Issue 049
May 2009
By Rosi Sexton.
What is it?
A costochondral separation is an injury to the ribcage that is relatively common in combat sports. It is sometimes called a ‘separated rib’ or a ‘dislocated rib’.
The ribs are connected to the sternum (breastbone) by bands of cartilage. Sometimes the bone can become detached from this cartilage. It is a similar injury in some respects to a fractured rib, but it often takes longer to heal fully.
What does it feel like?
The fighter may feel a pop when the injury happens. Afterwards, there is pain and tenderness at the place of injury. It may also hurt to cough, sit up, twist the body or even breathe. It may be possible to feel a bony lump or step in the rib itself where the bone and cartilage have slipped apart.
Specific instances
Although originally believed to have a ruptured spleen, Diego Sanchez turned out to be suffering from ‘torn rib cartilage’ that put him out of his fight with Thiago Alves at UFC 90. BJ Penn is also reported to have suffered this injury in the second round of his UFC 63 loss to Matt Hughes.
How it happens
Rib separations may occur from impact from a punch or a kick, or from pressure on the ribcage during grappling. Another cause of the injury is from sudden twisting movements of the torso. Rib separations that occur in this way, with no contact from an opponent, can be puzzling to fighters and, as in the case of BJ Penn, leave fans sceptical that there has been a real injury. Many rib separations in MMA happen due to a combination of pressure and twisting. Fighters often report that the injury occurred while twisting their body to escape from a hold.
Treatment
It is important to seek medical advice if you are concerned about a rib injury, as some fractures may need immediate treatment. The main treatment for a rib separation is rest. It may take two to three months to heal and during this time it is important to avoid pressure on the chest or excessive movement of the ribcage. A support belt worn round the ribcage can reduce movement and keep the bone and cartilage together while the injury heals. Taping can sometimes be used to support the ribs in the correct alignment.
How long can a fighter with this injury expect to be out for?
Depending on the severity of the injury, it may take anything from six weeks to six months or more before the fighter is able to train fully, without pain. For individual advice, see a qualified medical doctor, physiotherapist or osteopath.
What long-term problems is it likely to cause?
Often, fighters with this injury will be left with a bump where the bone and cartilage have come back together. Sometimes the fighter may have ongoing pain in the area, especially when pressure is put on that section of the ribcage. This is less likely to become a problem if the fighter rests and avoids pressure on the chest while the injury is healing.
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