Discussion Author: Pil Kang
Chronic repetitive stresses from sports such as golf, especially in a relatively de-conditioned “weekend athletes”, can cause musculoskeletal injuries. In particular, rib fractures have been seen in patients who are avid golfers, commonly misdiagnosed as “back strains”. The current medical literature’s most extensive series of this phenomenon is Lord et al.’s published results in 19 golfers. Eighteen golfers were beginners, and one golfer was more experienced, who substantially intensified his practice regimen. Sixteen of these golfers had fractures on the leading arm side of the thorax, as in this case (the patient is right-handed, and her left side would be the leading side in the typical golf stance). For most of these patients, plain films were diagnostic, but three cases required skeletal scintigraphy. These rib fractures generally occur in the posterior and/or posterolateral aspects of the ribs, usually affecting the 4th through 6th ribs, as in this case. The leading theory is that the fatigue of serratus anterior muscle is the major contributor to these injuries. Rehabilitation from these rib fractures includes strengthening the serratus anterior muscle (1). Rib fractures in general have been also associated with baseball pitchers and rowers (2).
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