Sternum pain in rugby player

Hi

A rugby union player sustained a direct impact injury to the chest at the end of last season (5 months ago) and complained of shortness of breath and pain directly on the central part of the sternum. I assessed him and there was no evidence of broken ribs or sternum, however I advised him to attend a and e for an xray and painkillers. He was going on holiday the following day so did not bother!, and played the rugby league season with pain in the chest after most matches. On return to union season, he still complains of pain over the sternum and costo-cartilage during physical exertion.
I suspect bony bruising and advised xray, rest.
I have given him pecs stretches and have done gentle mobilisations to the ribs and he reported feelings slightly better.

Any suggestions on further action/treatment would be much appreciated!

Thank you

Kate

Impact on the front of the chest has potentially put some ribs out of position (according to some lines of thought) As a result potentially some muscle reaction which maintains the problem. You use either MET techniques to sort it out or Strain-Counterstrain. the latter I find far more effective. As you can understand elevated or depressed ribs will affect the breathing and definitely when breathing heavily. You should look 1st in the spinal mobility: rotation (left=right?) flexion and extension of the thoracic spine. All directions of the neck. The reason is that you will not solve the problem with focusing on the ribs because most of the time it is a combination of (mobility)problems. Look into the mobility of the ribs on inhaling exhaling. Look for tenderpoints in the area and definitely the ones which seem to cause a feeling of thightness of the chest (sternum, ribs anterior/lateral/dorsal, Vertebraes). I can recommend you to buy the MET DVD's by Tom Ockler which you can obtain on this website (I feel they promote a good understanding of the function of the musculoskeletal issues you mention and beyond). By the way I have no financial interest in these dvd's
Hope this will help.

Thank you very much for your advise. I will also look at the DVDs mentioned.

Kate