Mid & Upper Back

What It Is

Rib injuries normally refer to rib fractures, which is a break in one or more of your ribs. At times, the ribs aren't broken, but there is severe bruising of the ribs or their surrounding muscles. Injuries to the ribs often occur when there is a strong force to the chest, such as from an accident, fall or sports injury (NHS, 2024; East Kent Hospitals University NHS Foundation Trust, 2023). Injuries to the ribs can also be caused by severe coughing (NHS, 2024). This is often more common in cases where the bones are already weak, such as from osteoporosis or other bone diseases.

In babies, rib fractures are a strong warning sign that the child may have been hurt on purpose (Shelmerdine et al., 2018). If a baby or young child has a rib injury, it is important that they are seen by a doctor and that the cause of the injury is found.

Many people get rib bruising, but mistake it for a fractured or "cracked" rib. Bruised and broken ribs can both be very painful, and you can have difficulty taking a deep breath, or get pain while coughing or sneezing (NHS, 2024). Ribs cannot easily be splinted or supported like other bones, so they are usually left to heal naturally, and there is often no need for an X-ray (NHS, 2024). Small rib fractures can also be hard to see on a chest X-ray (Shelmerdine et al., 2018).

Rib Anatomy

The ribs protect and encase the chest cavity, which is where a number of vital organs are located. To protect these organs, the rib cage is made up of long, curved individual bones that join the spinal vertebrae at the back. At the front, most of the ribs connect to the breastbone (sternum) by means of costal cartilage.

Even though they are fixed in position, the ribs do allow for some degree of movement, which helps the chest to expand and relax when breathing in and out. There are 24 ribs, 12 on each side of the body (Cleveland Clinic, 2024). The first seven pairs are called "true" ribs because their costal cartilage attaches directly to the sternum. Ribs 8 to 10 are called "false" ribs because they attach to the rib above rather than directly to the sternum, and ribs 11 and 12 are called "floating" ribs because they do not connect to the front of the rib cage at all (Cleveland Clinic, 2024).

The important point to note is that ribs connect to the front and the back, so a pain in the front can sometimes be felt as a pain in the upper back, and vice-versa.

Between the ribs are intercostal muscles, and these can become damaged during trauma.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Rib Injury or Fracture

Breathing exercises, supported coughing and gentle shoulder and upper-body movement exercises can help reduce stiffness in the chest (East Kent Hospitals University NHS Foundation Trust, 2023). I can guide you through these and, once the injury has settled, help with the surrounding muscles. See the My Approach tab for how I work.

1. Painkillers

Broken or bruised ribs usually get better by themselves within 2 to 6 weeks (NHS, 2024). During the healing process, you need good pain relief so that you can keep moving, breathe deeply and cough properly. Pain that stops you breathing deeply and coughing can lead to chest infections (East Kent Hospitals University NHS Foundation Trust, 2023).

The NHS recommends painkillers such as paracetamol or ibuprofen gel (or ibuprofen tablets if needed) for broken or bruised ribs (NHS, 2024). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

If your pain is not controlled, speak to your family doctor or nurse practitioner, as you might need stronger painkillers (NHS, 2024).

2. Breathing and Movement

Breathe normally and cough when you need to, as this helps clear mucus from your lungs and prevent chest infections. Hold a pillow against your chest if you need to cough. Regularly take slow, deep breaths, walk around and sometimes move your shoulders (NHS, 2024). Try to sleep more upright for the first few nights, and do not lie down or stay still for a long time (NHS, 2024).

Tips

Avoid wrapping a bandage tightly around your chest or strapping your ribs. This stops your lungs being able to expand, which can lead to chest infections (East Kent Hospitals University NHS Foundation Trust, 2023).
Depending on what type of work you do and how severe the injury is, you might need to take time off work (NHS, 2024).
Do not strain yourself or lift heavy objects, do not play sports or do exercise that makes your pain worse, and do not smoke (NHS, 2024).
Expect healing to take around 2 to 6 weeks (NHS, 2024). If the area does not feel any better after 6 to 8 weeks, contact your family doctor or nurse practitioner (East Kent Hospitals University NHS Foundation Trust, 2023).
Holding an ice pack (or a bag of frozen peas) wrapped in a tea towel to the affected ribs regularly in the first few days can help bring down swelling (NHS, 2024).
Ask for an urgent appointment with your family doctor or nurse practitioner if your pain has not improved within a few weeks, you are coughing up yellow or green mucus, or you have a very high temperature or feel hot, cold or shivery, as you may have a chest infection (NHS, 2024).

Treatment

My Approach

Bruised and broken ribs usually heal by themselves, but the pain can make you breathe shallowly and hold yourself stiffly, so the muscles around your chest and upper back tighten up. My aim is to keep you comfortable enough to breathe deeply, cough and keep moving while the ribs heal, without putting pressure through the injury.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I assess your breathing, posture and how your neck, shoulders and upper back move. If your ribs were treated surgically, or the injury stops your normal daily activities, I need your medical team's okay before any hands-on treatment.

While the Ribs Heal

No pressure on the injured ribs and no forceful work through the rib cage
Gentle work for the neck, shoulders and upper back, in a comfortable position
Breathing exercises, supported coughing and gentle shoulder movement
Warm applications away from the injury, and I'll show you how to use ice safely at home

As It Settles

Work on the muscles around the ribs; chest wall work needs your informed consent and a written consent form
Gentle upper back mobility, then building back up to lifting, work and sport

If your breathing or chest pain gets worse, or you cough up blood, call 911 (see When to get emergency help).

What to Expect

Typical Course

Typical course: Usually short visits once or twice a week at first, then weekly, then less often as you return to your normal activities. Most broken or bruised ribs heal in about 2 to 6 weeks, in step with your medical team's advice.

What I Focus On

Working Within Your Medical Team's Advice

Comfortable Breathing

Neck & Shoulder Relief

Gentle Chest Mobility

Gradual Return to Activity

Please read

When to See a Doctor First

When to get emergency help

Call 911 or go to the emergency room at your nearest hospital if you have a broken or bruised rib and (NHS, 2024):

your injury was caused by a serious accident, such as a car accident
you have shortness of breath that is getting worse
your chest pain is getting worse
you have pain in your tummy or shoulder
you are coughing up blood

These can mean a broken rib has damaged something else, like your lung, liver or spleen (NHS, 2024).

Sources

References

NHS (2024) Broken or bruised ribs. Available at: https://www.nhs.uk/conditions/broken-or-bruised-ribs/ (Accessed: 7 October 2026).
East Kent Hospitals University NHS Foundation Trust (2023) Rib fractures. Available at: https://leaflets.ekhuft.nhs.uk/rib-fractures/html (Accessed: 7 October 2026).
Cleveland Clinic (2024) Rib Cage (Thoracic Cage). Available at: https://my.clevelandclinic.org/health/body/rib-cage (Accessed: 7 October 2026).
Shelmerdine, S.C. et al. (2018) 'Chest radiographs versus CT for the detection of rib fractures in children (DRIFT): a diagnostic accuracy observational study', The Lancet Child & Adolescent Health, 2(11), pp. 802–811. doi: 10.1016/S2352-4642(18)30274-8. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6350458/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooRib Bruising and Fractures

What It Is

Rib Anatomy

Self-Care & Treatment

How to Treat a Rib Injury or Fracture

1. Painkillers

2. Breathing and Movement

Tips

My Approach

While the Ribs Heal

As It Settles

Typical Course

When to See a Doctor First

When to get emergency help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooRib Bruising and Fractures

What It Is

Rib Anatomy

Self-Care & Treatment

How to Treat a Rib Injury or Fracture

1. Painkillers

2. Breathing and Movement

Tips

My Approach

While the Ribs Heal

As It Settles

Typical Course

When to See a Doctor First

When to get emergency help

References

Related Conditions

Congenital Scoliosis

Long Thoracic Nerve Palsy

Scapula Fracture

Scoliosis in Children and Adolescents

Book a session