♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- 'Cause we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Today we're gonna talk about cracked and broken ribs.
We're gonna talk about essential precautions.
We're gonna show you at-home treatments and recovery time.
This is an updated video.
We did this before, we're doing it again.
- Right, and again, we've got some better information on it
or otherwise we wouldn't have updated it
'cause rib fractures can be very painful.
- Yeah, you don't want to mess around with them.
- And it's amazing.
You know, they can be fatal.
And we're gonna talk about that potential as well.
And then we're gonna give you-
- Brad, you're gonna scare people now.
- It's- - Cautious.
- It's a truth.
I've got some sa, satis- - Statistics.
- Statistics, exactly.
- By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos, how to stay healthy, pain free,
and we upload every day.
Pay attention.
- Bob, block out Sam.
- Go to bobandbrad.com.
Go to the giveaway section.
We're always giving something away.
This week, we're giving away the booyah stick.
- Oh, yes. - Booyah, hold on there.
I got our.
You can also go to Facebook.
It'll be pinned to the top of page.
Go to Twitter, Instagram or TikTok
if you want a 60 second version of our program
and if you want to listen to us in the car.
- Sure, podcasts we do have.
And we have some wonderful speakers.
- Or while you're working out.
Yeah, great interviews.
- So Bob, are we gonna continue?
- Yeah, let's get to it.
- So rib fractures, we're gonna give some statistics.
I've got it right that time.
95% of all rib fractures are from blunt trauma,
which is not hard to. - It could be a fall.
It could be a motor vehicle accident, it could be.
- As a matter of fact, 53% are from MVA,
or motor vehicle accidents.
Typically falls, it's the elderly, when they fall.
As you age, things get a little more brittle
and those ribs are more susceptible.
- Just happened to my mom.
She's 90 years old.
She fell and she broke a rib.
- Oh, so how's she doing?
- She's doing good now. - Okay, now we're good.
- I'll talk about one of the things I did for it.
- Okay, good, so then we're gonna carry on
to which ribs are most commonly fractures,
and it's the middle ribs.
- Which just makes sense
because they're sticking out the most.
- Exactly, keep in mind with the ribs, towards the sternum,
the sternum is a pretty solid bone down the middle,
but then there's some cartilage here
between the sternum and the ribs.
So this area here.
- You can see this, you know, different color here.
- Right, exactly.
So the cartilage can rip or tear.
But usually it's the bone that.
- That gives way. - That get fractured.
And x-rays, you need x-rays to confirm this.
And sometimes you have to have it done by the radiologist
'cause they're small fractures.
You don't see them real clearly,
but they hurt and they can be painful.
And a big thing is if you have fractured ribs
up on rib number one or number two,
way up here underneath the collarbone,
that can be a serious problem
because right below that, there's an artery and a vein
that come right from the heart.
And they if they get punctured,
that can be life threatening.
- Like the subclavian arteries, up in that area.
- Exactly, the other thing is with fatalities,
it's typically in the geriatric population, older people.
The rib, what happens, it breaks, cracks,
and then it punctures into the lung.
And that's a hemo pneumothorax.
- Or a pneumothorax, depending on what has happened.
- Right, so the lungs can get punctured
and then either blood or some fluid gets into the lungs.
You get pneumonia, you get complications,
and that's a real problem.
- Oh, and the fact that you can't use one lung,
it doesn't help matters either, so.
- Typically, if you're a younger person,
it's not as likely to happen.
But you really should go in and get this checked out
if you've got a lot of pain in your ribs.
Typically with breathing,
your rib cage expands as you breathe in.
So if you've got fractured ribs from that blunt trauma
and those rib cage expands,
it's like taking and irritating that injury
with, kind of like a knife 'cause it's very painful.
There's also muscles between each of the ribs.
Intercostal muscles.
And when you exhale,
they contract so you can breathe better.
It's all part of the breathing process.
And that irritates it.
So you cannot laugh.
I mean, you want to minimize your laughing, your coughing.
- So don't watch Bob and Brad because.
- (laughing) Yeah.
We're not supposed to make anybody laugh here.
All right.
- But you know, it's funny, Brad.
On my mom, what I did is I actually put my hands on the ribs
and I could find a spot.
- Just 'cause it was point tender.
- Yeah, and we were just trying to decide
whether or not to send her in.
I don't want you to use this as a judgment.
You should go in.
But I pushed on there and that really confirmed it.
There was a really tender spot.
- Yep, yep, so what we do want to do
is give you some things that we talked about avoiding.
The laughing, the sneezing.
Sleeping, this is a little interesting to me.
They said try to avoid sleeping on your back
and you can actually sleep, if you can do it.
- On the side. - Right, on the side.
- That's fractured. - Where the fracture is.
If you sleep the other way,
if this is my right side's fractured,
I sleep on my left side.
That can cause some drainage in there
that can cause a problem with the pneumothorax, right.
One thing's for sure is you need to get comfortable.
You're gonna take pillows as you lie down and place them.
Use your comfortable position.
When you fall asleep, you start rolling around.
Put pillows alongside of you on each side.
Or if you're on one side,
it helps put a pillow on that side
under the rib cage there.
And that may help you from inadvertently rolling
in the middle of the night.
And then you wake up with extreme pain
and you're, you know, saying bad things because it.
- Yeah, you may need some medication here, definitely.
It's a little bit hard because my mom,
we didn't want her on any medication
that's gonna make her sleepy, you know?
So no muscle relaxants, no. - Right.
- So we kind of stuck with Tylenol
or ibuprofen or something like that.
- And that you want to consult with your physician with,
depending if you're on other medications particularly.
You've got to go through the doctor
and make sure things are all working together.
- All square.
- But you can always go,
particularly right after this fracture.
Things are very tender.
Get the cold pack out.
Let's get Sam out of the way here.
Yeah, you did a good job for us, Sam, but we don't need you.
You should get a cold pack that's soft and pliable
when you pull it out of the freezer.
I've had patients, they'll take the cold packs
that are in from your cooler and they're plastic, hard.
And they put it on there and it's not very comfortable
and it doesn't conform.
So you want to, can you just move.
- Brad actually, if you look up Bob and Brad,
How to Make a Ice Pack,
Brad goes over on how to make one of these just for using.
Rubbing alcohol and- - Water.
And water.
- Yep, and Ziploc freezer bags.
- Yeah, it makes a great bag.
- They work really well actually.
Just like this.
I have one at my house in my freezer right now.
My mother, I made one for her.
It's cheap, they work wonderful.
And anyways, there we go.
We can put that on here.
Getting out of bed can be a real challenge.
You're gonna have to work on log rolling and not twisting.
And getting up using your arms, taking your time.
And you'll know, it's not gonna be fun.
- So, later on, what I did with my mom,
because this lasted a couple days to a week
and I wanted to get her the best help she could get.
So I bought her a Thermotex.
These are pricey, but these provide deep heat.
Normal heat only goes like skin deep.
- Right.
- But this goes 2.36 inches?
- Exactly. - 2.36 inches.
So I knew it'd get in there into the rib area,
the muscles around it.
And she liked it, I mean, so.
I moved up on the list on our family.
I come from 11 kids.
- So start out with a cold pack.
But after the inflammation's settled down
and it's starting to feel better,
in a few days transition, maybe even a week.
- To some type of heat. - Try some type of heat.
The other thing is wrapping the ribs with that ACE bandage
and keeping it all.
- You're not supposed to do that, right?
- No, now. - No wrapping.
- Absolutely no wrapping.
It constricts things and it can cause problems.
So that's one less thing off the list.
That's a good deal I'm thinking.
So no wrapping.
Once your ribs start to feel better,
coughing, breathing is getting better,
then start think about deep breathing.
Five to 10 deep breaths.
So using the rib cage, good posture,
let the shoulders go back, and let that rib cage expand.
And you'll know it, when you'll get so big,
and then all of a sudden it's gonna start to hurt.
When you hit the sharp pain, don't push it, exhale.
So you go in, and maybe 50%, ow, then exhale.
And do that five to 10 times.
And do that every couple hours throughout today
because you don't want that scar tissue
where the broken ribs are to scar down and get tight,
'cause it's gonna cause problems down the road.
- You could even lie on your back
and bring your arms up overhead.
- There you go.
- And take some deep breaths that way
to really expand that rib.
- Exactly, should we, here Bob, let's let's just show that
because I want to bring this into something else.
So you're doing your breathing.
And then your 10 breath feel pretty good like this.
And then start to do this.
And you may find you only get to here,
especially on the broken side.
Ooh, 'cause bringing it up is gonna hurt.
But you know, after a few days, deep breath with this.
And once you can do this, five or 10 repetitions,
and it's not so sharp pain, it's just feeling some stretch.
Then we're gonna progress on to rotation.
- Sure, were you gonna use the?
- Yeah, and this is where you really need,
you can use a cane.
I've done this with patients.
- A broomstick you could use.
- Use a broomstick, something, has to be strong
because you're gonna put it over the back of your shoulders
and like this.
And the reason we use this,
and you do it in a seated position, not standing,
is because seated locks your pelvis in.
Putting your hands here lock your shoulders in.
And then we're gonna rotate.
So all the rotation happens in the thoracic area
or the ribs.
So you're gonna go both directions.
Now if one way is probably gonna hurt more,
when you get to the sharp pain, just stop.
Don't push it.
If the other way feels better,
go until how pain tolerates and allows you.
And again, you might just go one way
'cause this way really hurts, you know?
And the next day you'll find that
you do 10 to the left and back to the right,
you can do five and it's not as far, but it's better.
So progress as tolerated.
- So you can see if I did that standing,
my pelvis might move.
- Yep, I mean, you can do it,
but it's gonna be more effective in a seated position.
Bob, the next one I want to talk about
is you're gonna use a stick again in a seated position.
Not on a rolling stool,
but you know, as long as you're in a chair.
And let's say it's on my right side.
We're just gonna stretch this.
I call this a Statue of Liberty stretch.
Arms up like that. - There we go.
- Bring that arm up until you feel a stretch.
Lock the hand on that stick and just lean forward.
And you're gonna feel that rib cage stretch.
Again, 10 repetitions, not into the sharp pain,
into the stretch and do that a few times a day.
And that will improve until you get to the top.
Then you can really stretch it out.
- Yep, you're stretching all the muscles
that attach into the rib cage too when you do that.
So it really works out well.
- Exactly.
For these younger people, you want to do that for sure.
You could, if you have a pull up bar, you could.
Okay, if you have a pull-up bar,
that, you can just use body weight to hang
and stretch that rib cage out.
We have our pull-up system here that works well.
Back to the wall actually
kind of can help work on your posture.
Use whatever you have to hang on.
And gently, don't just.
If you have to jump,
you get a quick stretch that won't work.
You want to get up on a stool
and let your body weight go down gently.
Same rules, no sharp pain, just a stretch.
And you can go on and off with that.
Or if you can hang and it's starting to feel good,
you know, you may hang for 20 to 30 seconds
and get a good stretch.
- You get most of the weight on it.
- You can move around when you get better.
This is for the younger people who are gonna get active.
They're gonna get into a sport.
You may do this as well, five or 10 repetitions,
and really get things mobilized, yep.
Situps, get into your situps,
'cause you want to work on contracting those muscles.
However you want to do situps.
- Not full situps though.
- No. - Curls.
- Yeah, curls.
I'll show if you. - Sure.
- So you know, just this.
We're doing this.
We're not, and you want to make sure.
- Bringing the head straight up always.
- Some diagonals as well.
Not this.
- By keeping the back flat against the bed or the floor.
- Exactly, very good.
Oh, I do want to talk about this too.
I think it's really helpful.
- Right, this is a good one I think.
- If you got a band with handles, they work wonderful.
You're gonna connect it to a door, to a wall.
We used the wall anchor, it works well.
And this really works that core.
And we call it stir the pot.
You're gonna get in that athletic position
and you make circles.
Tighten everything up.
And you'll probably find one way, yeah, not so bad.
Then you go the other way.
Oh, that's waking you up a little bit.
So you're gonna work yourself into it
so you can do that for 30 seconds at a good resistance.
If you need more resistance, simply step away from the wall.
- What's funny about that,
every time I watch that or if I do it,
it doesn't look like you're working that hard.
- No. - But you are (laughing).
I mean it's, you feel it and you're working the muscles.
- Yep, exactly.
Yeah, it's a great way to trunk or strengthen that core.
- All right, good job, Brad.
I'm gonna give you some kudos.
- Really. - Yeah.
- Oh wow, okay then, say no more.
- All right, thanks for watching.
(upbeat music)