Rib Fracture Occupational Therapy Intervention

Background on Rib Fractures

  • Ribs protect the lungs as they contract/expand with breathing.

Rib Fracture Mechanism

  • Typically from a blow to the chest
  • General population: motor vehicle accidents
  • Children’s bones bend easily and can often withstand breaks during a blow or fall
  • Older adults: fall
  • Patients with weak bones (cancer or osteoporosis) may fracture a bone from coughing too hard or sneezing.

Rib Fracture Management

  • Risks: hypoventilation, atelectasis, pneumonia
    • Incentive spirometer
  • Generally, heal in 1 to 2 months with rest or activity modification.
    • Overall recovery may take longer if internal organs (lungs) are involved
  • Indications for surgical intervention include a flail chest (three or more adjacent ribs broken in multiple places) or multiple rib fractures that are causing breathing problems.
  • Aren’t treatable with a cast or splint
  • Ice to the affected area
  • Pulmonary hygiene and “pulmonary toileting”
  • Yoga and other strenuous activities are to be avoided for up to 6 weeks in most cases.
  • Avoid intensive hand, arm, and leg exercises, with the use of clinical judgment, unless appropriate for neurological conditions such as stroke, Parkinson’s disease, or brachial plexus injuries.
  • Avoid lifting over 10 pounds.
  • Avoid contact sports or high-impact activities, including golf (excruciating pain).
  • Avoid activities that require pushing or pulling.

Occupational Therapy Intervention

  • Early mobilization in acute care
  • Pain management education
  • Splinting/bracing a pillow or folded blanket for coughing or deep breathing.
  • Breathing Techniques
  • Modified techniques to reduce pain during ADLs and using…
    • Sleep positioning
    • Bed mobility
    • Dressing
    • Bathing
    • Sexual activity
    • Light housework
    • Return to working within precautions
  • Adaptive equipment if appropriate
  • Maintaining ROM/strength in neighboring joints
  • Energy conservation & pacing
  • Posture education
  • Fall prevention
  • Home safety/modifications





Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.