Everything You Need to Know About a Rib Stress Fracture
What is a Rib Stress Fracture?
A rib stress fracture is a tiny crack or overuse injury in a rib, usually caused by repetitive strain or repeated loading rather than a sudden impact. Unlike a typical rib fracture, which happens from direct trauma, a stress fracture develops gradually over time from activities that involve repeated bending, twisting, or forceful breathing.
An analogy…
Think of bending a paperclip over and over again, eventually, it weakens and cracks. That’s how a rib stress fracture works: small amounts of stress build up over time until the bone becomes irritated and cracks.
What are other names that a rib stress fracture can be referred to?
Stress Fracture of the Rib
What causes a rib stress fracture?
Rib stress fractures usually happen when repeated force is applied to the rib bones, especially through muscles like the intercostals and serratus anterior, which pull on the ribs during breathing or arm movement. This repeated stress gradually weakens the bone, particularly in athletes or people who do repetitive upper body movements (e.g. rowers, gymnasts, swimmers, or those doing heavy lifting or intense coughing).
What are the signs and symptoms of a rib stress fracture?
- Gradual onset of localised pain in the rib area
- Pain worsens with deep breaths, coughing, laughing, or twisting
- Pain during specific activities (e.g. rowing, throwing, or overhead movements)
- Tenderness when pressing on the affected rib
- Pain that may improve with rest and return with activity
- No obvious bruising or swelling (unlike acute fractures)
What tests are used to diagnose a rib stress fracture?
Physical examination: Pressing on the ribs and checking for tenderness, swelling, or movement-related pain
X-ray: Often used to confirm the fracture, although small cracks can be hard to see
How long does a rib stress fracture take to heal?
Recovery can take anywhere from 4 to 8 weeks, depending on the severity and how early it’s diagnosed. Rest and activity modification are key. Returning too early can lead to a full fracture or delayed healing.
How does a rib stress fracture happen?
- Repetitive upper body movements (e.g. rowing, throwing, lifting)
- Sudden increase in training load or intensity
- Poor technique during sport or exercise
- Weak bones (e.g. due to osteoporosis or low vitamin D)
- Chronic coughing or respiratory conditions
- Muscle imbalances causing uneven pull on the ribs
What treatment can help a rib stress fracture?
- Relative rest from painful movements
- Pain relief (e.g. anti-inflammatories if advised)
- Modification of training or activity
- Breathing control and posture exercises
- Addressing poor technique or biomechanics
- Strengthening surrounding muscles (once pain settles)
- Gradual reintroduction to sport or activity under supervision
What exercises or stretches can I do for a rib stress fracture?
- Breathing exercises
- Postural correction drills
- Shoulder and thoracic mobility exercises
- Gradual strengthening of core and upper back muscles (guided by a practitioner)
What products can help with a rib fracture?
Breathing control
Sit upright in a chair or sit upright on your bed with your legs supported.
Place one hand on your chest and the other hand on your stomach.
Keep your shoulders relaxed.
Breathe in gently through your nose and feel your stomach gently rise.
Breathe out through your nose and feel your stomach gently fall.
Pendular shoulder swing
Lean onto a table with your good arm, letting your affected arm dangle forwards in front of you.
Using gentle movements of the body, let this arm swing backwards, forwards, side to side, and in circles.
The more you lean your body forwards, the more you will stretch your arm
Bicep stretch – arms to abduction
Sit or stand up straight.
Lift your arms out to your side at shoulder height.
Ensure your elbows are straight.
Move your arms backwards until you feel a stretch down the front of your upper arms.
Hold this position, ensuring you do not hunch your shoulders.
You may find extending your wrists backwards increases this stretch a little.
