Frequent ribcage injuries, is this normal?

Question

I have been training Krav maga for about 4 months now, no previous martial arts experience and very little sport/fitness experience.

In that time, I got prolonged rib pain (3-4 weeks) on three occasions. The first time I went to a physician, who told me it's bruised but not broken, and just to wait, afterwards I didn't go to a physician. The second and third time, it hurt not only at the place where I got injured, but also at another, roughly symmetrical place in the right half of the ribcage (all three injuries were at the left half, but different heights).

We are a considerate group, and attack with rather too little aggression than too much. None of the injuries resulted from a sudden strong blow, which I would have assumed is a usual risk in martial arts. The first time I held a punching shield wrong (didn't brace it) while a partner punched, the second time it was a bear hug, the third time I supported a partner while rolling on the floor because she was about to hit her head, and happened to support her knee with my ribs (it was a slow movement, not a blow). Others in the group did the same exercises, including receiving many more bear hugs (I stopped after the painful one, which was at the beginning), and nobody seemed to have any problems.

It doesn't seem to me that the force in the injuries is too strong. I have the feeling (maybe I'm wrong?) that a similar force to, say, the thigh, would only leave a blue spot, if anything at all. Certainly not prolonged pain. And on the ribs, there is no visible injury afterwards, no blue spots. Just the pain.

Am I doing something wrong, because I don't know correct safety practices? Or is my ribcage unusually prone to injury, should I try to get a medical examination? Or is this normal when starting with such an aggressive sport? Or just bad luck? Should I be worried, and how can I reduce these injuries?

Answer 1

It sounds to me like you're describing a phenomenon whereby you experience a larger than expected amount of bruising and pain given the light contact you're being exposed to. This surprised you enough to see a medical doctor, which tells me you're probably experiencing something real, as opposed to just being a hypercondriac. Of course, it could still be that or something in your head (related to neurotransmitters and feeling pain), but let's first rule out the obvious things.

Here's my advice. Have your doctor (MD) perform some blood tests. Ask for tests for deficiencies in any vitamin or mineral that might lead to increased amounts of bruising. Inquire also about diseases whereby the body might bruise more easily and whether or not those can be tested.

According to this article, you especially should check for blood levels of Vitamin B12, Vitamin B9, Vitamin K, Vitamin C, and Iron:

http://www.livestrong.com/article/420033-vitamin-deficiencies-causing-bruises/

I've also seen articles suggesting a deficiency in Vitamin D, Zinc, and protein might cause increased levels of bruising.

Simply taking a multivitamin (one with iron) might help or even completely prevent the problem. However, digestion of multivitamins varies from person to person. Some people don't absorb much that way. You'll get better results from using sublingual vitamins (under the tongue lozenges, liquids, or sprays). But some of those vitamins and minerals don't come in that form.

And be careful not to overdo things. Stick with the RDA dosage if you can. Especially for fat soluble vitamins and minerals. For water soluble vitamins, overdosing is much more difficult.

You can also simply eat more foods that are higher in those vitamins and minerals. In particular, you should look into leafy greens. And take lots of them. And get more protein.

If I were you, I'd have my blood tested first without doing any extra supplementation. I'm thinking you want a complete blood nutrient profile, CBC (complete blood count), creatine, and maybe a liver profile. If something pops up in that test, your doctor will suggest ways you can improve it.

That's my advice. Rule those out first, and then go from there.

By the way, bruising increases with age, supposedly. I don't know why that is. Perhaps it's just a myth. You're 30 years old according to your profile. That's still young, but it's about the time when most people report that they're beginning to notice changes in their body due to aging. It's just a fact of life. Your body will change over time. Still, the changes aren't generally bad enough to cause people to see a doctor like you did. So I wouldn't be too quick to attribute your case to simple aging.

Oh, one other thing. Some foods and herbal supplements have anti-coagulant properties. That means they reduce blood clotting and make blood thinner. This can cause bruising to become larger, more painful, and longer lasting. So you might want to look into all of the supplements you're already taking as well as the various ingredients in your diet to see if there's anything you're ingesting that might be significant enough to cause your blood to thin. My advice is to just have your doctor test for "blood clotting factors" in addition to all the other tests I mentioned (actually the CBC test should also check for platelet count, which is a determination of how well your blood will clot). It may even turn out that you have a mild case of hemophilia, which is generally due to genetics.

Hope that helps!

Answer 2

Bruises and light muscle strains resolve after about a week. This is far too long for a mild injury. If it's a bone bruise, the expected healing time is about 2-3 months, provided you're taking it easy and not continuing to subject it to additional trauma.

Feeling the pain on the opposite side means it could be a skeletal issue - your ribs connect at the spine, so if it's pushed hard enough on the left, it could, potentially also throw off the corresponding ribs on the right.

You want to find someone who is skilled in skeletal-muscular problems, which general practitioner doctors often have little specific training in. You can reliably find physical therapists, sports medicine therapists who are well versed in this. You can find, with some research, massage therapists, chiropractors, osteopaths, and folks who do cranial-sacral therapy work who have sufficient education to assist in the same way.

If you do have a joint/bone issue, you'll want someone who can assess and identify things like rib dislocation, minor facet slippage, tendon damage and potential disc damage in the spine. They should be versed in performing joint manipulations of Grade I-IV on the Maitland scale of Joint Mobilization. You will want to avoid people who regularly use the Grade V manipulations, which are the fast, jerking mobilizations practiced by some chiropractors, as these tend to destabilize tendons.

Along with all that, they should be providing you with some form of strengthening exercises targeted to the areas affected to prevent re-injury.

Answer 3

It sounds like you're overreacting to bruises. If the doctor says it's just bruising, and there's no other sign of injury, then what's the problem? Get a second medical opinion if you like, but you're not describing anything out of the ordinary for contact sports. You're going to get bruised.

Answer 4

Dont worry too much about it, it happens with contact training. Just remember to ICE it down when you get back, then if it is painful enough to disrupt your concentration, take a day of or do no-contact activities during the training. This is important as you might accidentally injure yourself more or even your partner.

If the bruises do not subside after 2 days or so, please consult with your doctor. But most of the time it will basically heal itself with ice and lots of rest.

Answer 5

If you have no visible bruising, you might want to consider if it's something else. There are muscles all along the side, and it's not horribly difficult to pull them. Several of your examples above seem to involve you having to change a movement into a direction you weren't expecting whether it was holding the shield wrong or trying to arrest the movement of your partner. I can tell you from experience that it can feel like the pain of an impact, including the soreness happening in a localized area. Unfortunately, I can't really give very good advice other than that the pain eventually passes and that, outside of uncontrolled movements like catching someone, you'll run into this when you attempt to check your own motions where you're moving faster than you can stop yourself. Coming back to training after a period of inactivity is usually when that happens.