Question
I was in the ocean on Oct 9, 2007.  When I jerked away when a crab bit my foot, I felt a twinge in my lower right rib area at the base of the ribs.  Pain & discomfort increased in the next 24 hrs.  I get painful twinges if I move the wrong way, or sit or get up & cannot sleep on the right side.   Especially tender on the right side at base of rib cage.  At first, the area spasmed when I tried to massage it.  It is very sensitive to the touch in that area.  

My question is: what is the best way to facilitate healing?  I had something similar in 1997 & took about 6 weeks to completely heal.  It was a Camp & the Camp doctor told me there wasn't much I could do, except use castor oil packs & heating pads.  Do you recommend this & anything else.  Thank you.

Answer
Hi Randy,

Pulled, damaged, red, hot, swollen, irritated and inflamed areas of connective tissue do not respond well to heat. Your Camp doctor was grossly in error to suggest heat on an acute rib injury. Ice will minimize the above and add the benefits of heat after 10 minutes with a phenomena known as reactive hyperemia (basically an inrush of blood to the area). Use a rib belt and ice it down as much as possible with occasional use of Motrin. Taking an OTC supplement such as glucosamine sulfate will certainly benefit healing by getting cartilage to the site. This is a well documented and proven supplement for connective tissue repair needs such as osteoarthritis and disc injuries. The rib cartilage is no different and will respond in kind. These things take forever to heal due to poor blood supply and constant motion, thats why the rib belt is necessary to minimize this and the ice and GS to increase blood supply rich in biochemicals needed for repair.

Good Luck and enjoy the crab!

Dr. Timothy Durnin