Exercises to Strengthen Core with Broken Ribs?

There are lots of strange symptoms to blame on either sarcoid or the treatment for it. I continue to break ribs and the bone density came back normal so it can't be osteoporosis. My doc said the focus needs to be on bigger current issues, with the ribs just treat the pain and do careful exercises and guarded coughing.
I am swimming 45-90 minutes a day, walking and moving when I get tired doing laps. I do sustained walking 20 minutes multiple times a day to move and clear airways.
I have been warned against yoga, which I had been doing daily before the ribs started breaking. Would physical therapy have exercises that can strengthen the core without aggravating the rib situation? Can modified sit ups be allowed? I have a swiss ball, resistant bands. I have been through PT to help deal with muscular skeletal issues before the ribs. (The broken ribs have been identified by CT, I know the nerve and muscular pain can be intense too.)
TT

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Hoo weeeee...WOW!!!

If recent bone density scans check out and you do not know of any specific trauma causing rib fractures...this is odd. Have you had periods of violent coughing fits?

Fractured ribs take a long time to heal and should be carefully ranged through deep breathing. You do not want your chest cavity to heal down with scarring that decreases your chest volume and resiliency...the chest wall's ability to expand with inhalation and contract with exhalation. There are modified setting and muscle energy exercises that will help guide and strengthen your trunk musculature without stressing the rib cage and causing excessive pain. If you are happy with your PT clinic I would stick with them. However, I do recommend searching out a PT who is certified in manual therapy with a spine specialty.

Are you confident that your are NOT osteopenic or osteoporitic? Are you on prednisone? Are you taking Calcium +D3 supplements or Fosomax? How often are you receiving bone density scans?

brucath

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Brucath,
Thanks for the reply. I had a baseline DEXA 2 years ago and everything was above the range for age and other criterea. It was just repeated a month ago and again everything was excellent. I have been on prednisone continuously since Nov 07, and was on it for two month stretches about a year before that. I am taking Actonel and Tums twice a day for calcium.
Last November I had an open lung thoracotomy, with a rib spreader. The beginning of January I had a bad round of bronchitis. The coughing started with pulled costo muscles. Then it changed pretty dramatically, one cough a snap and I couldn't move, breathe etc. Went to ER, nothing showed on xray. The pattern continued every couple of weeks. I had a CT done in March that showed a couple of broken ribs at that time. In June, another CT for sarcoid followup, 4 more on the right and one on the left, one displaced. A few weeks ago another one went when I was in with my cardiologist, this one did show as an acute break on the xray. At night I can feel them shift around as I breathe. I am using Fentenyl patches to deal with the pain so it doesn't restrict my breathing.
What would I ask for from my PT clinic? My primary will happily support whatever will help.
TT

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Goodness! I have never heard of so may rib Fx's from coughing...you must be miserable. I also had a thoracotomy and the recovery was rough. I have not broken any ribs that I am aware of.

You are combatting some serious challenges to your rib cage! Any PT with respiratory experience should be able to help guide you through gently range-of-motion therex with primarily breathing exercises to maximize range and strength in accessory breathing muscles and intracostals. Slow setting and isometrics for abdominal and back stabilization should help maintain or increase trunk strength within a pain free range. For aerobic activity I am guessing recumbent bike would be the best for you.

I only recommend calling around to PT clinics to look for a manual spine therapist (NOT a chiropractor!) who would be able to treat your rib complaints...but if you are still in acute healing stages for those Fx's you probably do NOT to be manipulated!!!

I hope you can find some gradual relief and healing soon. I am sorry you are having such a rough time. Let me know what happens.

brucath

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What is the difference between a manual spine therapist and a physical therapist?

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Don't trust your DEXA scan...see another MD and get a DEXA scan that measures your hip and spine. See an endocrinologist at a medical university center. Sounds like you may have osteogenesis imperfecta--extremely rare....and these patients don't reach adulthood.

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My DEXA was of the hip and spine. It was done at a medical university center. It is definitely weird.
Thanks for the input.
TT

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