Expert: Dr. J. Shawn Leatherman - 2/6/2007

Question
Hello,
A few weeks back I sustained an injury to my bottom left rib. Basically I was doing some jujitsu (wrestling type movement)when my opponent was holding my upper body and I tried to escape moving in the opposite direction. Result was a very sharp pain on my left side. It was very painful..so much I had real trouble getting up. Anyways most of the guys there suggested it was a muscle tear between the bones as it was not painful to touch...yet hurt to move..breathe..laugh..etc. It was swollen a bit..but after a few days the pain was manageable. I started boxing again but laid off the hard core ground work..ie wrestling. So after a few weeks the pain is very slight..only if I lie on that side..or do anything requiring super strength.
But..I have a lump sticking out at the base of my rib at the bottom right at the front. It would appear as if my rib has moved an inch or so. If i feel the difference between both sides..it is very noticeable. My question to you sir...and thanks for bearing with the long read..
Can I get this reset? Could it heal itself? Or am I stuck with an odd shaped rib now? Any recommendations are gratefully accepted.
With thanks..

Sore Rib in Canada

Answer
Dear Kevin,

Sounds like you have a derangement of the cartilage which attaches the rib to the sternum.  This is not a serious injury, but may not heal fully due to the type of tissue. I also agree that it is likely that you have a strain/sprain of the surrounding muscle and fascial structures. in addition, It is not likely that your rib has actually moved an inch, soft tissue swelling is probably most of the visual problem, with a small movement of the rib head.  The only true way to check the actual derangement would be with a radiographic assessment.

Cartilagenous tissue is notoriously slow to heal due to the deficient blood supply, and is prone to degeneration. The best way to promote proper healing is to make sure that the ribhead approximates as close as possible the normal anatomical position to allow the cartilage to form a proper scar.  A chiropractic physician can easily evaluate this and utilize manipulation to reposition the rib head if needed, and you may need the rib to be manipulated in the back as well as the chest due to the connections.

In addition, there are some nutritional concerns that will help the initial healing process as follows:

Glucosamine/Chondroitin/MSM:  Glucosamine is thought to promote the formation and repair of cartilage.  Glucosamine hydrocloride is the form that is best absorbed by the body, but glucosamine sulfate is utilized more appropriately for repair. Chondroitin sulfate promotes water retention and elasticity in cartilage and inhibits enzymes that break down cartilage. MSM is also important in cartilaginous repair.  You need to consume a minimum of 1500 mg of Chondroitin and Glucosamine, as well as 750mg of MSM per day after injury.  A minimum dosage period would be for two months.

Vitamin-C: and additional anti-oxidants have also been shown to speed the healing process.  Whole food complexes of vitamin c are preferred over synthetic forms.  Ascorbic acid is a poor form. Vitamin C is a major constituent concerning collagen repair.

Omega-3 Fatty Acids:  act as anti-inflammatory agents, making them beneficial for patients with any inflammatory condition. There are three major types of omega 3 fatty acids that are ingested in foods and used by the body: alpha-linolenic acid (ALA)-18 carbons, eicosapentaenoic acid (EPA)-20 carbons, and docosahexaenoic acid (DHA)-22 carbons. Once eaten, the body converts ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used by the body.  Unfortunately, the conversion is many times incomplete or slow in humans, therefore, EPA and DHA supplements are most effective.  Extensive research indicates that omega-3 fatty acids reduce inflammation and help prevent certain chronic diseases such as heart disease and arthritis.  Typical dosage after injury is 4000 to 6000 mg daily for 3 months.  Then reduce to a maintenance dose of 3000 to 4000 mg daily.  In addition the supplement should be molecularly distilled, pharmaceutical grade, and free of toxins.

Kevin, these types of injuries can be a nagging pain in the *** due to the long healing times and the recurrence of injury, so make sure that you don't continually aggravate it...well with your level of physical activity, just do your best.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net