Aretha Franklin, “Queen of Soul”, has broken ribs

The “Queen of Soul”, Aretha Franklin, fell in her Detroit home on Sunday evening, breaking two ribs.

Just last week, the 68-year-old singer shared the stage at a Philadelphia gala benefit with former US Secretary of State Condoleezza Rice.

Ms. Franklin, the first woman inducted into the Rock and Roll Hall of Fame in 1987, will have to cancel at least two performances scheduled for the next couple of weeks while she recuperates. Franklin had also complained of abdominal pain from the injury and was advised to have further testing done. The results of these have not been reported.

There are twelve pairs of ribs, connecting to the spine in the back, and by cartilage extensions (called the costal cartilages) to the breastbone (sternum) in the front. This space is called the thoracic cage. The ribcage has two main functions-the first being protection of the delicate vital organs within it – the heart and lungs.

The second is its participation in the process of breathing. Between each rib is a muscle called an intercostal muscle. Across the floor of the ribcage is the large muscular diaphragm. During an inspiration, the diaphragm contracts and flattens, and the intercostal muscles contract, pulling the ribs up and out. This action causes a partial vacuum within the thoracic cage, which pulls air into the lungs. On expiration, the muscles relax, and air is expelled from the lungs.

Rib fracture
The curved design of the ribs makes them resistant to fractures. Their ability to flex helps the bone to absorb the force of a blow. However,any bone will break if the force exerted against it is stronger than it can structurally withstand. A rib is most likely to fracture at its outer curve, which is its weakest point.

The symptoms of rib injuries depend on the type and severity of the injury, but can include:

  • Pain at the injury site
  • Pain when the ribcage flexes – with movement, with a deep breath or when you cough, sneeze or laugh
  • Crunching or grinding sounds (crepitus) when the injury site is touched or moved
  • Muscle spasms of the ribcage
  • Deformed appearance of the ribcage
  • Breathing difficulties.

Risk factors for rib fractures include:

  • Age: 65 years and older
  • Difficulty doing activities of daily living
  • Playing contact sports
  • Having weak bones
  • Having a chronic cough

Treatment consists of rest, and pain relief, usually with over the counter medications like Tylenol or Ibuprofen. In the past, elastic bandages were wrapped around the chest to act as a kind of splint for the fracture.  They are not used as much today as they may prevent the injured person from taking deep breaths, which could lead to pneumonia (infection in the lung).

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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