The serratus anterior is a muscle in your back that helps you perform pull-ups and push-ups. But when this muscle contracts repeatedly, it can batter the rib bones. One possible result is an overuse injury: stress fracture of the rib.
Sports that involve a lot of overhead motion, such as tennis or baseball, increase the risk of a stress fracture of the first rib when a muscle in the neck pulls on a small recession in the ribs known as the subclavian sulcus. Rowing also involves a lot of contraction of certain back muscles, and most commonly causes a stress fracture of the fourth or fifth rib.
Symptoms of a rib stress fracture include soreness at the front of your neck, along with pain and tenderness around the shoulder blade.
If you think you have a stress fracture of the rib, stop training to avoid further damage. Then consult a sports medicine specialist. He or she will rule out other possible causes of your pain, and may use X-rays, computed tomography (CT) scan, a bone scan, and/or magnetic resonance imaging (MRI) to evaluate the extent of any possible damage to your rib.
If you do have a stress fracture of the rib, your sports medicine specialist likely will recommend you avoid using the arm, immobilizing it in a sling. It generally takes about eight weeks for a stress fracture of the rib to heal.
Use caution when you are given the go-ahead to get back to training. You may need to perform rehabilitation strengthening or stretching exercises to make sure that your muscles and bones are up to the task; certain strengthening exercises, which your sports medicine specialist or coach can recommend, can also decrease the risk of re-injury. In addition, increase your training gradually, and in sports such as rowing, don’t overload the resistance when training on an ergo-meter.