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General Information

DEFINITION--Injury and displacement of a rib where it joins the sternum (breastbone) or spinal column. DISLOCATION means the rib and adjoining bones no longer touch each other. SUBLUXATION is a minor dislocation in which the joint surfaces still touch, but not in normal relation to each other.


  • Rib and sternum or spinal column.
  • Ligaments attaching ribs to the sternum or spinal column.
  • Soft tissue surrounding the dislocation or subluxation site, including periosteum (covering to bone), nerves, tendons, blood vessels and connective tissue. {280}


  • Excruciating pain at the time of injury.
  • Loss of function of the injured rib, causing breathing difficulty.
  • Severe pain when moving.
  • Visible deformity (lump) if the dislocated bones have locked in the dislocated position. Bones may spontaneously reposition themselves and leave no deformity, but damage is the same.
  • Tenderness over the dislocation.
  • Swelling and bruising over the rib.
  • Pain when taking a deep breath, coughing or laughing.
  • Numbness or paralysis of other ribs below the dislocation or subluxation from pressure, pinching or cutting of blood vessels or nerves.


  • Direct blow to the ribs.
  • End result of a severe rib sprain.


  • Contact sports, especially football, boxing, wrestling, basketball or hockey.
  • Previous rib dislocation or sprain.
  • Repeated chest injury.
  • Arthritis of any type (rheumatoid, gout).
  • Poor muscle conditioning.


  • Build your overall strength and muscle tone with a long-term conditioning program appropriate for your sport.
  • Warm up adequately before physical activity.
  • After healing, wear protective devices, such as wrapped elastic bandages or a special rib vest, to prevent reinjury during participation in contact sports.
  • Consider avoiding contact sports if treatment is unsuccessful in restoring strong, normal rib connections.


  • Doctor's treatment.
  • Surgery (rare) to restore the rib to its normal position and repair torn ligaments and tendons.


  • Your own observation of symptoms.
  • Medical history and exam by a doctor.
  • X-rays of the chest and spine.


  • Shock.
  • Pressure or damage to nearby nerves, ligaments, tendons, muscles, blood vessels or connective tissue.
  • Injury to the underlying lung. AFTER TREATMENT OR SURGERY:
  • Excessive internal bleeding.
  • Impaired blood supply to the dislocated area.
  • Death of bone cells due to interruption of the blood supply.
  • Infection introduced during surgical treatment.
  • Continuing dislocations, often with progressively less provocation.
  • Prolonged healing if activity is resumed too soon.
  • Unstable or arthritic rib joints following repeated injury.


    After the dislocation has been corrected, the chest may require padding and gentle compression with an elasticized bandage. Injured ligaments require a minimum of 6 weeks to heal.


    NOTE -- Follow your doctor's instructions. These instructions are supplemental.


  • Use instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.
  • The doctor may manipulate the dislocated rib to return it to its normal position. Manipulation should be done within 6 hours, if possible. After that time, internal bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position.


    At home:
  • Use an ice pack 3 or 4 times a day. Wrap ice chips or cubes in a plastic bag, and wrap the bag in a moist towel. Place it over the injured area for 20 minutes at a time.
  • After 48 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 with an elasticized bandage between treatments.
  • Massage gently and often to provide comfort and decrease swelling.


    Your doctor may prescribe:
  • General anesthesia or muscle relaxants to make joint manipulation possible.
  • Acetaminophen to relieve moderate pain.
  • Narcotic pain relievers for severe pain.
  • Stool softeners after manipulation to prevent constipation due to decreased activity.
  • Antibiotics to fight infection if surgery is necessary.


  • Begin reconditioning the chest area after clearance from your doctor.
  • If surgery is necessary, resume normal activities and reconditioning gradually after surgery. Don't drive until healing is complete.


  • Drink only water before manipulation or surgery to correct the dislocation. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
  • During recovery, 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.
  • Your doctor may suggest vitamin and mineral supplements to promote healing.


  • Begin daily rehabilitation exercises when supportive wrapping is no longer needed.
  • Use ice massage for 10 minutes before and after workouts. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly in a circle over the injured area.
  • See section on rehabilitation exercises.


  • Any of the following occur after chest injury: The skin of the chest wall becomes numb, pale or cold. You experience nausea or vomiting. You feel very short of breath or have an extreme air hunger.
  • Any of the following occur after surgery: Increasing pain, swelling or drainage in the surgical area. Numbness or loss of feeling below the dislocation site. Signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
  • Rib dislocations that you can "pop" back into normal position occur repeatedly.
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