Triathlon Racing with Bruised Ribs

author : AMSSM

comments : 0

Is it possible to race with bruised ribs?

BT Member Question from JimBob:

"Will I hurt myself running and swimming with bruised ribs?  I bruised my ribs three weeks ago, and I have a half ironman in two weeks.  Biking is now fine for me.  As far as swimming: I can use one arm with minimal discomfort.  Running results in total discomfort.  How can I minimize it for race day?"

Answer by Grant Morrison, MD
Member AMSSM

By now, I suspect that you have completed your triathlon; I hope that it went well.

Your question about bruised ribs raises more questions.  First and foremost, how did they become bruised?  Was it a direct blow?  Contact sports such as football, a bike crash, or (as one of my patients experienced) a fluke trauma such as getting slammed by your kid on a swing when you’re not looking, could create such an injury.  A more serious injury could create bleeding into the lungs, a collapsed lung, or if hit in the back, even a kidney injury.  Any blood with coughing, shortness of breath, or blood in the urine is a sign to see your doctor immediately.

However, if you did not suffer direct trauma, then I would be concerned about the source of your pain.  It would be very unusual for a triathlete to experience bruised ribs from typical training.  Muscle soreness from swimming is one possibility.  More serious injuries could occur, however these are uncommon.  Published medical journals have reported rib stress fractures in competitive rowers and in golfers.  These are thought to occur from stress on the ribs from muscle groups pulling in opposite directions.  I can imagine that this may occur from swimming, but it would be unusual.  Such an episode would make me consider checking your bone density to see if your bones are weaker than expected and therefore more vulnerable to fracture. 

“Rib pain” is also close to “chest pain.”  Chest pain could refer to a heart condition.  If you are having chest pain with exercise, then I would recommend absolutely no exercise until you have this evaluated by your physician.

Assuming that there is no ominous issue going on, pain would be the only limiting factor preventing you from competing.  Participate as comfortably as you can once you have gotten the above questions checked out.  Since you are still exercising, I imagine that you are only having soreness.  Avoid the “Clint Eastwood” approach of wrapping tape around your chest like they did in the old cowboy movies.  This would only limit your breathing.  Consider Tylenol for pain, but avoid Ibuprofen with serious exertion.  Cold packs before the race can reduce soreness, but once you are competing, there is little that you can do. 

Grant Morrison, MD

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date: December 1, 2011