon oars increase rib loading), bigger boats with more drag and position in the boat (bow rowers have less incidence due to lower stroke rate and force). Rib cross section and density also influence the chance of stress fractures, and women have a higher chance due to a higher likelihood of bone density issues. Finally, training variables such as volume, intensity, type of loading and off water training can also be factors in stress fracture development.

The signs and symptoms are usually straightforward. These include generalized rib pain with a focused spot of tenderness, pain rolling onto the ribs while sleeping and pain with deep breathing, confirmation with a bone scan (black spot) and MRI (white spot).

Unfortunately for the rower, the immediate management of the injury involves rest. Usually 4-6 weeks away from rowing will be enough to allow some bone healing followed by a progressive increase in rowing load over another four weeks before the athlete is back to full training.

The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900.

Additional Topics: Chiropractic and Athletic Performance

Chiropractic care is a favorite, alternative treatment option which focuses on the diagnosis, treatment, and prevention of injuries and conditions associated with the musculoskeletal and nervous system, primarily the spine. Many athletes and civilians alike seek chiropractic care to restore their natural health and wellness. However, chiropractic has been demonstrated to benefit athletes by increasing their athletic performance.

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