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