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Devin Smith: Understanding His Injury

Ed Mulholland-USA TODAY Sports

Early in training camp, Smith partially punctured a lung and broke three ribs during practice. This primer looks at Devin's recovery process.

What is the injury?

There are 12 ribs in the body – 7 of them connect directly to the sternum while the last 5 do not. Broken ribs are often caused by a direct blow to the chest. Whenever ribs are broken, a punctured lung is always possible. If part of the broken rib pierces the lung, air escapes into the pleural space (space between the lungs and the chest) as the lung deflates/collapses. The lung is re-inflated through several mechanisms performed by a medical doctor or EMT; the focus of the procedure is to create another channel for air to get back into the lung.

How long will Devin be out for?

Broken ribs take at least 6 weeks to heal; with the punctured lung, this time period may be slightly extended. From a physical therapy perspective, there is not much to be done initially. People can take medication/given local anesthesia to minimize the pain as breathing in and coughing is especially painful. As the bone begins to heal, breathing exercises are prescribed so the ribs do not begin to "stick" as it is healing. Once the rib has fully healed, physical therapists can manually mobilize the rib if it is lacking range of motion. The main focus of recovery is the regain the ability to breathe deeply as the rib cage/lungs expand to take in more air. This is especially important to athletes who are often seen gasping for breath after a huge play or by the end of the game from fatigue.

Other aspects of physical therapy include exercises that correct posture and increase the flexibility of the thoracic spine (meaning ability to rotate the trunk from side to side). Based on the severity of the punctured lung, certain interventions can be performed while the patient is in the hospital to help breathe better and more efficiently.

Devin can resume playing once X-rays has shown the ribs have healed and the pain subsided. He may need to wear a rib cage protector/chest binder for the first 6-8 weeks while he is playing to provide additional support and protection to his ribs. The injury occurred at the beginning of August, thus reaching the 6 week mark at Week 1. His conditioning is not ideal and will probably take him a week or two to get used to running routes and absorbing hits. Barring any setbacks, he may see some limited action Week 2 but may not return to true form until Weeks 3-4.