Orthopedics Fractures & Broken Bones The Difference Between Bruised, Broken, and Fractured Ribs What to Know About Common Rib Injuries By Abby Norman Abby Norman LinkedIn Abby Norman is a freelance science writer and medical editor. She is also the author of "Ask Me About My Uterus: A Quest to Make Doctors Believe in Women's Pain (2018)." Learn about our editorial process Updated on December 13, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Miho J. Tanaka, MD Medically reviewed by Miho J. Tanaka, MD Facebook LinkedIn Twitter Miho J. Tanaka, MD, is a board-certified orthopedic surgeon who specializes in the treatment of sports medicine injuries. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Chest Anatomy Definitions Symptoms Risk Factors Diagnosis Treatment If you hurt your ribs, you may hear the terms bruised, broken, or fractured. They're similar injuries but have some key differences. You can injure a rib any time there's chest trauma. Car accidents and sports are common causes. This article explains chest anatomy, the differences between common terms, symptoms and risk factors of rib injuries, and how they're diagnosed and treated. Life-Threatening? Rib injuries themselves aren't life-threatening. But some complications of a rib injury can be. The Ribs and What They're For Chest Anatomy The chest, or thorax, contains several important structures and organs. The ribcage protects some of the most important organs. That includes the heart and lungs. The ribcage contains 12 bones on each side, divided into three different types: The first seven ribs attach to the sternum (breastbone). Ribs 8, 9, and 10 are called "false" ribs because. They attach to the cartilage—not bone—of the ribs above them. Ribs 11 and 12 are called "floating" ribs. They aren't attached to the sternum or to other ribs. Their only attachment point is the vertebrae (bones of the spine). Chest trauma puts not only the ribs at risk. It can also damage the sternum, spine, and organs in the chest and abdomen. Bruised, Broken, or Fractured? The chest wall can become injured in many ways. Most often, it's the result of blunt force trauma during a car accident or fall. The bones of the ribcage and sternum can break/fracture. The muscles supporting the ribcage can also be injured, strained, or bruised. To understand your injury, it may help to know what healthcare providers mean when they use different terms. Bruised Ribs The term "bruised rib" is used when the ribs are hurt but the bones aren't involved. The pain of a bruised rib comes from the strain or damage to: Soft tissuesCartilageMuscles of the chest wall It doesn't sound as serious as a break. Still, these injuries can be quite painful. Breaks/Fractures A "fracture" or "break" are the same injury. Rib fractures can be regular breaks or stress fractures. Those can be caused by overuse. They're common in athletes. The sternum can also be fractured. The term "cracked" rib is sometimes used to describe a broken rib or sternum. Recap A bruised rib or sternum is an injury that involves tissues other than bones. Injuries to the bone are called breaks, fractures, stress fractures, or cracks. Symptoms Any rib injury can be extremely painful. It's harder to manage than pain in some places. Unlike an arm or leg, your ribs can't be immobilized with a cast or brace. They move every time you take a breath. These structures are also part of most normal body movements. It can make you want to hold still. But that's a bad idea—it can make the injury worse or lead to complications. Illustration by Cindy Chung, Verywell Symptoms of bruised or broken ribs include: Sharp painTendernessSwelling or visible bruising This sharp pain may get worse when you twist at the waist, move your arms or shoulders, inhale, or cough. You may hear a "snap" or "crack" when the injury occurs. Others feel something "pop." That can mean a bone is broken. Symptoms of Serious Injuries With serious rib injuries, your chest may be visibly deformed. This can be a sign of multiple broken ribs. A major rib injury can lead to flail chest. It makes your chest movement the opposite of what it should be when you breathe. This is called paradoxical movement. In flail chest, at least three ribs are broken in two or more places. It's usually caused by severe trauma, like a car accident. Flail chest is a medical emergency. If you see or experience it, get immediate medical attention. Emergency Symptoms Rib injuries can cause potentially life-threatening conditions. Get emergency care if your or someone with a rib injury has:Severe pain that's getting worseWorsening shortness of breath or trouble breathingA high feverA cough that brings up blood or yellow-green mucus (phlegm)A visibly deformed chestParadoxical movement Complications Pneumonia is a common complication of broken ribs. It develops when you resist coughing because of the pain. In one study, one broken rib increased your risk by about 4%. Two broken ribs raised it to more than 17%. Other risk factors for pneumonia after rib fracture are: Being maleDrinking alcohol regularlyMore use of IV (intravenous) fluid right after injuryBeing over 65Chronic obstructive pulmonary disease (COPD) A condition called pneumothorax (collapsed lung) can develop if a broken rib injures a lung. Broken ribs can damage other nearby organs as well. That can lead to hemothorax (bleeding into the chest cavity). Recap Any rib injury can be really painful. You may hear the bone snap. Breathing and other movements can make it worse.Pneumonia is a possible complication. That's true even with minor breaks.Get immediate help for anyone with trouble breathing, paradoxical breathing movements, or other serious symptoms. Risk Factors You're more at-risk for rib fractures if you: Have osteoporosis (low bone density) Are prone to falls Are over 65 Have COPD or a chronic cough Smoke cigarettes Play contact sports Play sports with repetitive upper-body motions, like rowing (stress fractures) Young children have a lower risk of rib fractures. That's because their ribcages are more flexible. Diagnosis Rib injuries are often diagnosed based on your symptoms and a physical exam. Sometimes more tests are needed. Tests You may be sent for an X-ray or computed tomography (CT) scan if: Your provider isn't sure about the diagnosisYou're at high risk for complicationsThe injury could make an existing medical condition worseThe trauma may have injured nearby organs Injuries in Children Children with rib injuries should get a more thorough diagnostic process. Because of their ribcages' flexibility, it takes a lot to break a child's rib. That level of trauma is especially likely to damage organs. Additional tests and evaluations can help determine whether there's damage to more than just the ribs. How Are Broken Bones in Kids Different? Treatment Unlike an arm or a leg, a broken rib can't be set or put into a cast. It's not easy to keep a broken rib rested until it heals. Your entire ribcage moves with each breath. The primary treatment for rib injuries is time. It typically takes between four and six weeks for bruised or broken ribs to heal. Some breaks may take longer. Don't try to manage your rib pain by: Reducing movementBinding your torso to prevent movementAvoiding coughs or deep breaths These things can make complications more likely. In the first few days after the injury, you can use ice packs to reduce your pain and inflammation. While you heal, the main goal of treatment is to manage pain and prevent complications. Over-the-counter (OTC) painkillers, such as Advil (ibuprofen) or Tylenol (acetaminophen), can help. If you need stronger painkillers, talk to your healthcare provider. You may need to get extra rest. Consider taking a few days off from work or school to help with healing. Things that may help with your recovery include: Sitting upright: Rib pain may get worse when you lie down. That can make it hard to sleep. Try sleeping upright in a chair, instead. This can also help with breathing.Coughing with a pillow: To lessen the pain of coughing, hold a pillow against your chest. It absorbs the impact of sudden movement.Breathing normally: The pain can make you take shallow breaths. Try to breath as normally as you can to prevent pneumonia. Ask your provider about breathing exercises that may help.Avoiding smoking: Smoking delays bone healing, so try to stop or cut down. Summary A "bruised rib" doesn't involve bone injures. Fractures (or breaks) do. Rib injuries can be highly painful. Pneumonia and other serious conditions are possible complications. Get immediate help for trouble breathing or other concerning serious symptoms. Age, illness, and playing sports raise your risk of rib injuries. They're usually diagnosed based on symptoms and an exam. Imaging may be used. The main treatment is time. Also try ice packs, OTC pain medicine, and sleeping upright. A Word From Verywell To be safe, always get medical attention for a hard blow to the ribs and chest. Rib injuries aren't usually life-threatening. But some can lead to complications that are. Try to be patient while your ribs heal. It can be hard to deal with the pain and limited activity. But the discomfort should gradually go away. If it doesn't, talk to your healthcare provider. Was this page helpful? Thanks for your feedback! Dealing with joint pain can cause major disruptions to your day. Sign up and learn how to better take care of your body. Click below and just hit send! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 20 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Center for Biotechnology Information, U.S. National Library of Medicine: StatPearls. Anatomy, thorax, wall. Graeber GM, Nazim M. The anatomy of the ribs and the sternum and their relationship to chest wall structure and function. Thorac Surg Clin. 2007;17(4):473-vi. doi:10.1016/j.thorsurg.2006.12.010 National Center for Biotechnology Information, U.S. National Library of Medicine: StatPearls. Anatomy, thorax, wall movements. Majercik S, Pieracci FM. Chest wall trauma. Thorac Surg Clin. 2017;27(2):113-121. doi:10.1016/j.thorsurg.2017.01.004 Talbot BS, Gange CP Jr, Chaturvedi A, Klionsky N, Hobbs SK, Chaturvedi A. Traumatic rib injury: Patterns, imaging pitfalls, complications, and treatment [published correction appears in Radiographics. 2017 May-Jun;37(3):1004]. Radiographics. 2017;37(2):628-651. doi:10.1148/rg.2017160100 Miller TL, Harris JD, Kaeding CC. Stress fractures of the ribs and upper extremities: causation, evaluation, and management. Sports Med. 2013;43(8):665-674. doi:10.1007/s40279-013-0048-7 Khoriati AA, Rajakulasingam R, Shah R. Sternal fractures and their management. J Emerg Trauma Shock. 2013;6(2):113–116. doi:10.4103/0974-2700.110763 National Center for Biotechnology Information, U.S. National Library of Medicine: StatPearls. Flail chest. Agrawal A, Jena R, Sandeep Y, Shrikhande N. Understanding of flail chest injuries and concepts in management. International Journal of Students' Research. 2016;6(1):3. doi:10.4103/ijsr.int_j_stud_res_8_16 Kent R, Woods W, Bostrom O. Fatality risk and the presence of rib fractures. Ann Adv Automot Med. 2008;52:73–82. Ho SW, Teng YH, Yang SF, et al. Risk of pneumonia in patients with isolated minor rib fractures: a nationwide cohort study. BMJ Open. 2017;7(1):e013029. doi:10.1136/bmjopen-2016-013029 Marco CA, Sorensen D, Hardman C, Bowers B, Holmes J, McCarthy MC. Risk factors for pneumonia following rib fractures. Am J Emerg Med. 2020;38(3):610-612. doi:10.1016/j.ajem.2019.10.021 Flores-funes D, Lluna-llorens AD, Jiménez-ballester MÁ, et al. Is the number of rib fractures a risk factor for delayed complications? A case-control study. Eur J Trauma Emerg Surg. 2020;46(2):435-440. doi:10.1007/s00068-018-1012-x Hanak V, Hartman TE, Ryu JH. Cough-induced rib fractures. Mayo Clin Proc. 2005;80(7):879-882. doi:10.4065/80.7.879 Park S. Clinical Analysis for the correlation of intra-abdominal organ injury in the patients with rib fracture. Korean J Thorac Cardiovasc Surg. 2012;45(4):246–250. doi:10.5090/kjtcs.2012.45.4.246 Bulloch B, Schubert CJ, Brophy PD, Johnson N, Reed MH, Shapiro RA. Cause and clinical characteristics of rib fractures in infants. Pediatrics. 2000;105(4):E48. doi:10.1542/peds.105.4.e48 Tulay CM, Yaldiz S, Bilge A. Do we really know the duration of pain after rib fracture?. Kardiochir Torakochirurgia Pol. 2018;15(3):147–150. doi:10.5114/kitp.2018.78437 Bemelman M, de Kruijf MW, van Baal M, Leenen L. Rib Fractures: To Fix or Not to Fix? An Evidence-Based Algorithm. Korean J Thorac Cardiovasc Surg. 2017;50(4):229–234. doi:10.5090/kjtcs.2017.50.4.229 Fagevik Olsén M, Slobo M, Klarin L, Caragounis EC, Pazooki D, Granhed H. Physical function and pain after surgical or conservative management of multiple rib fractures - a follow-up study. Scand J Trauma Resusc Emerg Med. 2016;24(1):128. doi:10.1186/s13049-016-0322-4 Patel RA, Wilson RF, Patel PA, Palmer RM. The effect of smoking on bone healing: A systematic review. Bone Joint Res. 2013;2(6):102–111. doi:10.1302/2046-3758.26.2000142 Additional Reading Bhavnagri SJ, Mohammed TL. When and how to image a suspected broken rib. Cleve Clin J Med. 2009;76(5):309-314. doi:10.3949/ccjm.76a.08026 de Jong MB, Kokke MC, Hietbrink F, Leenen LP. Surgical management of rib fractures: Strategies and literature review. Scand J Surg. 2014;103(2):120-125. doi:10.1177/1457496914531928 Senekjian L, Nirula R. Rib fracture fixation: Indications and outcomes. Crit Care Clin. 2017;33(1):153-165. doi:10.1016/j.ccc.2016.08.009 Wanek S, Mayberry JC. Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury. Critical Care Clinics. 2004;20(1):71-81. doi:10.1016/s0749-0704(03)00098-8