A bruised sternum, medically referred to as a sternal contusion, is a soft tissue injury to the breastbone and the surrounding muscles and cartilage. This injury typically results from blunt force trauma, such as striking the chest on a steering wheel during an accident, a direct blow during contact sports, or a hard fall. Although the pain can be intense, a simple sternal contusion generally heals on its own with conservative management. The primary focus is managing discomfort and ensuring no more serious underlying injuries have occurred.
Knowing When to Seek Medical Attention
The sternum protects the heart and major blood vessels, meaning any significant force to this area carries the risk of more severe injury than a simple bruise. Before relying on self-care, a medical professional must definitively rule out a sternal fracture or damage to internal organs. A doctor will typically perform a physical examination and may order imaging tests, such as an X-ray, to confirm the diagnosis and ensure the injury is only a contusion.
Immediate emergency medical care is necessary if you experience “red flag” symptoms following a chest impact. These include difficulty breathing or shortness of breath, which could suggest an underlying lung injury like a pneumothorax or pulmonary contusion. Pain that rapidly worsens, radiates to the jaw or arm, or is accompanied by dizziness, fainting, or a rapid heart rate could signal a cardiac issue.
Any visible chest wall deformity, an audible grinding or clicking sound (crepitus) when breathing or moving, or a sudden fever should prompt an immediate trip to the emergency room. These signs may point toward a displaced sternal fracture or an infection. Prompt medical evaluation ensures that any potentially life-threatening complications are addressed.
Managing Pain and Promoting Healing at Home
Once a serious fracture or internal injury has been ruled out, the focus shifts to conservative pain management and promoting healing. Rest is paramount, requiring you to limit any activities that engage the chest muscles, such as heavy lifting, pushing, pulling, or twisting the torso. This period of reduced activity helps minimize further irritation to the bruised tissue.
Ice application is recommended immediately following the injury to reduce swelling and inflammation, which are major sources of pain. Apply a cold pack wrapped in a thin cloth to the affected area for 15 to 20 minutes at a time, several times a day, for the first one or two days. After the initial acute phase, some people find alternating between cold and gentle heat helpful for muscle relaxation and blood flow.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often used to manage pain and inflammation effectively. These medications should be taken as directed on the packaging, and it is wise to consult a healthcare provider regarding appropriate dosage, especially if you have existing health conditions. Acetaminophen is another option for pain relief, but it does not provide the same anti-inflammatory benefits as NSAIDs.
A common complication of chest wall injuries is shallow breathing, where pain causes the injured person to avoid taking full breaths, increasing the risk of lung infection. To combat this, practice taking 10 slow, deep breaths every hour, even if it is uncomfortable, to keep the lungs clear. Bracing the chest by holding a pillow firmly against the sternum when coughing, sneezing, or taking a deep breath can significantly reduce the painful movement.
Finding a comfortable position for sleep is also beneficial, as lying flat can put pressure on the sternum. Sleeping semi-upright, such as in a recliner or propped up with several pillows, can reduce this pressure and make breathing easier throughout the night. It is advisable to sleep on your back or unaffected side to prevent direct compression of the injured area.
Navigating the Recovery Timeline
The typical recovery period for a simple sternal contusion ranges from two to four weeks, although this timeframe can vary depending on the severity of the initial trauma. During this time, pain and tenderness should gradually decrease, and any visible bruising will begin to fade. The constant movement of the sternum during breathing means the injury site is continually irritated, which contributes to the prolonged nature of the discomfort.
As the pain subsides, you can gradually reintroduce normal daily activities, but it is important to avoid strenuous actions or high-impact sports until the area is completely pain-free. Returning to physical activity too soon risks re-injuring the area, which can significantly delay the overall healing process. Gentle movement and light stretching can be incorporated to prevent stiffness, but only if they do not cause a sharp increase in pain.
If the pain persists beyond six to eight weeks, or if you notice any new or worsening symptoms, schedule a follow-up appointment with your doctor. Persistent pain may indicate that the injury was more extensive than initially diagnosed, or that another issue, such as costochondritis, has developed. Adjusting your activity level based on your pain is the most reliable way to navigate the recovery timeline.