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Chest pain with RIB FRACTURE on workout. OSTEOPOROSIS?

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Hi, I am a 42 year old active mum of four. I have been working out for many years, both long distance-running (marathon) and gym training (free weights) at a medium intensive level (at least 3 times a week). About two months ago I started a new training program focusing on heavy weights. Five weeks ago, about 12 hours after a training session, I started to experience pain in my chest region (around the sternum and to the right). It was similar to the pain related to a rib fracture, which I have had earlier on two occasions, but this time I had no memory of any "real" recent trauma, just that during the session the same morning I had done a new exercise which involved lying on my chest and stomach on a bench, lifting dumbbells from the floor in a rowing motion. I remembered my chest had hurt from being pressed down on the bench but I couldn't imagine this leading to a rib fracture. Neither could the doctor I talked to on the phone, who though it could be a muscle strain and referred me to a physiotherapist. During the next days and weeks, the pain persisted. I had to take pain killers and it hurt when I lifted the kids or pulled at door handles with my right arm etc. After two weeks upon seeing the phsyiotherapist for the first time, the pain had subsided a bit, but I still had pain in the middle/right chest when trying to get up from lying down to sitting and when lying on my stomach, and I could still feel pain when pressing on the sternum or rib cage. The physio therapist pressed on spots along my spine while I was lying down and it did hurt a bit in the back while she did that. She said she thought it was a bulging disc in my spine that caused the problems and told me to do some exercises for that and avoid lifting weights. For the following week I did the exercises and tried to sit straight etc but suddenly my back started to hurt more (before this week I have almost never in my life had back pain before, although I have a slight scoliosis) as well as the chest. So I stopped doing the exercises (foam rolling, raising my head up from lying down on my stomach etc) and started to live like before and now my back pain is better. My chest pain is also, after 5 weeks, much better, but I can still feel it when I press on the sternum and right part of the rib cage. It's more like a pinching sensation, no longer a sharp pain. I really really want to go back to my exercise programme and I have tried twice to go back to the gym just to work on my technique with light weights but I feel tense and worried that I will make it worse. Same when I do everyday movements like lifting stuff form the floor - I'm tense all the time because I'm scared it will hurt which it now rarely does. My question is: Do you think that the phsyiotherapist is right and that it could be a bulging disc in the spine causing these problems? If so, why is there pain when I press down with my fingers on the rib cage (and also when I take very deep breaths). Or could it be a small fracture on the rib cage or sternum, even if there was no severe trauma? I should mention that I suffered from anorexia for many years old patient(I'm OK now, and this training programme, focusing on gaining weight and building muscles was very good for me both physically and psychologically) and I am still very thin, especially my upper body. My OB gyn once said in passing and related to another matter that she thought I might have an oestrogene deficiency although that has never been confirmed. I know that can be related to osteoporosis. Could I suffer from osteoporosis at this age and would that affect my tendency to easily get fractures in my rib cage?

Two questions actually:). I just want to be able to get better and go back to the gym, but I don't want to make things worse if its a bulging disc I have. It's hard to rest but it would be easier if I knew this was something that would go away on its own so that I can look ahead.
 

PS: I shoud mention that when I press on the spot on my back opposite to the "chest pain spot" it does hurt at pressure and for a while afterwards, and it radiates out from that spot, but it's not intolerable. I feel a little bit like I'm going crazy thinking about this, while i have almost never before felt a pain in my back. 

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 30 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I have read your question with diligence.
Going through all details it sounds to me like Tietz syndrome.
In this syndrome there is inflammation of articular junction of ribs near the sternum.
The problem of pain can be resolved by taking good anti inflammatory analgesic like voltren.I prescribe combination of tramadol with paracetamol in such cases.
If a few days of conservative therapy with anti inflammatory analgesic medicine do not help then you may ask from your doctor about steroid injection.This is generally given at the area of maximum tenderness at chest area.
Feel free to discuss further,
Hope this will help you.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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