Dr. Mike Evans - Saturday Feb. 8, 2014 17:57

Rib injury makes McMorris bronze more impressive

Adrenaline likely helped him through pain

Canadian snowboard Mark McMorris fought the pain from a broken rib to win a bronze medal in Sochi. (Mathieu Belanger/Reuters)

They say being broken hearted is like breaking your ribs: you look fine on the outside, but every breath hurts.

Mark McMorris won a bronze medal Saturday in the new Slopestyle snowboarding event and may have suffered from both conditions. I'm not sure if he was ecstatic to medal or disappointed not to win.

Likely both. I do know that he won an Olympic medal with a broken rib, which is a stunning achievement.

If you were an artisanal metal worker and I asked you to make me a special armour that protected me but was also light and flexible enough move with my every breath, you could do no better than our ribs.

One of the impressive features of our ribs is that they have a built in casting system should they fracture. The vast majority of rib fractures heal with this natural splinting system and usually get better in six weeks.

About six per cent of rib fractures are more serious and require hospitalization. For example, if you have three or more rib fractures, or the fracture pushes through your built-in casting system and endangers your lungs or other organs, you may need emergency care.

We can also fracture our ribs in less sexy ways than snowboarding, with the classic being a cough. The Mayo clinic studied this for nine years and found that it most commonly involved the middle ribs, 85 per cent had been coughing for over three weeks, 78 per cent were female, and 65 per cent had osteoporosis.

We focus on two slightly opposing concepts when somebody has a simple rib fracture: Pain control and chest expansion.

Anybody who has had a rib fracture will tell you that it is quite painful, especially for the first few days. This is partly because a nerve, called your costal nerve, runs along a groove in the bottom of your rib and when these nerves are irritated or damaged they can be unremitting in their discomfort.

Having said that we also want people to take the occasional deep breath to prevent a condition called atelectasis. If you don't use part of your lung it begins to shut down and becomes vulnerable to infection.

We often give people who are susceptible to this a spirometer: basically a small tube that you blow into that measures your breathing and motivates a deep breath.

So what did McMorris do about his pain?

Well, he could have just gone with the mix of time and adrenalin. His fracture was two weeks ago on Jan. 25. A week can make a big difference in ribs, and it sounds like it had for him.

Other strategies include strapping or taping the ribs, taking analgesics, and blocking the nerve with injections. I will sometimes set up my hockey or football player with a “flak” jacket to protect them, but these would not work for the precise bodywork that a snowboard aerialist like McMorris would require. Winning an Olympic medal could very well be nature’s best painkiller.

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