Stress fractures of the ribs can be caused by excessive contraction of the muscles that attach to the ribs such as serratus anterior.
Symptoms include gradual onset of chest or back pain. Pain may be felt on one side, but difficult to pin-point the exact location. Pain is usually worse on deep breaths, as well as coughs and sneezes and gets worse with activity and eases with rest. Tenderness when feeling the rib involved (although this may be hard to locate).
Baseball pitchers tend to suffer stress fractures of the first rib as might tennis players and other overhead sports. Repeated contraction of the anterior scalene muscle (in the neck) pulls on its attachments on the 1st rib, causing a stress fracture. Rowers tend to get stress fractures of the 4th or 5th ribs which are caused by contractions of the serratus anterior muscle.
- Treatment may involve rest and immobilisation in a sling.
- Pain may take two weeks or more to go with return to sports specific training taking 8 or more weeks.