The sternum, or breastbone, is the long, flat bone situated in the center of the chest, connecting the ribs via cartilage. Due to its exposed location, the sternum is vulnerable to impact from falls, sports injuries, or motor vehicle accidents. Trauma frequently results in a soft tissue injury known as a contusion, or bruise. Understanding the expected duration and how to manage discomfort aids recovery.
What is a Sternal Contusion?
A sternal contusion is an injury to the muscles, connective tissues, and small blood vessels overlying the breastbone, resulting from blunt force trauma. This injury is distinguished from a fracture because the bone remains intact. The impact causes capillaries to rupture, leaking blood into the tissues, which manifests as the visible discoloration of a bruise.
The primary symptom is localized pain and tenderness directly over the sternum. This pain can feel intense, particularly when pressed, and may be accompanied by noticeable swelling. Discomfort often sharpens with movements involving the chest wall, such as twisting the torso or taking a deep breath, or by coughing or sneezing.
The Typical Recovery Timeline
For a simple sternal contusion without bone involvement, the usual healing period ranges from two to four weeks. Recovery follows a phased pattern, beginning with acute symptoms in the first few days post-injury when pain and swelling peak.
Weeks one and two involve a gradual reduction in sharp, constant pain. Bruising may become more prominent as the body clears pooled blood, and tenderness becomes manageable. By weeks three and four, most individuals experience near-complete resolution of symptoms, allowing a return to normal daily activities.
The duration is influenced by the severity of the initial impact. A more forceful blow causing extensive soft tissue damage may require the full four weeks or slightly longer. Consistent rest and adherence to pain management strategies are factors in ensuring recovery stays within this timeline.
Home Management and Pain Relief
Managing a sternal contusion at home focuses on reducing inflammation and controlling pain to promote healing and maintain respiratory function. Rest is primary; avoid activities that strain the chest, such as heavy lifting or strenuous exercise, until the pain resolves.
Applying a cold pack to the injured area for 10 to 20 minutes several times a day during the first 48 hours helps limit initial swelling. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, can be taken to reduce pain and inflammation.
Continue taking deep breaths hourly, despite the discomfort, to prevent the collapse of small air sacs in the lungs and reduce the risk of chest infection. To ease the pain, hold a pillow firmly against the sternum while taking a deep breath or coughing.
Recognizing When the Injury is More Serious
While most sternal contusions heal without complication, certain signs indicate a more severe injury requiring immediate professional evaluation.
Warning Signs
Persistent, sharp, or worsening pain that does not improve after the first few days of home care is a significant warning sign. Difficulty breathing, shortness of breath, or chest tightness must be addressed quickly, as these symptoms can suggest injury to the lungs or other internal structures.
Other red flags include pain that radiates outward to the shoulder, neck, or jaw, which may accompany internal trauma. A visible deformity, such as a bump or depression over the breastbone, or a crunching sensation, can indicate a sternal fracture. If symptoms fail to show improvement after the expected two-to-four-week recovery period, a medical consultation is necessary.