Randon Hall, MD
LeSean McCoy - Not an Ordinary Rib Fracture
(Modified) Photo by Nino Liverani on Unsplash
LeSean McCoy’s Injured Rib
LeSean McCoy sustained a significant rib injury this past Friday. Specifically, he was diagnosed with an incomplete cartilage fracture of the rib. His injury is unique in that it is not actually of the bony part of the rib, it is of the cartilage connection of the rib to the sternum. Incomplete means that it has not broken all the way through the cartilage attachment. These type of injuries likely occur from either direct impact to the area or from wear and tear through the season. The diagnosis is usually made with an MRI of the chest which is typically used when looking for a stress injury or injury to the cartilage. Many times rib fractures are unlikely to show up on an x-ray. The reports state that he will be out for 1 -2 weeks however that is a true unknown in this situation. When the rib injury affect the bony aspect of the rib we have a good idea to how long the bone will take to heal. When it affects the cartilage healing rates can vary dramatically and it can become a recurring issue that returns when activity is resumed.
Rib Fracture Insights
Rib fractures can be extremely painful. The symptoms usually consist of difficulty with breathing as well as tenderness over the ribs. Pain management can be difficult as the thorax is constantly moving when a person is breathing. When an athlete has a traumatic rib fracture, evaluation must be done to ensure there was no injury to internal organs or lung tissue. The most common area for injury are the middle ribs of 4-10. Usually the diagnosis can be made based on a medical provider's exam, however an x-ray is usually the quickest test to make the diagnosis. Keep in mind, rib x-rays can be difficult to interpret as the rib fracture may not clearly show up. A CT scan of the chest can be performed if the fracture is thought to be subtle. Where as an MRI might be helpful to detect a stress fracture or injury to the cartilage. Generally, bony rib fractures can be tender to the touch for approximately 3 weeks. Treatment can be as basic as icing, bracing, taking oral pain medication and limited activity until resolution of pain. However, more aggressive treatment may include injecting numbing medication around the nerve that goes to the rib or at the site of the injury, which has risks. Of note, when injury occurs to the cartilage and is persistent, one could attempt a cortisone injection in the cartilage area to reduce pain and inflammation.
What is the impact on LeSean McCoy?
It is possible that the rib injury could resolve within one to two weeks and McCoy is ready to go soon, but I have my doubts. This type of an injury will be affected from twisting, turning and body to body impact. It will also impact deep breathing and the ability to take deep breaths during the game. I expect this to effect McCoy in pass catching, blocking and taking a hit. He may even need to play with a protective rib padding on which could impact his game even further. Although he has dealt with this before, the injury is at the cartilage and not at the bone, it is very well possible this continues to bother him throughout the season.