Safety Considerations
Due to the high-force trauma that causes sternal fractures, bruising, swelling, and pain at the site are expected, according to PhysioAdvisor. You may also experience pain related to movement of the upper back, chest, and arms.
Your healthcare team will examine you for other injuries, including injuries to the lungs and heart. These need immediate medical attention. Some sternal fractures, particularly those involving other injuries in the chest area, will require surgical treatment, according to StatPearls. Most isolated sternum fractures will heal in about 10 weeks, but it can take longer if you have additional injuries or risk factors, such as advanced age, osteoporosis, or diabetes, or have used steroids for a long time.
Most people will be able to return to normal activities, including working out and playing sports, within a matter of weeks to months. People with severe sternal fractures will usually require a prolonged recovery period that can take many months. This is often the case when surgery is required, or when other injuries are involved.
Initial Treatment
In the first three days (72 hours) after a chest wall injury such as a sternum fracture, it’s important to rest and apply ice to the affected area, according to the Rib Injury Clinic in London. Limit any activities that cause pain, aside from deep breathing and coughing — it’s important to continue these despite discomfort, as they’ll help prevent lung issues from developing.
Compression using bandages or corsets isn’t recommended right after an injury, since it can interfere with breathing. However, if your ribs are also broken, your healthcare team may use compression to stabilize them. Don’t do this on your own. You may also learn techniques to support your chest wall when coughing or moving from sitting to standing. You can begin rehab, including gentle range of motion and breathing exercises, only after your doctor clears you.
Chest and Shoulder Range of Motion
If your pain levels allow, it’s important to begin gentle range-of-motion movements as soon as possible, according to the Rib Injury Clinic. After you’re evaluated by a physical therapist, they’ll recommend specific movement exercises that are safe to do as you heal. Fear of moving and holding your body in protective positions can cause a muscle imbalance around the injured area, which can make the pain last longer.
Breathing exercises are also crucial, as they can prevent complications following an injury, such as chest infections like pneumonia. Deep breathing from the diaphragm is one technique that’s encouraged, according to PhysioAdvisor. You can do this sitting or standing, as long as you keep a straight posture. Breathe in as deeply as you can from the diaphragm without increasing symptoms — the diaphragm is located just below the lower lungs, at the bottom of your rib cage — then relax to let the breath out. Consult your healthcare provider about how many repetitions and sets you should do as you heal.
Chest, Back, and Shoulder Strengthening
Once you’ve healed from your acute injury or injuries, your physical therapy regimen will be adjusted to incorporate strengthening exercises, according to the Rib Injury Clinic. It’s important to strengthen the upper chest, back, and shoulders, so that you don’t risk neck, back, and shoulder injuries as you return to your normal routines. The exercises will also help you practice good posture, which can help you avoid musculoskeletal issues as you age.
If you plan to go back to the gym or return to playing sports, it’s especially important to work with your healthcare team to develop a strengthening program that’s specific to your favorite workouts and activities. This will help prevent injuries once you do.
