The sternum is a long, flat bone in the center of the chest, also known as the breastbone. It is the attachment site to many chest muscles and connects the bones of the rib cage. Sternal fractures are most commonly caused by motor vehicle collisions, but also can occur during chest compressions for CPR or direct-contact sports, such as hockey or football. Damage caused by a fracture is rarely limited to the sternum, as it is closely linked to other bones, muscles, ligaments and organs. Therefore, rehabilitation exercises must consider the entire chest cavity.
Safety Considerations
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Due to the high-force trauma that causes sternal fractures, bruising, swelling, stiffness, soreness and pain is expected. Treat these symptoms before starting an exercise rehabilitation program. Diagnosis from a health care professional allows for the ruling out of accessory injuries, such as cardiac and vessel lesions, internal bleeding, and compression fractures of the thoracic spine. These need immediate medical attention. In addition, if the sternal fracture is severely displaced, it will require surgical treatment before exercises can begin.
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Initial Treatment
Rest from your physical activities. In addition, limit the use of your chest and shoulder muscles. No pulling, pushing, lifting, or activity requiring heavy breathing. To initiate pain relief, hold crushed ice in a plastic bag against the breastbone without adding pressure to the fracture site. Hold the ice, cycling 20 to 30 minutes on and off, for the first 24 to 72 hours.
Chest and Shoulder Range of Motion
To combat chest stiffness and re-instate proper respiratory function, practice slow and controlled breathing. This will expand the chest, stretch the tissue surrounding the sternum and re-establish range of motion. Complete eight to 10 slow, deep breaths. To stretch the muscles of the chest, begin in a comfortable standing position with your arms by your sides. Raise both arms in front of you, 90 degrees. Move one arm at a time out to the side and as far back as you can without pain. Hold for 30 seconds. Complete three to five repetitions for each arm.
Chest and Shoulder Strengthening
Even though rest is necessary initially for the chest muscles, they need to be strengthened later in the rehabilitation process. Begin by standing facing a wall. Plant your hands on the wall, directly in front of your shoulders, and perform small pushup movements against the wall. Progress to doing pushups on the floor, but from your knees. Progress further to a normal pushup from your feet. To advance the exercise further, do a pushup with elevated feet and use one arm at a time. Repeat 10 to 12 repetitions for three sets. To strengthen the muscles of the rib cage and sternal joints, participate in cardiovascular exercise that will increase your heart rate for 10 to 20 minutes a day.