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Journalism of Courage
At 80, actor Amitabh Bachchan has displayed a rare grit and determination in coming through his health problems. So, when he got injured while shooting for the film, Project K, emotions ran high about his condition. But from what he described in his blog, popping a rib cartilage and an accompanying muscle tear are common among the elderly population, especially if they perform a high-intensity physical activity. “Normally, wearing a rib belt takes care of the problem. A surgery is required only in extreme circumstances and depending on the severity of the tear,” says Dr Akhilesh Yadav, Associate Director, Orthopaedics and Joint Replacement, Max Super Speciality Hospital, Vaishali.
Bachchan wrote in his blog, “And it needs to be told, not be held. In Hyderabad at the shoot for Project K, during an action shot, I got injured…. rib cartilage popped, broke and muscle tear to the right rib cage, cancelled shoot, did doctor consult and scan by CT at the AIG Hospital in Hyderabad and flown back home. Strapping has been done and rest been advocated, yes painful, on movement and breathing, will take some weeks they say before some normalisation will occur. Some medication is on also for pain. So, all work that was to be done has been suspended and cancelled, dropped or postponed for the moment until healing occurs.”
What is popping of ribs?
“The human rib cage consists of 12 paired bones. Now, the first seven pairs are attached directly to the sternum. But the remaining three pairs are not directly attached to the sternum but are connected by cartilage. This part, called the costochondral junction, is prone to excess movement. And in older people, hyperactivity tends to stress out the age-weakened cartilage even more. A popped rib happens when the cartilage attached to any of these ribs breaks, resulting in abnormal movement. So, the ribs may slip out of normal position, causing pain that’s felt in your upper abdomen or lower chest,” says Dr Yadav.
“The popping is the noise created by the surfaces of this cartilage-sternum joint rubbing together. With the cartilage snapping, the rougher surfaces rub together. Muscles and connective tissues that are slightly out of place can swell, putting pressure on surrounding structures that can lead to a popping sound,” says Dr Yash Gulati, Senior Consultant Orthopaedic, Joint Replacement and Spine, Indraprastha Apollo Hospital, New Delhi. “This is a minor problem that happens among the elderly, athletes, gym-goers who lift heavy weights or to accident trauma patients. Among the elderly, whose muscles and bones are already worn out, such pops can happen due to heavy strain, a bout of cough, cold and sneezing. But we need to rule out pathological fractures and make sure no other intervention is required. If there is inflammation and pain, one needs to probe the problem deeper,” he adds.
Why does the muscle tear?
“Ribs are also attached to the muscle, so when the cartilage lacerates, the muscle can tear. In some cases, a popping sound can also indicate a fracture in the sternum. This usually happens in high-intensity contact sports and car accidents. Sternum fractures can be very painful and may cause other symptoms, such as difficulty breathing and swelling in the chest. In some cases, the injury may also affect the lungs and heart,” says Dr Yadav.
Treatment and recovery
“The treatment protocol involves wearing a rib belt, taking pain killers, using muscle relaxants, and taking calcium and vitamin supplements. If the pain is tolerable, the patient can be active,” says Dr Yadav. “The muscle tear can heal spontaneously,” adds Dr Gulati.
The healing process, say both doctors, can take anything between six to 12 weeks but in cases of elderly patients, it may even take longer.
