Question
On Monday I hit my head pretty heard on the garage door. I was running out of the garage avoiding the door closing on me. IAs I jumped to hit "avoid" the sensor I whacked my head and landed, on my back, mostly on my elbows (they are not broken but bruised.) I had no back pain until yesterday. It is well below my left shoulder blade. It hurts when I cough and take a deep breath. I would like to go see my Chiropractor, but wonder if this could be a symptom of a possible broken rib?

Answer
Dear Katie,

Very easy question to answer...go see your chiropractor and have the area examined.  It is very possible to crack a rib from a fall such as you have described, and x-rays should be taken to rule this out, but an examination should be performed first.

Concerning the rib, if it is fractured, then you should not be adjusted near the rib, I would actually advise that you not get adjusted any closer than 3-4 vertebral levels away from where the fracture could be until radiographic analysis has ruled out fracture.

This is where it gets tricky, if clinical examination suspects a fracture, you get the rib x-rays, and a fracture is not seen, that does not mean there is no fracture.  Rib fractures are many times difficult to see on x-ray, and cracks are often missed.  Even after a week when callous formation can be seen around bone, it can be missed on ribs.  You will have to get a bone scan for diagnostic certainty, and this may be a better test from the initial exam than an x-ray.  this must be clinically determined by the examination doctor.  Again do not get adjusted until you know for sure.

If the rib is cracked or broken, there will most likely be no treatment.  Ribs are a problem, we don't cast the chest cavity, and wrapping them for support should only be done on a limited basis as it reduces the lung volume and the exchange of air thereby increasing the risk of lung infection.  Hard spot to be in, but you will just have to deal with it and allow it to heal.  

Bottom Line...get it checked out, if not by the chiropractor then by your medical doctor.  If pain lasts for more than a week and is not getting any better, make sure that you get the imaging tests.

Hope this helps Katie. Best of luck and let me know how you do.

Respectfully,
Dr. J. Shawn Leatherman