Most broken ribs heal on their own in about 6 weeks, without surgery or a cast. Pain is usually worst in the first 1 to 2 weeks and sharpest when you breathe in, cough, laugh or turn in bed. The main risk is usually not the bone. It is a chest infection, because pain makes people breathe shallowly and hold back coughs. Slow, deep breaths every hour and coughing with a pillow held against the ribs are the most useful things you can do.
A cracked rib and a broken rib are the same thing. A bruised rib has no break but can hurt as much and recovers on a similar timeline.
Key takeaways
- Typical healing: most broken ribs heal in about 6 weeks; an ache with twisting or lifting can last longer.
- Main risk: a chest infection, from shallow breathing and holding back coughs.
- What helps the lungs: slow, deep breaths every hour while awake, and coughing with a pillow held against the ribs.
- No tight strapping: binding the chest is no longer advised because it limits breathing.
- Higher risk: several broken ribs, age over about 65, smoking or lung disease raise the chance of complications.
Where are you right now?
- Just injured: check the safety sections near the end first, then read the breathing routine.
- Weeks in and still sore: go to “Is this normal?” and “If it isn’t going to plan”. An ache with twisting at week 4 to 6 is common; pain that is getting worse is not.
- After a hospital stay or rib surgery: follow your hospital team’s plan. Plating is used for a small number of people with several badly displaced breaks.
- Getting back to work or sport: the “When can I…” table gives typical ranges.
Breathing and coughing while it heals
- Deep breaths: sit upright, breathe in slowly as deep as the pain allows, hold for 2 to 3 seconds, then breathe out slowly. Do 5 to 10 every hour while awake.
- Supported cough: hold a folded towel or pillow firmly against the sore ribs, then cough. Do this after your deep breaths and whenever you need to clear phlegm.
- Pain relief with a purpose: the aim is to let you breathe deeply and cough. Ask your doctor or pharmacist how to take it regularly in the first days.
- Stay upright and moving: short walks several times a day keep the lungs working better than lying flat. Many people sleep propped on pillows at first.
Week by week
- Days 1 to 7: pain is sharpest. Breathing in, coughing and getting out of bed all catch. A bruise may appear and spread.
- Weeks 2 to 3: sharp catches usually become less frequent. Turning in bed and short walks get easier.
- Weeks 3 to 6: most people notice clear easing as the bone knits. Desk work and driving often return.
- Weeks 6 to 12: the bone is usually healed. An ache with twisting or lifting can linger while heavier work and sport are built back.
- After 3 months: pain or clicking at the break that has not settled is worth a review, as a rib is occasionally slow to join.
The rib heals whether you breathe deeply or not. The lungs need you to.
Where else this could be coming from
- Irritated rib joint: sharp pain beside the spine, often without a clear injury, that catches on breathing and twisting. See rib joint pain in the upper back.
- Muscle strain: an ache along a muscle after lifting or a bout of coughing, tender over a wider area than one point on a rib. See upper back strain.
- Spinal compression fracture: central spine pain after a minor fall or lift, more likely with thin bones. See spinal compression fracture.
- Irritated nerve or shingles: burning pain in a band around one side of the chest; shingles adds a rash within days. A pinched nerve in the upper back can feel similar.
- Lungs and heart: pleurisy, pneumonia or a blood clot in the lung can cause pain on breathing, usually with fever, breathlessness or a fast heartbeat. See upper back pain when breathing.
Is this normal?
- I can feel a click when I move: common in the first weeks as the broken ends move slightly. It usually fades as the bone heals.
- The bruise is spreading lower: common. Bruises track down with gravity and change color over 1 to 2 weeks.
- Getting out of bed is the worst part: common. Rolling onto your side first, then pushing up with your arms, usually hurts less.
- Day 3 felt worse than day 1: common as swelling builds. It should then trend down. Breathing that is getting harder is not normal.
If it isn’t going to plan
It is week three. Reaching across for the seatbelt still makes you catch your breath, and you have got used to taking small sips of air so the rib does not stab. The thought in your head is that if you keep still and breathe gently, the rib will knit faster.
The rib knits at much the same pace either way. Shallow breathing changes the lungs: the lower parts are less well aired and mucus can collect, which is how a chest infection starts. Staying still also stiffens the upper back, so twists keep catching after the bone has healed. A broken rib needs full breaths every hour, a supported cough, enough pain relief to do both, and a gradual return to movement.
If pain still stops deep breaths after about 3 weeks, or is getting worse, see your doctor. A physical therapist can help with breathing and upper back movement. Questions worth asking:
- Have my lungs been checked for infection?
- Is my pain relief enough to let me breathe deeply and cough?
- Could the rib be slow to heal, or is something else adding to the pain?
- When can I go back to lifting, work or sport?
When can I…
| Activity | Typical range |
|---|---|
| Sleep on that side | Often 3 to 6 weeks; your back or the other side is usually easier first |
| Drive | Often 2 to 4 weeks, once you can turn, brake hard and wear a seatbelt comfortably, and are not taking medicine that makes you drowsy |
| Reach overhead | Often 2 to 6 weeks, built up gradually |
| Lift | Light loads close to the body within 1 to 2 weeks; heavier lifting often 6 to 8 weeks or later |
| Desk work | Often 1 to 2 weeks, with a change of position every 30 minutes |
| Manual work or sport | Often 6 to 8 weeks; contact sport often 8 to 12 weeks, once your doctor agrees |
If you have had surgery, your surgeon’s protocol comes first.
Call your local emergency number or go to the emergency department if
- Breathing getting harder: breathlessness at rest, or breathing that is getting worse.
- Coughing blood: any blood in what you cough up.
- Several broken ribs or major injury: pain at several points along the ribs after a car accident, a fall or a heavy blow, or part of the chest wall moving inward as you breathe in.
- Belly pain or feeling faint: after an injury to the lower ribs, pain in the belly or shoulder tip, dizziness or fainting.
See a doctor today if
- Signs of a chest infection: fever, chills, or a cough with yellow, green or rusty phlegm.
- Pain stops deep breaths: you cannot breathe deeply or cough, even with pain relief taken as advised.
- Higher risk: you are over about 65, or have lung disease such as COPD, and have injured your ribs.
Get it checked soon if
- Not easing: the pain is not clearly easing after about 3 weeks.
- Broke too easily: the rib broke from coughing or a minor bump, which can point to thin bones (osteoporosis).
- Wider health: unexplained weight loss, night sweats, or a history of cancer.
More on this area: upper and mid back conditions.
Breathe deeply every hour, cough with support, and keep moving gently while the rib knits.
Written by Louise Yow, Neck & Shoulder Physio.