The League

Dr. A. Brion Gardner
Orthopedic Surgeon

Dr. A. Brion Gardner

Staff Orthopedic Surgeon at Camp LeJeune

McNabb Takes a Little Ribbing


Donovan McNabb sustained a rib fracture in Sunday's game. Reportedly, it is on his left side and involves the lower rib cage. The immediate concern for the Eagles organization and Philadelphia fans is how long, if at all, will this sideline McNabb.

These fractures are usually caused by a direct blow to the rib cage. It is rare that surgery is required for this injury. The return to sporting activity is limited by the level of pain experienced and the presence or absence of internal organ damage. McNabb reportedly has one isolated rib that is broken, indicating it was a lower energy injury. In severe cases, such as a car accident, multiple ribs can be broken and displaced causing injury to the lungs, spleen, liver, or kidneys.

If the upper ribs are injured, pain is experienced with every breath, as this level protects the lungs. If the lower ribs are injured, pain is experienced with running and the throwing motion, as these ribs are connected to the abdominal oblique muscles. And obviously, a direct hit to the ribs will cause the most pain!

In a situation such as McNabb's, where only one rib is broken, a player usually can return to playing the next week if the pain level allows. A flak jacket will be worn for protection. The fractures heal on their own within six weeks.

In the event that there are multiple rib fractures and internal injury, return to play will be much longer. There would have to be little to no pain AND evidence that the internal organs have normal function. (Usually proven by lab tests). This can be up to four weeks.

I wouldn't expect him to miss more than two weeks if he misses any time at all. He will only be limited by his pain tolerance, which he has demonstrated in the past is pretty high. He likely will receive anti-inflammatory medications and judicious use of narcotic medications to help control the pain. With the added protection of a well padded flak jacket, he shouldn't have any drop in performance.

By Dr. A. Brion Gardner  |  September 14, 2009; 1:04 AM ET  | Category:  Medical , Michael Vick , Philadelphia Eagles , Quarterbacks Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati  
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