Broken sternum

The sternum is located in the thorax and is palpable over its entire length. It is connected to 10th of the 12 ribs by cartilage and to the clavicle, the collarbone. In general, the sternum breaks very rarely, as it is a very stable bone, which is very rarely stressed to such an extent that a break is even possible.

However, it is possible that in martial arts, when falling from a horse onto an obstacle or in a car accident where the driver falls with the sternum onto the steering wheel, the sternum is damaged to such an extent that it is fractured. Rarely, only the sternum is broken. In most cases the adjacent structures, such as ribs or collarbone, are also involved.

However, the actual problem is usually not the fracture itself. Much more dramatic are the consequences that can result from a fractured sternum. Since the sternum is located above the lungs and heart, a fracture of the sternum can result in an injury to the heart and/or lungs.

In this case, in addition to severe pain in the area of the sternum and water deposits (edema), breathing difficulties may also occur. In addition, redness and haematomas can form in the area of the fractured sternum. As long as “only” the breastbone is broken, there are two possibilities.

On the one hand, there is conservative therapy, which means that the patient does not have to undergo surgery. This is possible for most fractures. However, the patient must take strict rest and under no circumstances should the breastbone be put under stress so that the bone has the chance to grow back together properly.

Since inhalation (inspiration) in particular can lead to pain or discomfort, it is important to prescribe the patient sufficient pain medication since breathing must be unimpeded and without problems in any case. However, if the sternum has a more complex fracture or if surrounding structures are affected, the fracture may require surgery. In this case, the patient is given a plate to be inserted in the area of the fracture. However, this plate should be removed as soon as the sternum has grown together sufficiently. In spite of the plate, a fractured sternum should be spared so that it can grow together adequately and no malpositioning occurs.

Crackling sternum

The sternum is built into the body in many ways. If there is a cracking in the area of the sternum, this can have different causes. On the one hand, the cracking in the sternum can be attributed to incorrect posture and thus also to incorrect tension of muscle groups.

Patients who spend a lot of time at their desk or computer all day long and frequently support themselves with their elbows, in particular, train themselves to adopt the wrong posture. The sternum is thus incorrectly loaded. If the patient stretches, however, there is a cracking in the sternum, which is due to the fact that the ribs are stretched again and the muscles additionally pull on the ribs and the sternum.

In principle, however, the cracking in the sternum can also be attributed to a blockage in the cervical or thoracic spine or in the sternocostal joint (the joint that connects the ribs and the sternum). As soon as the patient stretches, he or she puts the joint back into the correct position, it cracks briefly and the pain or rather the feeling of pressure in the sternum disappears. However, if there is a recurring feeling of pressure and the cracking in the sternum, a physiotherapist or osteopath should be consulted.

They can help the patient to avoid the feeling of pressure and the cracking by adopting a suitable posture. You can find more information on this topic on our page Breast cracking A blockage in the sternum is often accompanied by a cracking sound and can be extremely painful. In mild cases, various strength and stretching exercises, which can be performed by the patient himself, can help.

A new method is the use of so-called fascial balls. These balls, the size of tennis balls, are hard and have a rough surface. The patient lies on his back and rolls the fascia ball from the lower end of the sternum to the upper end.

This exercise is repeated several times. If the pain is very severe, a physiotherapist or chiropractor should be consulted. They have expert knowledge and can determine exactly which joint is affected by means of specific tests.

In most cases, the problem lies with the two clavico-chest-bone joints (sternoclavicular joints). This joint is the connection between the clavicle and the sternum. It can be blocked due to poor posture, which leads to severe pain.

These radiate into the arms, neck and head, making it difficult for the patient to precisely localise the cause of pain. The chiropractor is able to adjust and mobilise this joint. Often the first attempts are painful and the treatment takes a long time.