Experiencing chest pain? This detailed recovery guide explains everything about sternum bone fracture, from causes to when to seek medical care.
Causes of Sternum Bone Fracture: Key Risk Factors
Common mechanisms of sternum bone fracture
A sternum bone fracture typically results from direct trauma to the chest. One of the most common causes is high-speed motor vehicle accidents, especially when the chest forcefully impacts the steering wheel or a tightly worn seatbelt. The fracture can also occur in contact sports, such as football, rugby, or martial arts, where direct blows to the chest are common. In some rare cases, falls from significant heights or blunt trauma (e.g. being struck with a heavy object) can lead to a sternum bone fracture. According to a study published on ResearchGate, although uncommon, sternum fractures can occur in athletes and require a high index of suspicion for accurate diagnosis.
Predisposing conditions increasing fracture risk
Certain underlying health conditions can increase the likelihood of a sternum bone fracture. Osteoporosis, a condition characterized by reduced bone density, weakens the bones and makes them more susceptible to fractures—even with minimal trauma. Other factors such as chronic steroid use, metabolic bone disease, and aging can also compromise the integrity of the sternum. In elderly individuals, even minor impacts can result in a sternum bone fracture, especially if the bone has already been compromised by degenerative changes.
CPR-related sternum bone fracture in medical settings
A known but unfortunate side effect of cardiopulmonary resuscitation (CPR) is the potential for causing a sternum bone fracture. During vigorous chest compressions, especially in older adults or those with brittle bones, the force applied can fracture the sternum. This risk is generally considered acceptable in emergency situations, as the goal of CPR is to preserve life. Clinical literature, such as the review in MDPI, notes that sternum fractures from CPR are not uncommon and usually resolve with conservative management if the patient recovers.
Symptoms and Clinical Presentation of Sternum Bone Fracture
Typical symptoms and signs
The most prominent symptom of a sternum bone fracture is sharp, localized chest pain that worsens with deep breathing, coughing, or movement. Many individuals describe the sensation as a stabbing or pressure-like pain in the center of the chest. Swelling and tenderness over the sternum are often present. Some patients may hear or feel a cracking sound at the time of injury. Pain may also radiate to the shoulders or back, leading to misinterpretation as cardiac pain in some cases. In more severe cases, breathing difficulty or visible chest deformity may accompany the injury.
Physical examination findings
On physical examination, a healthcare provider may observe visible bruising, localized swelling, and tenderness over the sternum. Palpation of the area can reproduce pain, and in some cases, a step-off deformity may be felt, indicating a displaced sternum bone fracture. Chest movement may be reduced due to pain. If there are accompanying rib fractures or internal injuries, additional signs such as shortness of breath or abnormal lung sounds may be present.
When to seek urgent medical evaluation
Immediate medical evaluation is crucial if a sternum bone fracture is suspected. Chest pain should never be ignored, especially if accompanied by symptoms like shortness of breath, dizziness, rapid heart rate, or confusion. These could indicate internal injuries such as lung contusions, cardiac trauma, or vascular damage. In all cases of suspected fracture—especially following high-impact trauma—it is essential to rule out associated thoracic injuries. CT imaging or chest X-rays are typically used to confirm the diagnosis and assess the extent of the injury. According to current clinical guidelines, prompt assessment and monitoring can significantly reduce the risk of complications.
Physical Therapy for Sternum Bone Fracture: A Crucial Role in Recovery
When to start physiotherapy after sternum bone fracture
Physical therapy plays a vital role in the long-term rehabilitation of a sternum bone fracture. However, the timing of initiating treatment is critical. In most cases, physiotherapy is recommended once the acute pain has subsided and the bone shows signs of initial healing, typically after 2–3 weeks. Starting too early can risk displacement or aggravation of the fracture, while starting too late may contribute to stiffness and postural compensations. According to evidence in trauma rehabilitation protocols, initiating gentle breathing and mobility exercises early on can significantly enhance functional recovery in sternum bone fracture patients.
Breathing and postural correction exercises
Following a sternum bone fracture, patients often develop shallow breathing patterns due to pain and reduced thoracic mobility. Diaphragmatic breathing techniques can help restore normal respiratory function, enhance oxygenation, and reduce accessory muscle overuse. In addition, poor posture – such as forward rounding of the shoulders – may develop as a protective mechanism. Postural correction exercises like thoracic extension mobilizations, scapular retractions, and wall angels are essential for maintaining alignment and preventing chronic dysfunction. Regular practice supports both musculoskeletal health and respiratory efficiency, especially in the post-acute phase of a sternum bone fracture.
Activity progression and return to normal function
The return to daily activities and eventual reintegration into physical work or sports requires a carefully structured program. Gradual activity progression ensures that the healing sternum bone fracture can tolerate increased stress. A progressive approach includes low-load isometric exercises, core stabilization, resistance training, and dynamic posture work. It’s essential to monitor for any signs of pain recurrence or instability during progression. Clinical guidelines recommend reassessing function and strength regularly to adapt the program. As noted in ResearchGate’s study, tailored physiotherapy significantly contributes to restoring full function post-injury.
Surgical Treatment for Sternum Bone Fracture: When to Consider Surgery
Indications for surgical intervention
Most sternum bone fractures are treated conservatively, but certain situations require surgical management. Indications include displaced fractures, non-union, or fractures associated with chest wall instability. Patients experiencing severe pain unresponsive to conservative care, or those with associated injuries such as rib fractures or cardiopulmonary compromise, may also be candidates for surgery. Surgical intervention is especially crucial in polytrauma cases where a stable thoracic cage is essential for ventilation and mobility.
Surgical fixation techniques
When surgery is indicated, internal fixation techniques are employed. These include the use of titanium plates, screws, or sternal wires to stabilize the fractured segments. These devices are biomechanically designed to withstand respiratory and muscular forces acting on the sternum. Advances in sternum bone fracture fixation have led to less invasive approaches and better outcomes. Surgeons may opt for minimally invasive thoracic access when possible, reducing recovery time and postoperative discomfort.
Post-operative care and recovery timelines
Post-surgical recovery following a sternum bone fracture requires careful coordination between the surgical team and rehabilitation professionals. Initial rest is followed by gradual mobilization, pain control, and breathing exercises. Full recovery may take 6–12 weeks depending on the complexity of the fracture and the patient’s health status. During this period, patients should avoid lifting heavy objects or performing high-impact activities. According to current evidence-based guidelines in MDPI, postoperative physiotherapy is key to restoring function and preventing complications such as chest stiffness or postural deficits.
How to Diagnose a Sternum Bone Fracture: Imaging Techniques
Chest X-ray and its diagnostic value
The initial imaging modality for suspected sternum bone fracture is typically a standard chest X-ray. It helps visualize gross disruptions of the sternal contour, displacement, and any associated rib or clavicular injuries. However, chest X-rays may miss subtle or non-displaced fractures. While accessible and quick, X-rays alone may not provide the full diagnostic picture, particularly in emergency settings or when evaluating trauma from high-energy mechanisms.
CT scan in severe sternum bone fracture cases
For a more detailed and accurate assessment, computed tomography (CT) scans are considered the gold standard in diagnosing complex sternum bone fracture cases. CT provides a three-dimensional view of the sternum and adjacent structures, revealing fine fracture lines, displacement, and the relationship of the sternum to the mediastinal organs. In trauma centers, CT is often used for patients with chest injuries resulting from high-speed collisions or falls. It is especially useful in preoperative planning when surgery is being considered.
Role of ultrasound in emergency diagnostics
Ultrasound has gained attention in recent years as a non-invasive, bedside tool for detecting sternum bone fractures, particularly in emergency departments. It allows rapid assessment without radiation exposure and can be helpful in patients who are unable to undergo X-ray or CT due to instability or contraindications. Although ultrasound is operator-dependent, it can identify cortical disruptions and hematomas near the sternum with relatively high accuracy when performed by trained professionals.
Myofascial release, mobilization, and gentle spinal techniques to manage mild scoliosis
Postural re-education and functional movement
After a sternum bone fracture, compensatory posture and movement patterns often emerge. Postural re-education helps realign the thoracic spine, shoulders, and ribs. Myofascial release and gentle spinal mobilization can improve tissue pliability and thoracic extension. Techniques such as foam rolling, fascial stretching, and assisted thoracic mobilizations can be safely integrated after the acute healing phase. Emphasis is placed on restoring functional movement patterns using neuromuscular training focused on symmetry, control, and fluidity of motion.
Breathing techniques and core activation
The diaphragm and deep core muscles play a central role in postural stability. After a sternum bone fracture, restoring diaphragmatic breathing is essential—not only for respiratory function but also for improving intra-abdominal pressure and core engagement. Techniques include crocodile breathing, 90-90 breathing with pelvic tilt, and abdominal hollowing. Activating the transversus abdominis and pelvic floor muscles helps stabilize the trunk during movement and minimizes compensatory strategies. These techniques are best taught by physiotherapists trained in postural and respiratory rehabilitation.
Sternum Bone Fracture: Associated Injuries to Heart, Lungs, and Ribs
Cardiopulmonary complications after trauma
A sternum bone fracture may indicate or contribute to damage of vital organs within the thoracic cavity. One of the most concerning complications is cardiac contusion—a bruise to the heart muscle caused by blunt chest trauma. Symptoms may mimic myocardial infarction, including chest pain and arrhythmia. Lung-related complications, such as pneumothorax (collapsed lung) or hemothorax (blood in the chest cavity), are also possible.
Monitoring cardiac rhythm post-injury
Continuous monitoring of ECG and cardiac enzymes is often recommended in patients with a suspected sternum bone fracture, especially following high-impact accidents. According to MDPI, early detection of cardiac complications improves survival and reduces long-term sequelae.
Rib fractures and their relationship with sternum bone fracture
Rib fractures often occur alongside a sternum bone fracture, particularly in high-energy trauma. These fractures may exacerbate pain and compromise breathing, leading to reduced ventilation and increased risk of infection or atelectasis. In some cases, a flail chest may develop, requiring surgical stabilization.
Pain synergy between rib and sternum fractures
Because ribs and sternum move with every breath, concurrent fractures increase discomfort and hinder recovery. Effective pain control and breathing strategies are crucial to minimize complications and enhance healing in patients with both injuries.
Internal injuries requiring hospitalization
In more severe cases, a sternum bone fracture may be associated with internal organ injury such as pericardial effusion, lung contusion, or injury to major blood vessels. These complications often require ICU monitoring and interdisciplinary management involving trauma surgeons, pulmonologists, and cardiologists.
Conservative Management of Sternum Bone Fracture: Non-Surgical Approaches
Pain management and medication
Initial treatment of a sternum bone fracture focuses on effective pain relief, allowing for proper breathing and functional movement. Common medications include acetaminophen, NSAIDs, and, if needed, short-term opioids. In certain cases, intercostal nerve blocks may be considered for severe pain.
Caution with overuse of analgesics
Long-term use of opioids is discouraged due to dependence risk. Non-pharmacological methods such as ice therapy, TENS (transcutaneous electrical nerve stimulation), and posture support can be used alongside medication.
Recommended rest positions and movement limitations
Proper body positioning reduces pain and prevents stress on the healing bone. Sleeping in a semi-reclined position or supported with pillows can help. Movements that involve torso rotation, lifting, or pushing should be avoided for the first 4–6 weeks post-injury.
Ergonomic adjustments during daily tasks
Patients recovering from a sternum bone fracture are advised to avoid slouched sitting, sudden reaching, or driving during the early healing phase. Ergonomic supports such as thoracic braces may be considered in selected cases.
Breathing exercises and patient safety at home
Controlled breathing exercises prevent complications like pneumonia. Techniques include incentive spirometry, diaphragmatic breathing, and segmental breathing to restore chest mobility.
Creating a safe recovery environment
At home, patients should avoid slippery floors, low chairs, or any activities that risk falling. Education about activity pacing and recognizing signs of overexertion is a key part of conservative management for a sternum bone fracture.
Sternum Bone Fracture Recovery Timeline and Prognosis
Average healing duration by fracture type
Uncomplicated sternum bone fractures typically heal within 6–8 weeks with conservative management. Displaced or compound fractures may require longer healing times or surgical intervention.
Timeline breakdown by fracture severity
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Stable fracture: 6–8 weeks
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Displaced fracture without surgery: 8–12 weeks
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Post-surgical fracture: 10–14 weeks with physical therapy
Factors affecting individual recovery
Recovery speed can vary depending on age, bone health, smoking status, comorbidities (e.g. diabetes, osteoporosis), and adherence to rehabilitation protocols. Older patients and smokers may require more time due to impaired healing capacity.
Psychological factors and recovery adherence
Fear of movement and post-traumatic stress can hinder the rehabilitation process. Supportive counseling and patient education are important in maintaining motivation and consistency in the recovery plan.
Long-term outcomes and possible complications
With proper care, most individuals recover fully from a sternum bone fracture. However, complications such as chronic chest pain, postural abnormalities, or non-union of the fracture may occur. Regular follow-ups and imaging can help detect and manage these issues early.
Preventing long-term dysfunction
Physical therapy focusing on posture, core stabilization, and gradual return to functional tasks is key to avoiding chronic musculoskeletal problems. As emphasized in the ResearchGate article, targeted rehabilitation strategies are essential for optimal long-term outcomes.
Prevention and Education for Sternum Bone Fracture
How to prevent chest trauma injuries
Preventing a sternum bone fracture begins with minimizing the risk of direct thoracic trauma. Whether in everyday activities, transportation, or sports, awareness and prevention strategies significantly reduce the likelihood of injury. Motor vehicle safety, for example, plays a key role. Ensuring the proper use of seatbelts and airbags can prevent the high-velocity chest impact that often leads to sternum bone fracture.
Vehicle safety considerations
In vehicle crashes, wearing a seatbelt across the pelvis and shoulder, rather than across the chest alone, lowers the risk of sternal injury. Advanced driver-assistance systems (ADAS) also contribute to impact avoidance and injury prevention.
Protective gear and positioning in sports and transport
Contact sports such as football, hockey, rugby, or martial arts present a higher risk of chest trauma. Protective gear, such as chest plates or padded vests, can help absorb impact forces and prevent a sternum bone fracture.
Importance of correct biomechanics
Proper posture and controlled body movement during sports or physical tasks reduce the transmission of force to the sternum. Coaches and trainers should emphasize form, core stability, and protective techniques when instructing athletes.
Educating patients for safe activity after recovery
Patient education is essential to reduce re-injury risks. After a sternum bone fracture, individuals should be informed about body mechanics, lifting techniques, and signs that suggest they may be overexerting themselves.
Returning to life with awareness
Structured guidance on activity pacing, breathing, and posture helps individuals resume normal life while protecting the healing bone. As noted in ResearchGate, education reduces complications and encourages proactive recovery management.
Sternum Bone Fracture in Athletes: Causes, Risks and Recovery
Sports with higher risk of sternum bone fracture
Athletes in high-impact disciplines are more vulnerable to a sternum bone fracture due to frequent collisions, falls, or blunt force trauma. Sports such as American football, rugby, wrestling, ice hockey, and even cycling (in high-speed crashes) are examples where direct sternum injuries may occur.
Role of protective training environments
Providing soft landing surfaces, enforcing rules around aggressive contact, and promoting sportsmanship can help mitigate trauma in competitive settings.
Special rehab considerations for athletes
Athletes require tailored rehabilitation programs. While the general healing time of a sternum bone fracture applies, sport-specific demands often necessitate advanced functional retraining, particularly for contact tolerance, breathing under load, and core control.
Gradual exposure to load and contact
Progressive re-introduction of impact through simulated drills allows safe adaptation. Monitoring pain thresholds, breathing patterns, and thoracic mobility is key during each rehab phase.
Returning to competitive performance safely
Full return to sports should only occur after confirmed radiologic healing, absence of pain during movement, and restored thoracic mobility and strength. Psychological readiness and confidence in body movement also influence successful return.
Clearance and testing protocols
Clearance often involves a stepwise return-to-play protocol, overseen by physiotherapists and sports physicians. Strength, endurance, and functional testing help determine the readiness for full competition.
Long-Term Effects of Sternum Bone Fracture on Posture and Breathing
Common chronic complications after sternum bone fracture
Although most sternum bone fractures heal without major complications, some patients experience persistent chest discomfort, tenderness to pressure, or limitations in thoracic movement months after injury.
Possible causes of lingering symptoms
Fibrosis, micro-instability, or myofascial restrictions can contribute to chronic symptoms. Early intervention and appropriate physiotherapy reduce the likelihood of long-term issues.
Postural imbalances and muscular compensation
Postural adaptations following a sternum bone fracture—like rounded shoulders, forward head posture, or kyphosis—can become habitual. These misalignments lead to overuse of compensatory muscles, including the upper trapezius, scalenes, and erector spinae.
Addressing asymmetries through movement retraining
Corrective strategies include thoracic mobilizations, neuromuscular re-education, and postural taping to promote symmetry and relieve compensatory tension.
Breathing retraining and long-term respiratory therapy
Pain-induced shallow breathing often persists long after a sternum bone fracture has healed. Proper respiratory training restores diaphragmatic breathing and enhances thoracic mobility.
Integrated respiratory therapy approach
A combination of manual therapy, breathing drills, and postural strengthening can be used to retrain efficient respiratory patterns. According to findings in MDPI, structured respiratory rehabilitation has shown measurable improvements in patients post-chest trauma.
Most Common Questions:
Is a sternum fracture serious?
Yes, a sternum bone fracture can be serious, especially if accompanied by cardiopulmonary injuries. While many cases are stable and treatable conservatively, fractures resulting from high-impact trauma may lead to complications requiring hospitalization.
Warning signs requiring urgent care
Shortness of breath, chest tightness, dizziness, or irregular heartbeats following trauma should prompt immediate medical attention.
How long does it take to heal from a fractured sternum?
On average, a sternum bone fracture heals within 6–10 weeks, depending on severity, age, general health, and whether surgery was required. Conservative cases heal faster than those involving surgical fixation.
Can doctors do anything for a broken sternum?
Yes. Physicians assess the sternum bone fracture through imaging and clinical examination. Treatment may include pain management, breathing support, physical therapy, or surgical intervention in complex cases.
How long does it take for a sternum bone to heal?
Most sternum bone fractures heal in 6–8 weeks with conservative treatment. Healing may extend up to 12–14 weeks in older adults or those with complications. Physiotherapy aids in restoring full function during and after healing.
⚠️All health-related information and recommendations provided here are based on the professional experience of a licensed physiotherapist and kinesiologist with several years of international and local clinical practice. These insights aim to support general well-being and rehabilitation, but they do not replace medical advice.
Each individual is unique, and responses to treatment or exercise may vary. Therefore, it is strongly recommended to consult with a medical doctor or healthcare professional before starting any new therapy, exercise program, or making changes to your current health routine.
These guidelines are intended for educational and informational purposes only.
