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kaitie
03-11-2010, 07:25 AM
Hey guys. I'm wondering about timelines on how fast broken ribs heal. Basically, I've got a character who broke two/three ribs in a fight. One of the things I'm really wanting to use for the final climax battle is having the bad guy knee him in the same ribs. In my mind, this would be excruciatingly painful and have him down on the knees gasping for breath (which probably hurts almost as bad). I've never had a broken rib, so goodness knows.

Anyway, I'm trying to figure out if it's okay to have the climax take place about two weeks out of the initial injury, or if I should shorten it up some. Would they have healed enough in two weeks to make it less painful?

Canotila
03-11-2010, 07:35 AM
They are still going to be broken for at least 6 weeks. The hardest thing is remembering to take deep breaths so you don't get pneumonia because it hurts bad to breathe. There is also usually soft tissue damage like bruising or tears and tears can take more than two weeks to heal up.

Getting kneed in already broken ribs would majorly suck.

firedrake
03-11-2010, 07:39 AM
Yup, six weeks.

I broke my 5th and 6th ribs and for six weeks it hurt to breathe, sneeze, cough, use a tin opener, drive a car...etc. etc. You don't realise how much the muscles around your ribs are used until you bust a couple.
The docs don't do anything, as Canotila said, you need to be able to breath unhindered. In the bad old days, they used to bind your chest but it leads to pneumonia.

Almost 6 weeks to the day, the pain just stopped, as if someone had turned a tap off.

I hope I never break another rib. It wasn't funny.

kaitie
03-11-2010, 07:46 AM
Alright, that's great! I was pretty certain it would still be painful for some time, but I wasn't sure. The guy's being really crazy and working in spite of this, but he's also got a doctor pumping him full of nerve blockers to do it. I was just thinking he can probably manage to get around (he has an incredibly high pain tolerance) but that something like this would just be one of those damn sorta pains. Plus it freaks me out to even think about it, which is the effect I'm going for lol. Thanks guys.

PGK
03-11-2010, 08:37 AM
I've had a rib "detached" from my sternum (doctor's words). Took a few days shy of a month to breathe or steer my car without sharp pain.
I guess I forgave the girl responsible since I ended up marrying her.

RobinGBrown
03-11-2010, 12:25 PM
I've had bruised and fractured ribs a couple of times from motorcycle falls (always the same rib too!). You can't sleep properly for at least two weeks and the pain gradually gets less over six weeks or so. There's difficulty and discomfort for considerably longer than that though.

Another impact to the ribs in the first two weeks would be absolutely agonising and leave you gasping for breath and completely vulnerable.

In fact getting into a fight would be agony, just trying to swing your arms (or a weapon) with a broken rib would be astonishingly painful.

kaitie
03-11-2010, 12:41 PM
I've had bruised and fractured ribs a couple of times from motorcycle falls (always the same rib too!). You can't sleep properly for at least two weeks and the pain gradually gets less over six weeks or so. There's difficulty and discomfort for considerably longer than that though.

Another impact to the ribs in the first two weeks would be absolutely agonising and leave you gasping for breath and completely vulnerable.

In fact getting into a fight would be agony, just trying to swing your arms (or a weapon) with a broken rib would be astonishingly painful.

That's why he's on the nerve blockers, and even then I imagine it's not a happy thing. He has a hard time moving and stuff. That's perfect, though. In this particular situation he doesn't have any medication, he had been drugged so he's still getting over the effects of that, and he's already vulnerable. I'm aiming for putting him in a position that he just can't fight back.

Scoody
03-11-2010, 02:43 PM
I've had bruised and fractured ribs a couple of times from motorcycle falls (always the same rib too!).

I have broken or cracked my ribs three times. Once playing football in high school, then a few years later falling off my horse and then t-boning a car on my motorcycle. The last one I had too many injuries to worry about the ribs much.

The football injury and falling off the horse though, put me through some excruciating weeks. I was on the bench for 6 weeks when I was hurt playing football. My first game covering a punt I took a hit and it put me out for a quarter. Jeez! That hurt. I saw stars before my eyes!

shaldna
03-11-2010, 04:44 PM
I;ve been unfortuante enough to break ribs on three separate occassions (I have horses) (i broke my back once too, but that's a different story) and you are generally looking at about two months before you can think of trying anything strenuous.

It's not just the break with ribs, it's that feeling of not being able to breath that is actually worse. Your movement is so restricted and you can't sleep.

So yeah, for a clean break (assuming no internal punctuing - done that too, in which case you're looking at about four months really before your fully 'recovered') then about 8 weeks or so will see you back to almost normal, but probably another four or five weeks on top of that before you are able to do all the things you did before.

Elaine Margarett
03-11-2010, 05:36 PM
I had *four* broken ribs due to a car accident where the seatbelt retracted and forced the underwire of my bra to slice through the ribs like a knife.

It took a good two to three months to heal. I could walk okay, and sitting was fine. Laying down was near to impossible the first two months.

I would imagine if your character was hit in the same ribs that were broken a few weeks before, they would break again.

Summonere
03-11-2010, 09:46 PM
Two weeks sounds awfully fast to heal two or three broken ribs. As the no doubt better informed among us say, expect longer.

Same old bottom line: it's your story, so your character can be as tough as you want.

My experience: Guy kicked me in the ribs once and I'm pretty sure one of them broke. I say “pretty sure” because it hurt to breathe, cough, sneeze, laugh, turn-twist upper body, for at least a couple of weeks after that. More like four weeks, as I recall. And I didn't go to a hospital to get checked out. I was young and stupid and didn't know any better, so a week or two after that sparring incident, I was sparring again, but I was much more protective of that angle than any other, and my left arm wasn't used much as it stayed protectively welded against the questionable-rib side in a covering position. I mostly relied upon kicking people away from me, or the occasional straight right.

Was this a serious break? I have no idea, but I now have a gravel-like lump under the skin where the rib probably broke, and had I soaked up another bone-breaking shot in the same place, I suppose I might have been out of the fight. See, the first time around, I knocked silly the guy who (I suspect) broke the rib. He gets woozy and quits, but feels fine a few minutes later. Meanwhile, just breathing hurts me, and for about a month. But my ability to continue fighting lasted for the moment, while I was still full of vim, vigor, and energy. That week or two later? I wasn't nearly as effective. And to get blasted in the same area? That hurts just to think about.

Another example. One of the black belt students broke about four of the ribs of one of my instructors while sparring, but the instructor took the student down and ended the fight, despite a lot of discomfort. Student wondered how he was able to do that. Instructor said: You must learn to fight through pain. The fight doesn't end just because you're hurt, nor does it end just because you've hurt your opponent. It ends when one of you can no longer continue. If you pause because you see that you've inured your opponent, you are just as vulnerable in that moment as he is.

Or something like that. More ribs certainly broken than mine, the instructor was out of sparring action for a good long time, tanked up on pain killers so he could sleep. Could he have fought again, two weeks later? I dunno. That dude's tough as nails, but his x-rays showed some serious breaks. I suspect mine wasn't nearly as bad.

So could your fictional character fight a couple of weeks later? Sure. No problem, it's fiction, after all. Would it be realistic? Well, in my meager experience, doable, but with great discomfort and at a performance disadvantage directly proportional to the amount of damage sustained. Two or three broken ribs? Good luck, hale fellow.

In light of this:



I'm aiming for putting him in a position that he just can't fight back.


I suspect you've already hit a very good nail on the head. Three seriously broken ribs? Two weeks later, knee bashed in the same area? Dude's in serious trouble. In fact, he was probably in serious trouble even before the new hit.

jeseymour
03-11-2010, 10:36 PM
Broken ribs are the gift that keeps on giving. I was stepped on by a horse in 1987 (he flipped over a jump, and when he stood up, he stepped on me.) Broke 6 ribs in 9 places. It still hurts. It hurts right now. I know when it's going to rain. :tongue It was years, and I do mean years, before I could sleep on that side. I wasn't even out of the hospital for eleven days, and 9 of those were in intensive care. Two weeks? I was barely moving around. Edited to add - I did start riding again in about 8 weeks. I went to a dressage show at 12 weeks out, and the judge asked me why I was favoring my right side.:D

boron
03-11-2010, 11:28 PM
WHISTLER, British Columbia — Slovenian cross-country skier Petra Majdic has been ruled out for the season with four broken ribs and a collapsed lung, injuries she sustained before her bronze-medal performance in the individual classical sprint.

Majdic crashed during training before Wednesday’s sprint but insisted on competing, skiing in obvious pain through a qualification round and three heats.

Link (http://www.bostonherald.com/sports/olympics/skiing/view/20100219petra_majdic_out_for_season_with_4_broken_ ribs/srvc=home&position=recent)

kaitie
03-12-2010, 04:50 AM
Summonere--he was definitely in trouble before that. He was going to get his ass kicked no matter what before the fight even started. It just occurred to me as one of those good lord that's awful and miserable things that added to the getting his ass kicked. I think the severity of the breaks also probably plays a factor. In my mind, they're fractures. I've had a stress fracture, and I actually broke a bone in my hand once without knowing it until a year or so later when I had an x-ray for another issue and the bones had fused together. I know exactly when it happened, but aside from being painful I was still doing gymnastics on the same hand the next week. It never occurred to me that I might have fractured it. I have another friend who recently broke his ankle. He was off it for a couple of days, then was walking around, fencing, etc. It wasn't until about three weeks later and it was still giving him pain that he went to the doctor and found out it was broken (and by that time it had already started to heal...he was not happy about their treatment lol).

Anyway, this sums up the character pretty well:


You must learn to fight through pain. The fight doesn't end just because you're hurt, nor does it end just because you've hurt your opponent. It ends when one of you can no longer continue. If you pause because you see that you've inured your opponent, you are just as vulnerable in that moment as he is.

He's a superhero and constantly getting beaten, cut, that sort of thing. Mostly, though, it comes from the fact that his superpower is actually painful to do, but he's been using it his whole life and just has learned to ignore the pain. In this case, he can't really ignore it, but he sees a job that needs to be done and gets up to do it. He doesn't see his pain as a valid reason not to. Of course, he'd be favoring that side and trying his best not to get hurt, and it's definitely going to slow him down.

The fight with the bad guy actually has me worried less than the one that gets him caught before that. He's going to be up against a few people and I imagine by the time the adrenaline rush has worn off he's definitely feeling it.

As for the skier--OMFG. That's insane and I couldn't imagine doing that. And she won a bronze! Just wow...

Summonere
03-12-2010, 07:59 PM
his superpower is actually painful to do

I like this idea.

GeorgeK
03-13-2010, 09:32 AM
All injuries lie between the ignorable and the deadly. The ribs that only take 2 weeks to heal are the ones that usually get brushed off as a bad bruise and are only noticed retroactively by callus formations seen on X-Rays at a later date. At the other end of the spectrum is a flail chest that only some survive. Avoid the term "Pneumothorax," except for when his doctor says, "It's not that." Avoid specifying which ribs, avoid having bones poking out the skin and it will probably be believeable.

My only complaint is this term, "Nerve Blocker." Is the physician giving him injections of local anaesthetics along the fractures to block the pain? The pills used for neuralgia do little for bone or muscular pain. He's going to need narcotics and anti-inflammatories, maybe some alcohol or benzodiazepines, but almost certainly not any of the neuroleptics.

kaitie
03-13-2010, 03:59 PM
Wow, George is awesome and knows more medical stuff than me! As for the nerve block, it was one of the treatments suggested that I found looking up ways to treat broken ribs. From what I understand, it's basically local anesthetics and/or steroids. I don't know about along the fracture. I was assuming it would be done somewhere along the nerves that go to that general area and from what I was reading basically can block sensation for a certain area. I assumed it was a little something like an epidural for a woman in labor worked, actually. I don't know specifically what his doctor is giving him, and I doubt he does, either. He's said, "Make it so I can go out there again" and the doctor argues some and he's like "look, "I don't care what you give me. I just need to be able to function."

His doctor also is a private doctor and I imagine occasionally gives him things that wouldn't be used (or might even be illegal) in normal practice. Thanks for the comments.

And it's nothing horribly bad when I first mention it. Actually, he goes on and gets some other stuff done before he ever even calls the doctor to have them checked. They make a bit of a fuss because they want him staying home and resting and not doing anything that might make them worse, but in general right now they're fractures that aren't going to cause pneumonia or puncture a lung or anything.

I tend to do my medical research from MayoClinic sites and what not, so clearly those aren't perfect haha. Thanks. :)

GeorgeK
03-14-2010, 03:33 AM
I'm sure you'd find somewhere someone padding the bill injecting steroids into a fresh fracture, but I'd advice against it until there's more than 10 years of data to support it, which as far as I know, there isn't. Today, that treatment would cross the border into quackery. 10 years from now, things may be different, but I doubt it.

Injecting locals to the underside of a rib (which is where the nerves and blood vessels run for rib pain and metabolism) to block pain so that a patient can breathe, sleep and heal is not out in wackoland and can be a very significant consideration for the right patient. That particular consideration is outside my realm, but I could easily envision it happening. Ultimately history and the courts are the judge so if this is for a patient who has proven to the physician that this patient is for some reason outside the normal physiology and needs special consideration, particularly if the patient is thought to be unlikely to sue, I could see it happening. I also would not be surprised if the physicain saw such a patient outside the office and was only paid in cash without a written record. Historically truly scientific pursuits have been outside the law, like Leonardo Davinci's anatomy drawings from illegal cadavers. If this physician is helping to help, or to further science, I'd expect them to only charge at cost. If they don't really care and only wanted to be paid, they'd charge a markup for the legal risk.

Oh yeah, provided your hero's metabolism can sustain adrenaline (epinephrine), a local mixed with epinephrine will last significantly longer than the same medicine without it. For surgeries done under local, provided there was no contraindication to epinephrine, I used to add epi so that the local would last until about an hour after they got home, but tell them to take tylenol an hour ahead of that expected time limit and then take it around the clock, every four hours while awake for the first 24 hours to head off the pain before it becomes unbearable. (Of course getting kicked in the wound would bypass that theory and practice altogether).

debirlfan
03-14-2010, 07:25 AM
Racking my memory here - which admittedly is a bit fuzzy, but...

I seem to recall instances of nascar drivers (auto racers) driving with broken ribs (and in one case, a broken sternum) - this being back a few years when the drivers had a culture of "playing hurt". If memory serves, generally they would put some sort of "flack jacket" on the guy, and I think there was at least one case where they used an electrical unit (TEMS? TENS?) that sent signals that blocked pain.

Hope that helps.

BTW - if you ever want to see what "real" people can do while injured, presumably at least without narcotics, take a look at racing.

kaitie
03-14-2010, 02:39 PM
Ooh, that's an interesting thought. I'll look into that, too.

The doctor is um...well, okay let's just say a lot of what they do is unconventional and off the records and if a judge ever went through them they could probably find some rather iffy instances of doping. I actually have toyed with the idea of him being on stimulants as well. I've heard stories of army soldiers using certain ones, and it's definitely something this character would do only if it wasn't a "real" drug and if it helped him get the job done. Actually, as long as it gets the job done, he'll do almost anything. I actually really like the idea of him being given epinephrine at the same time. He could definitely handle it, and it'd probably even help him with the whole working extra/no sleep things as well.

Thanks for the tips guys, and I think it's completely awesome that we have people here who know their stuff. :D This is so incredibly helpful.