The rib contusion ( rib contusion ) is caused by the action of blunt force, for example, by a blow or fall. There is no bone fracture here. Only the connective tissue, muscles, nerves and periosteum surrounding the ribs can be damaged or irritated.
Often, such an accident occurs in sports by a kick, punch or fall, for example in martial arts, handball or football. Also by riding, skiing or mountain biking is the danger of falling and thus the risk of contracting ribs increased.

Type of pain of a rib bruise

Typical for a rib bruise are severe pain at the site of the violence

In a rib bruise, severe pain is typical at the site of the trauma, which is also triggered or intensified by touching the area. Coughing and sneezing can increase the pain.
Partly the pain can radiate into surrounding areas. Even when the upper body is rotated, the pain is usually worsened. Due to the trauma, small blood vessels are affected. This can be seen in addition to a reddening of the skin by the possible formation of a bruise ( hematoma ).

At the beginning, however, hardly anything is visible externally, as a swelling or bruise develops later. Often, the pain is so severe and worse with deep inhalation, so that those affected often breathe only very shallow. To still pump enough air into the respiratory tract, breathing becomes faster. This may result in a feeling of shortness of breath in the patient. The pain is very great especially in the first three days. It is often difficult to find sleep at all.

Pain on the back

Pain in the back, especially between the shoulder blades, as well as in the area of ​​the breastbone can also occur as a result of the ribs. These are tension-related. Due to the pain of rib contusion, the patients take a restraint and try to " avoid " the pain. But this changed posture leads to muscle tension. A walk to the physiotherapist usually helps here. Furthermore, the circulation of heat packs promotes relaxation of the muscles.


The treatment of a rib bruise is conservative. In medicine, this means treatment by medication and / or physical measures such as physiotherapy.

Relieving the pain of a rib bruise

Analgesics are also useful for relieving pain, but the effectiveness of creams or gels is controversial

In the beginning the cooling of the affected area helps against the pain and the swelling, a timely cooling can also improve the further course. In addition, common analgesics such as ibuprofen or diclofenac are administered.
As prolonged use of NSAIDs ( non-steroidal anti-inflammatory drugs ) such as ibuprofen, the protective layer of the stomach is attacked, in addition, a stomach protection should be prescribed.
The effect of often-recommended painkiller gels or creams are controversial. Whether the analgesic even reaches the site of action through the skin barrier or the dose is high enough to achieve this is questionable. Often simply the cooling effect of the gel or even the feeling of applying something to the pain has helped.

A pack of ice, wrapped in a towel, is effective just in the first few hours and days. The ice should never be placed directly on the skin, otherwise it can lead to cold burns, which are very painful.
Cooling pauses of half an hour between applications should be kept. Also cool, damp towels help.
In the first few days is to be advised of a heat application. However, in the later stages heat can release muscle tension. Also massages by trained physiotherapists contribute to the improvement.

Physical conservation

Even if you feel better with ice pads and painkillers, you should avoid exercise or any other strong exercise for the next few weeks, as this will cause worse and prolonged disease. Physical protection is the most important thing, as long as the pain persists. Also carrying heavy objects or persons should be omitted. It should be discussed with the doctor when the right time for exercise is.

Proper breathing

Initially it is difficult to maintain a normal deep breathing due to the pain. However, this is especially important, since too shallow breathing causes insufficient ventilation of the lungs, which can lead to pneumonia. For this reason, one now sees of the lung constricting bandages in a rib bruise.

In this context, it makes sense to take pain medications, both to relieve the pain and thereby allow a sufficiently deep breathing. The renunciation of painkillers does not make sense, because the risk increases by a respiratory breath to contract pneumonia.
If it is a particularly heavy rib bruise, it makes sense to use a physiotherapist who helps with the right breathing technique.

Pain relief while lying down

Since a rib bruise caused by the pain often causes trouble sleeping, it is advisable not to sleep on the bruised side. With one or more large pillows, the situation can be supported, so you do not accidentally on the painful side at night.

Duration of a rib bruise

Depending on the severity of the trauma, the course and duration of the pain varies greatly. The healing of a rib bruise is slow. On average, the duration of a rib bruise is three to four weeks. But also courses of 10 or more weeks are described.
The duration is extended when several ribs are affected or the force was very large. Also, an early onset of exercise or some other type of stress has a negative impact.

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