Dominant-Sided First-Rib Stress Fracture in a Collegiate Baseball Pitcher

Chimenti, Peter C.; Elfar, John C.; Giordano, Brian D.

doi:10.2106/jbjs.cc.m.00019

Cited by 8 publications

(13 citation statements)

References 13 publications

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“…No epidemiologic data is available given the low incidence and prevalence of these injuries. Multiple case reports have described first and second rib posterior stress fractures as a result of overhead throwing or rowing in collegiate and professional athletes [1][2][3][4][5][6][7][8]. Even fewer cases are present that describe lower rib stress fractures in baseball and softball pitchers.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Seventh Rib Posterior Stress Fracture in a High School Baseball Pitcher

Mani¹,

Nicholas²,

Katherine³

2022

Int J Sports Exerc Med

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Posterior rib stress fractures may infrequently occur in baseball pitchers at the first or second rib. Lower thoracic rib stress fractures, however, are a rare phenomenon with only a few cases described at the collegiate or professional level. We present the unique case of a 16-year-old male, right-handed, high school baseball pitcher who presented with a few months of worsening right upper back pain. Physical exam was notable for tenderness to palpation at the T7 level between the spine and the scapula with an otherwise normal cervical and shoulder exam. Initial x-ray imaging of the shoulder was negative, but subsequent magnetic resonance imaging of the chest wall illustrated a stress fracture in the posterior right 7th rib. He underwent 4-5 weeks of rest followed by 4-6 weeks of targeted physical therapy. He returned to play after completion of his rehabilitation with resolution of his symptoms.

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Section: Discussionmentioning

confidence: 99%

Unilateral Seventh Rib Posterior Stress Fracture in a High School Baseball Pitcher

Mani¹,

Nicholas²,

Katherine³

2022

Int J Sports Exerc Med

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“…Stress injuries of the first rib have been the most commonly reported rib stress injury in pitchers. 5,8,9,24 In a study of 24 first rib stress fractures in overhead throwing athletes, three types of rib fractures were discovered. 24 The majority of the fractures (75%) occurred at the attachment of the middle scalene muscle (intrascalene type), while 12.5% were located at the subclavian artery groove (groove type) and 12.5% occurred posteriorly near the costovertebral articulation (posterior type), suggesting differing mechanisms of injury.…”

Section: Dovepressmentioning

confidence: 99%

“…5 Case reports of rib stress injuries in pitchers indicate that the first rib may be the most common site in the ribcage, with injuries at the lower ribs less commonly reported. [7][8][9] Unlike bone stress injuries of the lower extremity, which are often related to repetitive impact from running and jumping, stress fractures in the ribs are thought to be due to repetitive trunk muscle contraction leading to tensile, angular, and torsional stresses on the bone. Over time, these forces can result in cumulative microstructural damage that results in a stress injury at the muscle-bone insertion.…”

Section: Introductionmentioning

confidence: 99%

Rib Fractures in Professional Baseball Pitchers: Mechanics, Epidemiology, and Management

Schowalter¹,

Le²,

Creps³

et al. 2022

OAJSM

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Pitching is a complex kinetic chain activity requiring the transfer of energy from the lower body, through the core and trunk, and finally through the arm to generate explosive acceleration of the baseball. As a result, large forces are generated in the trunk musculature and rib attachments from the late cocking phase of pitching through deceleration. The repetitive cumulative load and high pitch velocities put professional pitchers at risk of rib stress fracture. Given the potential for a prolonged recovery course and high rate of recurrence, early recognition of rib bone stress injury is critical to optimize care. Identifying torso strength imbalances, suboptimal pitching biomechanics (such as late or inadequate pelvic rotation), as well as metabolic deficiencies that may adversely affect bone health are essential to expedite safe return to play and prevent future injury. In this review, we discuss risk factors, mechanism of injury, typical clinical presentation, diagnostic imaging findings, and propose treatment and prevention strategies for rib stress fractures in overhand pitchers.

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“…tured without severe external trauma [2]. However, several reports of first rib fractures without severe trauma have been published [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…The unique anatomy of the first rib lends itself to fracture in the event of sudden neck muscle contraction without external trauma [1]. Non-traumatic fractures of the first rib have been reported athletes participating in several sports including football [3], baseball [4], soc-…”

Section: Introductionmentioning

confidence: 99%

Non-Traumatic First Rib Fracture in University Wrestler

Wesley¹

2021

Int J Sports Exerc Med

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The first rib is well situated to be fully protected from external trauma as it is surrounded by soft tissue, muscles, and bony structures. It is rarely fractured by external trauma. However, two reports of non-traumatic first rib fractures have recently been reported: One in a basketball player and the other in a cheerleader. We present a third case of a non-traumatic first rib fracture, one that occurred in a collegiate wrestler secondary to cervical muscle contraction.

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Dominant-Sided First-Rib Stress Fracture in a Collegiate Baseball Pitcher

Cited by 8 publications

References 13 publications

Unilateral Seventh Rib Posterior Stress Fracture in a High School Baseball Pitcher

Unilateral Seventh Rib Posterior Stress Fracture in a High School Baseball Pitcher

Rib Fractures in Professional Baseball Pitchers: Mechanics, Epidemiology, and Management

Non-Traumatic First Rib Fracture in University Wrestler

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