Rib Crunch Question

**Travtex** · Posted On: 9/27/2008 12:23am

So, thanks to that wonderful time we all know as 'Training with the New Guy', I've managed to procure an injury that could seriously hamper happy fun training time.

Over the course of a class I got a few 'No big deal' accidents -- Stick to the knuckles, elbowed in the face, and one of my more impressive bruises, EVAH (It was kind of a stupidly amusing incident... Basically the kid stomped over my arm, catching a wee bit of tricep skin under his boot. Somehow that turned into about a 3" perfectly round 'What the HELL happened to you' bruise).

All of that was 'Ignored soon if not immediately' category stuff. Then, in the midst of a disarm/lock/subdue bit of flow, the guy dropped a knee into my ribcage. Crunch.

So, yeah, it hurt, though I went about my day just fine with some minor wincing and gimping about. Have a bum knee, anyway, so gimping about is no real change from the rest of my week.

Next day, little bit worse. Deep breaths, coughs, stretches... all give a pretty sharp stab. The location seems more like a cartlidge/separation injury than an actual rib crack. Bottom of the ribcage on my right side (With some ghost pain on the left side) around three or four inches along the rib from the xiphoid.

Today, on day four, I woke up to get ready for work and it's the worst day so far. Deep breaths, walking, twisting, sitting fucking STILL. Everything hurts with intermittent stabbing pains.

I'm a respiratory therapist, so I'm well aware of the risks of shallow-breathing/not coughing, and I'm taking care of pulmonary maintenance without problems. The specific things I'm wondering:

Do rib injuries normally keep getting worse before they start getting better? I already had a GP appointment scheduled for Monday, but if every day is a step up in discomfort I might have to just suck it up and do a walk-in sooner.

Is it better to lay a certain way when I sleep? Definitely seemed to be godawful worse when I woke up. I tend to lie flat on my back when I sleep, so it's not likely I rolled over onto the injured side, etc.

Knowing that there really isn't jack to be done for a rib issue, I'm not really in a heated rush to go to the doctor -- Particularly since I already had an appointment lined up (Chronic autoimmune stuff, just a checkup with the added benefit of being able to throw in, "Oh, and I jacked myself up again. Ha ha." While she rolls her eyes at my apparent psychosis.).

I don't THINK I gave myself a pneumo or anything. Breath sounds are normal, I'm forcing plenty of deep breaths to keep from getting atelectasis, etc. Just wondering if any rib injury veterans had some insight about things feeling progressively less pleasant.

**muddy** · Posted On: 9/27/2008 1:39pm

Originally Posted by Travtex

So, thanks to that wonderful time we all know as 'Training with the New Guy', I've managed to procure an injury that could seriously hamper happy fun training time.

Over the course of a class I got a few 'No big deal' accidents -- Stick to the knuckles, elbowed in the face, and one of my more impressive bruises, EVAH (It was kind of a stupidly amusing incident... Basically the kid stomped over my arm, catching a wee bit of tricep skin under his boot. Somehow that turned into about a 3" perfectly round 'What the HELL happened to you' bruise).

All of that was 'Ignored soon if not immediately' category stuff. Then, in the midst of a disarm/lock/subdue bit of flow, the guy dropped a knee into my ribcage. Crunch.

So, yeah, it hurt, though I went about my day just fine with some minor wincing and gimping about. Have a bum knee, anyway, so gimping about is no real change from the rest of my week.

Next day, little bit worse. Deep breaths, coughs, stretches... all give a pretty sharp stab. The location seems more like a cartlidge/separation injury than an actual rib crack. Bottom of the ribcage on my right side (With some ghost pain on the left side) around three or four inches along the rib from the xiphoid.

Today, on day four, I woke up to get ready for work and it's the worst day so far. Deep breaths, walking, twisting, sitting fucking STILL. Everything hurts with intermittent stabbing pains.

I'm a respiratory therapist, so I'm well aware of the risks of shallow-breathing/not coughing, and I'm taking care of pulmonary maintenance without problems. The specific things I'm wondering:

Do rib injuries normally keep getting worse before they start getting better? I already had a GP appointment scheduled for Monday, but if every day is a step up in discomfort I might have to just suck it up and do a walk-in sooner.

Is it better to lay a certain way when I sleep? Definitely seemed to be godawful worse when I woke up. I tend to lie flat on my back when I sleep, so it's not likely I rolled over onto the injured side, etc.

Knowing that there really isn't jack to be done for a rib issue, I'm not really in a heated rush to go to the doctor -- Particularly since I already had an appointment lined up (Chronic autoimmune stuff, just a checkup with the added benefit of being able to throw in, "Oh, and I jacked myself up again. Ha ha." While she rolls her eyes at my apparent psychosis.).

I don't THINK I gave myself a pneumo or anything. Breath sounds are normal, I'm forcing plenty of deep breaths to keep from getting atelectasis, etc. Just wondering if any rib injury veterans had some insight about things feeling progressively less pleasant.

Sounds like it could be a fractured rib. They dont always show up on the xray so the GP may call it a fracture if it doesnt show up on the xray (no Im not a Doctor). With those symptoms I would probably go to the emergency room if it were me (and Im not a panicky person at all) ... if I understood your description anyway.

**TheRuss** · Posted On: 9/27/2008 2:28pm

I was going to say "Go to the doctor", then I saw this...

Originally Posted by Travtex

I'm a respiratory therapist

But, uh, four days and it's getting worse? If you're not doing anything to it and it's getting worse, my non-medical logic would indicate that you should deal with it expeditiously and head off the trend.

***Cassius*** · Posted On: 9/27/2008 4:37pm

It definitely got worse before it got better for me:

In 2006 one of my false ribs (I think it was 8) on my right side was torn from the costal cartilage of the ribs directly above and below it (7 and 9) in a BJJ tourney. That sucked a lot. The ER was not helpful. They misdiagnosed it as a hairline fracture or "muscle strain" when the x-rays came up negative. I ended up seeing a sports medicine doctor for a second opinion, who took about 2 seconds to correctly diagnose the issue.

He couldn't do much, other than prescribe a lot of pain medication. I was in a lot of pain for about a month, and the lortab 7.5s didn't do much other than take the edge off. Fucking ribs still aren't lined up right.

**BudoMonkey** · Posted On: 9/27/2008 4:46pm

Tough it out, big guy. Hang in there till the doctor's appt or make one sooner if it gets worse.

That is all.

**Travtex** · Posted On: 9/27/2008 6:34pm

Yeah, I wasn't in a big hurry to drop into the ER... Already had a GP appointment, am not a huge fan of ER medicine for non-emergent issues (It's great if you're having a stroke, or have some hideous trauma, but for anything else they tend to give a quick 'n dirty diagnosis, throw some pain meds at you, and tell you to follow up with a GP appointment anyway.) Also, as people have pointed out, a rib fx isn't going to show on a chest film unless it's almost large enough to feel on the chest wall, anyway.

I often -work- in the ER, the aim is get 'em admitted or get 'em gone. They're usually not bad off enough to admit at the moment.

Anyway, after about hour eleven of work I was gimping and wincing enough to say 'Okay, **** this' and went down to our fast-track urgent care. X-ray showed jack, and the PA seemed to think I separated a couple of 'em. 'Here, take an assload of vicodin and plant your butt on the couch for a few days with ice packs'.

So, guess I tore the cartilage in the exact same spot I did a decade or so earlier. Damn things never do heal quite right.

**BudoMonkey** · Posted On: 9/27/2008 6:45pm

Yea, only what she really meant was; "Here, take an assload of vicodin, our $1000 bill, and plant your butt on the couch for a few days with ice packs."

**Nemesai** · Posted On: 9/27/2008 8:14pm

Not nice of someone to drop a knee on your chest. I'd have head butted the **** out of his nose for trying to damage me in such a manner.

**patfromlogan** · Posted On: 9/27/2008 8:25pm

Makes my chest hurt to read this.

After a cracked rib in HI I was back in Utah karate and told the brown we could spar but he HAD to avoid hitting THIS spot, about 1 inch below left tit. Of course first punch, bare knuckle, right to the spot. "You are turning white!" Hmmmm, I bet.

Sorry you hurt, and let us know if it gets better (or worse).

**Travtex** · Posted On: 9/27/2008 9:46pm

Originally Posted by Nemesai

Not nice of someone to drop a knee on your chest. I'd have head butted the **** out of his nose for trying to damage me in such a manner.

Generally, yeah. Though it falls under 'Yet another injury training with a new person'. More an instance of being off-balanced and spastic than malicious.

(I'm guessing his week wasn't all happy joy, either, as he had the tendency to not want to tap out of a lock. At one point his elbow made a disconcertingly disgusting noise mid armbar.)

The only error of the day that DIDN'T hurt was when he elbowed me in the face. I think that's going to be my training preference for a couple months whenever I get back: "Dude, if you have to hit something, punch me in the face. Touch the ribs and I'll stab you in the neck."