A strained sternum? How the heck?

[trickytiger]

Normally, I don't get injured much for all that I do. However, I woke up yesterday morning unable to move or breathe without a significant amount of chest pain! I'm way too young for a heart attack, and I couldn't remember doing anything traumatic to myself, so it was a bit of a mystery. Today I noticed that my sternum was swollen about 2 inches below the top, and decided to get it checked out. The doctor claimed that I've damaged the soft connective tissue around my sternum, and we figured out it was probably job-related (I'm a geologist and recently spent over 20 days in a row hauling awkward, heavy 5-foot lengths of rock core around all day). Apparently the repetitive motion of picking up the core and twisting my body to be able to walk with it was simply too much.

My question is, does anyone have any experience or recommendations with this type of injury? Running is out :mad: due to the arm motion, biking is out:mad: because I can't support my upper body on the handlebars without pain, and I'm having problems even deeply breathing or driving a stick-shift car or sleeping comfortably. How long can I expect to be out of commission, and what if anything can I do to help this heal?

[LBTC]

I imagine our PTs will have some words of advice for you - Wahine? Pika?

I for one, recommend very gentle exercise, like the most gentle of yoga movements, and walking. And I would think ice should help.

I can't imagine how awful this must be, but I do know that you need rest. You need to give your body a chance to heal! It hurts to not be able to do what you want to do, but you will recover with time, patience and lots of love and support.

Hugs and healing butterflies,
~T~

[Wahine]

TT - it's sounds like a rib subluxation or a good old fashioned costochondral joint irritation.

I would recommend getting in to see a manual therapist, a PT would work if they have manual therapy credentials. Unfortunately, in WA state PTs are not allowed to do spinal manipulation. You may need one. So I would look for a Doctor of Osteopathy (DO) or ask around to find a good chiro. I would go for the DO first. If it's a subluxation it may be treated in a few sessions with manipulation and other treatment techniques. Either the DO or Chiro could do this. However, if it's a costochondral joint strain with inflammation but no subluxation, a chiro could make it worse.

Ice is always good and some Aleve (make sure you're OK to take it by checking with the pharmacist). Avoid sitting too long, repetitive twisting and bending.

As for exercise, gentle movement like LBTC suggested would be in order. You won't be able to tolerate impact right now, that's whay you can't run. No weights. Swimming might be OK. You would have to go easy, stick with backstroke to start out with.

These suckers really hurt and you can significantly decrease recovery time with a little help. So go see someone, kay.

Pika - Other ideas? My brain's dead. I still have a virus.

[Veronica]

How about even just kicking with a kick board at the pool. I know it's kind of boring, but if you add fins that jazzes it up a bit. I know I can get my heart rate up pretty high just kicking.

V.

[mimitabby]

a good Osteopath in South SEattle (burien) is Dr RObert Perry
12610 Des Moines Memorial Drive
Seattle, Washington

(206) 243-7818
common sense, bicycling family.

[Wahine]

Thanks Mimi. I always feel better when people get referred to someone by word of mouth.:D :D

[Pika]

TT Sounds like wahine covered most of the bases- I agree with her with regard to seeing an osteopath-since manual therapists (PT) may not be able to do what you need.(if it is against the "rules" -out of their scope of practice- soo glad that isn't the case here)
I have found that a criss-cross of tape over the joint can serve as a reminder not to twist or pull too much- again as long as it is a strain and not subluxed- the DO will be able to help you know one way or the other.
wrt swimming- I think Veronica has the right idea- I am afraid even back stroke may pull the ribs and sternum too much- kicking may be the way to go:)-Kicking on your back holding the flutterboard by your tummy may be best because any arm movement overhead may also be too much.
Good luck- those doo hurt like a bugger but the good news is if you treat them right from the get go your down time will be shortened significantly.

[KnottedYet]

thread hijack:

I am amazed at how limited PTs scope of practice is here in Washington. The PTs aren't even allowed to do things that I (a PTAsst) was doing during my stint in the midwest. (spinal mobs and METs, for example) And if the doctor's script says "shoulder", then only the glenohumeral joint gets treated. Nothing done with the clavicle or first rib or anything else in the neighborhood.

PTAssts are even more limited in Washington. I only get to do even simple peripheral joint mobs maybe once every couple months, if I'm lucky! I've forgotten most of what I learned in school, and just about ALL of what I learned in the courses I was taking toward my CIMT. (I *never* get to use my advanced coursework here, so I haven't continued to shell out the $$ to finish the certification.)

End hijack.

[Wahine]

Pika - Good idea re taping. I like V's idea about the flutter board and kicking. You might have to play with the board position a bit to get comfortable. Maybe even try being on your back and holding the board into your chest like you're hugging it.

Knott - This is a very big reason why although I live in Washington State, I work in Oregon. I can do spinal manips etc there. Now if only I could figure out how to legally be able to do acupuncture.

[mimitabby]

Knott, Wahine, I had no idea they taught you guys so much, you're right,
it's criminal that you learn all that and then you can't use it!

[trickytiger]

Some very good suggestions- I am going to try icing and Aleve and see how far that gets me- and just stick with walking for excercise for now, although I did stick my bike on a trainer and may just pedal sitting upright and see if that works. I found I can sleep relatively comfortably if I put my arms above my head- while that's not exactly the best sleeping position ever (cold hands!), it appears to let me breathe easier.

Fortunately, I'm spending the next two days volunteering at two different PT clinics- and one of the PT's will have a look at it and see if there is anything they can suggest for me. I'm really hoping no subluxation is involved. Thanks so much for the word-of-mouth referrals- I will check and see if my insurance covers those folks!

[bullitgirl]

Hi, I am new to Team Estrogen and wanted to let you know how grateful I was to find that someone besides me had strained their sternum. I called my orthopedist and they refused to give me an appointment. They told me to go to the ER. What the :confused:? They don't do ribs? Those are bones and connective tissue too, like the rest of the body! I managed to make my chest pop when doing a push-up. It was bizarre, almost out-of-body for a second. The pain was intense and has been with me now for over 10 days. This forum has given me a starting point to get on the road to recovery. Tennessee must have those same restrictions on PTs, so I am going to try to see an osteopath this week. Guess this means no bike for a couple of weeks. If I get to see the doc, I'll post a follow-up on the treatment. So glad to have found you guys!:)

[sgtiger]

Bullitgirl, welcome to TE! Sorry, I have no advice to offer. I just hope you find someone soon who can help you find relief.

[alpinerabbit]

ow, ow, ow - poor thing.

when I was eleven, I ran full-on into a horizontal bar on on the playground.
I seem to remember it hurt for months, that cartilage is a sucker to heal.

Surely you could stationary bike in a while in a recumbent or upright position. Or stepper. Or just go for long walks.

[trickytiger]

Bullitgirl: If it makes you feel better, I DID eventually recover! The only thing is, I can't carry a messenger bag on that shoulder or it twinges in the original injury location. However, I probably shouldn't carry lopsided weight anyhow, so no biggie. I think my PT eventually decided it was a sternoclavicular/costoclavicular issue (where sternum and clavicle join, essentally). Rest, ice, and careful sleeping positions helped enormously. Good luck!

[crazycanuck]

I had a sterniclavicular (sp??) dislocation last year round this time :o

Sleep upright & try to use your core to move. It eventually works with a bit of practice.

TrickyT-same for me.

[bullitgirl]

I can't tell you how much I appreciate everyone's feedback. As I promised, I want to let you know how going to the doc went. I went for a meds check with a doc I use for holistic healing. He is an MD. I told him what had happened, so he palpated the area and having had experience with this type of injury, told me that I had strained and maybe even tore some soft tissue where the first, second, and third ribs meet the sternum on the left side. He gave me some muscle relaxers :) and told me to take naproxen (I have a bunch of that on hand) and use some Therma-Care pads to provide heat to the area at night when I am sleeping. I already sleep sitting up most of the night because of reflux and my chest tells me all about it if I try to roll on my side. I do have a nice Diamondback Recumbant bike at home and will be using it. The place I work is participating in the Walktober fitness program this month, so I am walking a lot too. Tonight we did take one of the dogs for a walk. They are Airedales and too big for me to handle with this strain, so my husband walks the dog and I walk with. I actually slept pretty good last night and am looking forward to going to Charleston, SC next week for vacation:D. We will be doing lots of walking there too.

I have been a bike fanatic since I was 13 yrs. old and bought my first bike. I lived on it. I rode off and on until the day my husband discovered cycling. I got into it with him for a while and got a couple of nice bikes. He doesn't ride much anymore and after dealing with back problems and having my fitness dwindle away, I made a commitment to get back in the saddle and commute to work. I have been loving that, especially the energy I get from being in better shape and the part about not contributing to pollution. I need to pick a photo to go under my "handle". I'll try to get one loaded when we get back from vacation.:o