The Difference Between Bruised, Broken, and Fractured Ribs

Bruised, broken, and fractured ribs are different injuries. "Broken" or "fractured" ribs both mean that the bones are involved in the injury. A "bruised" rib means the supportive muscle and tissues around your ribcage have been hurt.

The ribcage protects the heart and lungs. It is made up of 12 bones on each side of the chest. Any rib can be injured but some are more likely to break or bruise than others.

This article compares bruised, broken, and fractured ribs. It will go over the most common causes of rib injuries, as well as how broken and bruised ribs are diagnosed and treated.

Bruised vs. Broken/Fractured Ribs

Most rib injuries happen when there is blunt force trauma to the chest wall, such as from a car accident or fall.

There are different terms for rib injuries, depending on which structures are involved. The bones of the ribcage and sternum can break (fracture), and the muscles supporting the ribcage can be strained (bruised).

Bruised Ribs

The term "bruised rib" is used when the bones of the ribcage are not actually injured. The pain of a bruised rib comes from the strain or damage to:

• Soft tissues
• Cartilage
• Muscles of the chest wall

It might not sound as serious as a broken rib but bruised ribs can be very painful.

Broken or Fractured Ribs

The terms "broken rib" and "fractured rib" mean the same thing—a "fracture" or "break" are the same injury.

Rib fractures can be regular bone breaks (like from a fall) or stress fractures caused by overuse (common in athletes).

The sternum can also be fractured. The term "cracked" rib is sometimes used to describe a broken rib or sternum.

Symptoms of Bruised or Broken Ribs

You may hear a "snap" or "crack" when the rib injury happens. You may feel like something "popped" in your chest.

A rib injury can be extremely painful and is harder to manage than other injuries. Unlike an arm or leg, your ribs cannot be put in a cast or brace to keep them from moving. In fact, they move every time you take a breath.

These structures are also part of most normal body movements. The pain of a broken or bruised rib can make you want to hold still. However, not moving can actually make the injury worse or lead to complications of a broken rib (like pneumonia).

Symptoms of bruised or broken ribs include:

• Sharp pain (which may get worse when you twist at the waist, move your arms or shoulders, inhale, or cough)
• Tenderness
• Swelling or visible bruising on your chest

Symptoms of Serious Rib Injuries

With serious rib injuries, your chest might actually look different—even deformed. The unusual appearance can be a sign that you've broken more than one rib.

A major rib injury can lead to a condition called flail chest. When this happens, your chest movement is the opposite of what it should be when you breathe (paradoxical movement).

In flail chest, at least three ribs are broken in two or more places. The condition is 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.

Complications of Rib Fractures

Pneumonia is a common complication of broken ribs. Usually, it happens when a person avoids coughing because it hurts too much.

A 2017 study found that having one broken rib increased a person's risk for pneumonia by about 4%, and having two broken ribs raised it to more than 17%.

Other risk factors for pneumonia after rib fracture are:

• Being male
• Drinking alcohol regularly
• More use of IV (intravenous) fluid right after the injury
• Being over 65 years old
• Chronic obstructive pulmonary disease (COPD)

Other complications of a broken rub include:

• Collapsed lung (pneumothorax) from a broken rib that's punctured a lung
• Damage to nearby organs that causes bleeding in the chest cavity (hemothorax)
  

Risk Factors for Broken Ribs

You're more at risk for rib fractures if you:

• Have low bone density (osteoporosis)
• Are prone to falls
• Are over 65
• Have COPD or a chronic cough
• Smoke cigarettes
• Play contact sports or sports repetitive upper-body motions, like rowing (stress fractures)
  

How Are Bruised or Broken Ribs Diagnosed?

Rib injuries can be diagnosed based on your symptoms and a physical exam. However, in some cases, your provider might want you to have other tests.

Tests

An X-ray or computed tomography (CT) scan might be needed if you have a rib injury because:

• Your provider is not sure about the diagnosis
• You're at high risk for complications
• The injury could make an existing medical condition worse
• The trauma may have injured nearby organs

Rib Injuries in Children

Young children actually have a lower risk of rib fractures because their ribcages are more flexible than adults' ribcages.

That said, kids with rib injuries often need more tests. Since kids' ribcages are more flexible, it takes a lot to break a child's rib. Trauma that's enough to break a rib is also more likely to have damaged organs as well.

How Are Broken or Bruised Ribs Treated?

Unlike an arm or a leg, a broken rib cannot be set or put into a cast. It's not easy to keep a broken rib rested until it heals because your entire ribcage moves as you breathe.

That means the main 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 to get better.

There are some things you should not do if you have a rib injury because they can make complications more likely.

If you have a bruised or broken rib do not:

• Reduce your movement
• Bind your torso to prevent movement
• Avoid coughing or deep breaths

Pain Management for Bruised or Broken Ribs

While you heal from a broken or bruised rib, the main goal of treatment is to manage your pain and prevent complications.

In the first few days after the injury, you can use ice packs to reduce pain and inflammation. Over-the-counter (OTC) painkillers, such as Advil (ibuprofen) or Tylenol (acetaminophen), can also help. If you need stronger painkillers, talk to your healthcare provider.

It will help to get some extra rest. Consider taking a few days off from work or school to help with healing, especially if you have a physical job.

Other things that may help you recover from a broken or bruised rib include:

• Sitting upright: Rib pain may get worse when you lie down, which can make it hard to sleep. Try sleeping upright in a chair. This position will also make breathing a little easier.
• Coughing with a pillow: To lessen the pain of coughing, hold a pillow against your chest to absorb the impact of the sudden movement.
• Breathing normally: The pain from a rib injury can make you want to take shallow breaths. That said, breathing as normally as possible is key to preventing pneumonia. Ask your provider about breathing exercises that may help.
• Avoiding smoking: Smoking delays bone healing. If you can cut down or quit, it will help your recovery and be beneficial for your long-term bone health.

Summary

Bruised, broken, and fractured ribs are not the same injury. A "bruised rib" does not involve the bones of the ribcage while fractures (or breaks) do.

Your age, health, and activities can put you at higher risk for getting a bruised or broken rib, but it can also happen if you're in an accident.

A provider can often diagnose a broken or bruised rib easily, but there is not much to do by way of treatment. Pain management for a bruised or broken rib mostly involves ice packs, OTC pain medication, and finding positions that are comfortable for rest and sleep while you heal.

A Word From Verywell

Always get medical attention for a hard blow to the ribs and chest. Rib injuries are not usually life-threatening on their own, but they can lead to serious complications.

While it will probably hurt to cough (or even breathe normally) when you have a broken or bruised rib, doing these things will help prevent complications like pneumonia.

If you have "red flag" symptoms like trouble breathing or coughing up blood, you need immediate medical care.

If you're concerned about rib pain because it's not getting better or has started to get worse, call your provider.