Rib Fracture

Contact sports such as football and rugby increase the risk of getting hit with a ball or colliding with another player. When this happens, an injury known as a rib fracture can occur. After the impact, if you have a rib fracture you likely will experience pain and swelling, especially when you breathe in. Your ribs might also feel tender to the touch. If the pain is severe, you should head to the hospital to make sure that the fractured rib hasn’t punctured your lung or any other organs. That’s because if a rib fracture is left untreated, it can lead to internal bleeding, lung collapse, respiratory failure and pneumonia.

If hospital treatment is not necessary, pain medication can help control the pain so you can breathe normally. Fractures that require treatment in a hospital can cause so much pain that narcotics are necessary. Surgical rib fracture repair is rarely necessary but may be employed if the rib fails to heal on its own. You may experience severe pain for weeks, and low-level pain can persist for months.

Once your rib has healed, physical therapy or rehabilitation might be necessary to regain the ability to return to normal activity levels. It’s recommended that athletes wait at least four to six weeks before returning to training to ensure the rib has fully healed.

Elbow Fracture

Your elbow joint consists of three bones: the humerus, the radius and the ulna. These bones are held together by connective tissue, and these ligaments (in combination with the muscles of your arm) help hold the bones in place. If you fall and catch yourself with your hand, such as in sports that put you at risk of falling like ice skating and gymnastics, or twist your arm, you could fracture one of these three bones. This condition is known as an elbow fracture.

Symptoms of an elbow fracture commonly include sudden, intense pain; swelling; tenderness to the touch; stiffness around the elbow; and numbness in the fingers.

An X-ray is necessary to diagnose an elbow fracture and rule out other possible injuries such as a dislocation, so you should consult a sports medicine specialist as soon as possible. He or she might also examine your arm and hand to make sure that the injury did not hamper blood flow to the rest of the arm.

To treat an elbow fracture, all that may be necessary is keeping the arm in a sling for a few weeks to let it heal (under the close supervision of a sports medicine specialist). This method might also require wearing a cast or a splint.

If the fracture is serious enough to warrant surgery, however, it’s usually because the pieces of bone have moved out of alignment, and therefore your arm wouldn’t heal properly on its own, or because pieces of bone are sticking out of the arm from the fracture. To do this, screws and wires may be necessary to put the bone back together. Allowing the bones to heal improperly can result in long-term problems, such as an inability to fully straighten the arm.

After your elbow fracture has healed, get back into everyday activities slowly. Your doctor may recommend physical rehabilitation or exercises to help you regain strength and range of motion in the arm. Recovery is often a slow process; it can take six months or more to fully recover the arm.

Elbow Dislocation

The joint of your elbow is made up of three bones: the humerus, the radius and the ulna. These bones are held together by connective tissue, and these ligaments (in combination with the muscles of your arm) help hold the bones in place. If you fall and catch yourself with your hand, such as in sports that put you at risk of falling like ice skating and gymnastics, you could knock these bones out of alignment. This condition is known as an elbow dislocation.

Common symptoms of a dislocated elbow include intense pain in the elbow and possibly the inability to move the arm. The elbow also usually looks oddly twisted or deformed, due to the movement of the bones.

If you think you’ve dislocated your elbow, consult a doctor immediately. Depending on the severity of the dislocation, it could be a medical emergency. That’s because when the bones that make up the elbow move, they can disrupt the nerves and blood vessels that run through that area. If circulation to your arm is disrupted, it can cause permanent damage that may even require amputation.

Your sports medicine specialist will take an X-ray to determine the extent of the dislocation, and he or she likely also will ask you to move your arm and hand to evaluate whether or not you have circulatory or nerve damage to the arm, hand or elbow.

One way to treat a dislocated elbow is to physically push the bones back into their normal places. But if the injury is too serious for this method to be effective, surgery is necessary to repair ligaments and put bones back where they belong. Further surgery also might be necessary to repair damaged blood vessels and nerves.

After your arm bones have been returned to their normal orientation, physical therapy or rehabilitation exercises might be necessary to help you regain movement in the arm.

Osteitis Pubis

Groin injuries can be some of the most painful and most difficult to treat; one such injury is known as osteitis pubis. This condition occurs when the base of the bone where the two halves of the pubic bone meet in the middle (the pubic symphysis) become inflamed. Bony growths can also develop around the pubic symphysis.

Osteitis pubis is most common among soccer players and runners and causes intense pain that may be chronic. Symptoms include dull or sharp pain and tenderness in the groin area, located in the front and center of the pubic bone. In addition, this pain can sometimes spread up into the lower abdominal region and even down through the upper legs.

Causes of osteitis pubis are diverse. Increasing training too quickly, exercising on uneven and/or hard surfaces, tight muscles, and imbalanced muscle strength can all lead to osteitis pubis. Poor running or walking form can also cause osteitis pubis, as can having legs that are not the same length.

If you think you may have osteitis pubis, rest, ice, compress and elevate the affected area. After a period of rest, if your symptoms remain, consult a sports medicine professional. He or she can rule out other possible causes of your pain, and may recommend stretching or strengthening exericses to put you on the road to recovery. An X-ray or computed tomography (CT) scan may also be used to detect the telltale sign of osteitis pubis (a widened, irregular pubis symphysis).

Once your osteitis pubis has cleared up, prevent it from coming back by always wearing well-fitting footwear, increasing your training and mileage gradually, keeping your body strong and limber, and allowing yourself sufficient rest between training sessions to let your body recovery.

Clavicle Fracture

If you fall onto your outstretched arm or you shoulder, or are directly hit on your collarbone, this can cause a fracture of the collarbone, or clavicle. Symptoms commonly include pain and swelling around the collarbone, and you may also be able to feel the fracture through the skin. You may feel sharp pain whenever you make a movement that disturbs the clavicle.

Sports that increase the risk of a clavicle fracture include those that put you at risk of falling, such as figure skating and hockey, and those that often involve collisions with other players, such as football.

If you think you have fractured your clavicle, consult a sports medicine specialist. Also, try to avoid moving the affected arm, and apply ice to decrease swelling and ease pain.

A sports medicine specialist likely will examine your clavicle, and will take X-rays to determine whether the collarbone has been fractured. Depending on the severity of the fracture, you may need to keep your arm in a sling to give the collarbone a chance to heal. In most cases, the bone heals by itself, and no surgery is necessary.

If, however, the fracture is so severe that immobilizing the arm doesn’t heal it, or if parts of the bone are sticking out of the skin, surgical methods likely will be necessary to help the bone heal. Surgery to repair the bone generally involves inserting a metal plate and screws to hold the bone in place. Once the bone has healed, this metal plate can be removed, but often is simply left in place.

After the clavicle has healed, whether from surgery or from immobilization in a sling, it’s important to regain range of movement and strength through rehabilitation exercises, which your sports medicine specialist will prescribe to you.

Rib Stress Fracture

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.

Stress Fracture

Sometimes, gravity can be an athlete’s worst enemy—especially in the case of stress fractures.

This overuse injury occurs most commonly among athletes who run and jump a lot, repeatedly putting a significant amount of weight on the legs and feet. That’s why most stress fractures occur in the bones of the foot and lower leg (they can also occur in the spine in a condition known as spondylolysis).

In a stress fracture, the bone does not completely break in half; instead, tiny cracks form, and these grow into stress fractures. The condition can cause intense pain when you put weight on the bone and when you touch the fractured area. Swelling also can accompany the pain, and you may find the pain worsens with each workout.

If you have lower leg pain, and taking some time off from weight-bearing activities doesn’t relieve it, you may have a stress fracture—and because a stress fracture that heals improperly can cause chronic pain, it’s crucial to treat the condition.

Sports that most often cause stress fractures are those in which the legs and feet pound the ground repeatedly, such as in gymnastics, running, ballet dancing, basketball and soccer. However, anyone who has suddenly increased his or her activity level can develop a stress fracture.

There are a number of tests your doctor can perform to diagnose a stress fracture. These tests include magnetic resonance imaging, or MRI, on the affected bone, along with taking an X-ray or a bone scan, in which a radioactive tracer is tracked through the bone.

To help your stress fracture heal, it’s important to minimize the weight you put on the affected bone. To do this, you may need to use crutches, a splint, or, if the fracture is in your foot, a supportive boot. In very serious cases, surgery may be necessary to heal a stress fracture.