The sternum – sometimes called the breastbone – is the flat bone in the center of your chest. Your ribs and collarbone connect to your sternum.
A break in your sternum is also known as a sternal fracture. Most sternal fractures heal on their own and don't need surgery.
Causes of a Broken Sternum
A broken sternum is most often caused by an accident where something hits your chest with a great deal of force. Examples include:
- Car crashes
- Sports injuries – from high-impact sports like football
- Falling from a great height
- Physical assault or attack
- Cardiopulmonary resuscitation (CPR)
Stress fractures of the sternum are breaks that aren't due to a major injury. Occasionally, a sternal stress fracture is seen in a golfer, weightlifter, or other athlete who exercises their upper body over and over.
You have a higher chance of a stress fracture of the sternum if you have:
- Kyphosis, a severe curve in the upper back
- Osteopenia, bones that are weaker and thinner than they should be
- Osteoporosis, bone loss that's more severe than osteopenia
Additionally, older adults and people who must take steroids for long periods of time are at higher risk of a sternal stress fracture.
Signs of a Broken Sternum
Chest pain. A broken sternum typically causes moderate to severe pain when the accident occurs. The pain may get worse when you take a deep breath, cough, or sneeze. The area over the sternum may be tender and hurt if touched.
Shortness of breath. Up to 20% of people with a broken sternum feel like they can’t get enough air when they breathe.
Bruising. In about half of cases of sternal fractures, you can see bruises or swelling on the chest.
Treatment for a Broken Sternum
The doctor will check your heart to make sure it wasn’t also hurt in the accident. You may need pain medicine to move around and do normal daily tasks.
Most sternal fractures heal on their own without splinting or any other treatment. Complete recovery – when all pain is gone – usually takes 8 to 12 weeks. Surgery is only needed if the broken parts of the sternum aren't lined up correctly (your doctor might say "displaced") or if they can be shifted out of place when you move normally (your doctor might say "unstable").
Complications of a Broken Sternum
Normally you clear your lungs without even thinking about it. Every day you take deep breaths, laugh, and cough. All those actions move the chest wall though, which hurts when your sternum is broken.
Because of the pain, you may take fewer deep breaths, avoid laughing, and cough less often. You'd also probably move less than you normally would. This can allow fluid to settle in your lungs, which may lead to a chest infection.
Recovery From a Broken Sternum
While your sternum is healing, there's a lot you can do to prevent a chest infection and ease your pain.
Breathe deeply. Try to take at least 10 deep breaths every hour you are awake. This can help clear fluid from your lungs and prevent an infection.
Cough. Coughing is also important to clear your lungs. Don’t try to keep yourself from coughing. Don’t take cough suppressant medicine, either. When you do cough or sneeze, support your chest by tightly hugging a pillow or rolled-up towel.
Move. You need to rest as you heal, but try not to stay in bed all day. Alternate resting with light activity. Gentle movement will help keep your lungs clear.
However, for the first 6 to 8 weeks avoid lifting, pushing, or pulling anything that weighs more than 10 pounds. This includes pushing or pulling when you turn over or get out of bed. Instead, brace your chest by crossing your arms, hugging tightly, then using your legs to change your position.
Many people with a sternal fracture find that their shoulders and back get stiff and sore because they stop using their arms as much. You should avoid reaching overhead or reaching back with both arms at the same time. However, do try to move your arms gently by doing some of your normal activities. Start small and work up gradually. Be sure to stop if it makes your pain worse.
Take pain medicine as needed. Follow your doctor’s instructions about taking pain relief medicine. Keep your pain under control so that you can breathe deeply, cough, and go about your daily activities.
Don’t smoke. Talk with your doctor about how to quit. Smoking slows bone healing, and it'll raise your chances for infection.