Managing chest wall injuries

What is a chest wall injury?

Injuries to the chest wall include fractured ribs, fractured sternum (breastbone) and/or bruising to the lungs. They normally occur following an impact trauma to the chest, such as falling from a height, a road traffic accident or during impact sports.

Signs and symptoms

Following an injury to the chest wall, people frequently experience pain when coughing, taking deep breaths and when laughing. It can also be uncomfortable to move in bed and walk. Although chest wall injuries can be painful, you can expect this discomfort to improve over a period of 3-6 weeks. This may take longer for more severe injuries.


Chest wall injuries are managed differently depending on the severity of your injuries and the symptoms you are experiencing.

Some people may require surgery to fix broken ribs and some patients may require chest drains. However most chest wall injuries are managed without surgery and heal spontaneously over a period of weeks.

When you are in hospital some patients require oxygen to help their breathing and many will require some painkillers to manage enable them to move around and take deep breaths without discomfort.

Possible complications

The chest wall moves continuously while we breathe. Following rib fractures, this movement can be painful and can stop us from taking deep breaths, coughing or laughing. This in turn prevents us from clearing our natural lung secretions. These secretions can build up and cause a chest infection. Some people also experience pain and stiffness in the shoulder and spine. This mainly results from not moving as we usually would, due to pain caused by the injury.

What can I do to help my recovery?

To reduce the risk of developing a chest infection there are several things you can do.

These include:

  1. Taking deep breaths regularly throughout the day - aim to take 10 deep breaths every hour
  2. Do not suppress the need to cough or take cough suppressing medicine- it is important to clear any phlegm that builds in your lungs.
  3. Take regular pain relief
  4. Support your ribs when you cough by hugging a pillow or rolled up towel into your chest.
  5. Do a steady amount of exercise or activity every day and gradually increase this until you have returned to your usual activities
  6. Avoid spending prolonged periods of time in bed

What happens after I have left hospital?

You should contact your GP if you:

  1. Feel unwell
  2. Develop a fever
  3. Feel short of breath
  4. Start coughing up yellow, green or blood stained phlegm
  5. Experience pain on the chest wall that persists after 8 weeks
  6. Feel heart palpitations

Do I need follow- up physiotherapy?

You should contact your GP for a referral to your local physiotherapy service if:

  1. You have difficulty in achieving full movement of your arms or spine
  2. Pain in your chest, back or shoulder does not settle after 6-8 weeks
  3. You find it difficult to return to full work duties or hobbies
  4. Breathlessness stops you from returning to previous levels of fitness

Thanks to St Georges' University Hospitals NHS Foundation Trust, Major Trauma Therapy Team, @STGTraumaPTOT for this information