The sternum, often called the breastbone, is a flat bone located in the center of the chest. It connects to the ribs via cartilage, forming a protective shield for the heart and lungs. The sternum can be bruised, a sternal contusion. This injury causes discomfort and pain in the chest.
Understanding Sternum Bruises
A sternum bruise occurs when small blood vessels beneath the skin are damaged due to trauma, causing blood to leak into surrounding tissues. This results in discoloration and tenderness associated with a bruise. While a sternum contusion is not a fracture, it can still cause significant pain because of the sternum’s central location and its role in chest wall movement.
Common causes of sternum bruising involve direct impact to the chest, such as from a steering wheel or seatbelt impact during car accidents. Falls or blunt force trauma during contact sports are frequent culprits. In some less common instances, even a particularly forceful or prolonged cough can lead to a sternum injury due to repetitive strain on the surrounding muscles and cartilage.
Symptoms of a bruised sternum appear immediately after the injury. The most prominent symptom is localized pain and tenderness directly over the breastbone, which worsens when the area is touched. Swelling and visible discoloration, ranging from red to purple or blue, may be present on the chest skin. Many individuals experience increased pain with movements that involve the chest wall, such as deep breathing, coughing, sneezing, or twisting the torso. This occurs because the sternum moves with these actions, irritating the bruised tissue.
Managing a Sternum Bruise
Managing a suspected sternum bruise begins with self-care measures to reduce pain and promote healing. Rest is important, and individuals should avoid activities that worsen the pain, especially heavy lifting or strenuous movements. Applying an ice pack wrapped in a thin cloth to the affected area for 10 to 20 minutes at a time, several times a day, can help reduce swelling and discomfort during the initial days. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also help manage pain and inflammation.
Seek medical attention if symptoms are severe or do not improve with self-care. Persistent or worsening pain, difficulty breathing, or shortness of breath warrant prompt medical evaluation. If the injury resulted from a high-impact event, such as a significant car accident, medical assessment is recommended to rule out more serious injuries, even if initial symptoms seem mild. Visible deformity of the chest or symptoms like jaw pain, dizziness, or coughing up blood indicate a need for immediate medical care.
During a medical examination, a healthcare professional will conduct a physical assessment, checking for tenderness, swelling, and visible bruising over the sternum. To rule out more severe injuries, such as a sternal fracture or other chest wall damage, imaging tests may be ordered. While bruises themselves do not show on X-rays, a lateral chest X-ray or a CT scan can help identify fractures or other internal issues with similar symptoms.
Recovery from a sternum bruise varies by severity, but can take several weeks to fully heal. Although it is a bruise, the pain can be significant due to the constant movement of the chest wall with breathing. Individuals are encouraged to continue taking deep breaths and coughing regularly, despite the pain, to help clear the lungs and prevent complications like chest infections. Supporting the chest with a pillow when coughing can make this less painful.