Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated ConditionsTreatment
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
Treatment
The sternum (also called the breastbone) is a long, flat bone that protects the underlying muscles, organs, and important arteries within the front and center of the chest. This includes the lungs, heart, and stomach, along with all of their intricate blood vessels, muscles, and cartilage. The thymus sits just behind it. The sternum also acts as a joining structure to the upper ribs on either side of the body.
This bone is sometimes cracked duringcardiopulmonary resuscitation (CPR)because part of the sternum is located directly above the heart. The sternum must be cut through during operations on the heart includingopen-heart surgery, making the rehabilitation for that procedure more intensive than most others.
Measuring around 6 inches, the sternum has three main parts:
The sternum as a whole has been compared to an upside-down sword because:
Anatomical variations of the sternum include varying sizes of the sternal angle. This often has little impact on function or treatment following injury but can vary between individuals, like a two-pronged xiphoid process and the presence of a sternal foramen.
The sternum connects the first six ribs in the middle of the chest while serving as a strong protector of the stomach, heart, and lungs which lie below. The xiphoid process specifically acts as an insertion point for the tendons of the diaphragm,rectus abdominis, and transverse abdominis muscles.
The sternum does not assist with any visible range of motion to the chest or torso. However, cartilaginous connectors between the sternum and each of the upper six ribs assist with minor motions that occur with each breath. Each inward breath requires the lungs to fill with air and the intercostal (or rib) muscles to contract. All of these motions require some internal room to function appropriately.
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Beyond potentially breaking during CPR, other accidents, injuries, and illnesses—even acid reflux—can cause pain or damage to the sternum.
Bone Fracture
A fractured sternum can cause swelling and pain when breathing, coughing, or laughing, along with difficulty breathing.It’s also common for a fractured sternum to cause grinding bones with each arm movement.
Broken Xiphoid Process
Because the xiphoid process is thinner and more narrow in comparison to the rest of the sternum, it poses a safety risk during CPR, when it’s at risk of being broken.
Costochondritis
When the rib cartilage that connects with the sternum becomes inflamed, this pain can be local to the sternal area or can spread to the arms or shoulders in severe cases.
Costochondritiscan cause sharp, stabbing rib pain and tenderness to any of the first three ribs. Redness and warmth to the sternal and rib area may also be noted.
Digestive and Respiratory Issues
Heartburn,stomach ulcers,and gastroesophageal reflux disorder (GERD), also known as acid reflux, can cause pain in the sternal area if left untreated.
Lung disorders that can cause sternal pain and difficulty breathing include:
Damage Caused By Other Injuries
The top of the sternum joins with the collarbone to allow for normal range of motion and muscle use.Injury to the collarbonemay cause the sternum to swell, ache, pop, or click with significant movement.
The presence of a hernia can cause chest pain and muscle strain to the chest and torso muscles can cause pain, bruising, and tenderness in the sternal area.
These symptoms can also affect your ability to breathe easily, causing limited motion and sternal pain.
Treatment will depend on the cause of sternal pain.
Bone fracture:
Most bone fractures must follow a particular protocol for rehabilitation. However, sternal fractures are an exception to this since they do not assist in direct, gross range of motion. The protocol for sternal fractures is to manage pain and allow rest to encourage healing.
Sternal fractures often take up to three months to heal, with pain levels easing after this point.The prognosis for return of function after a sternal fracture is excellent, as it’s rather simple to immobilize a bone with such little functional motion.
Sternal precautionsinclude lifting restrictions and limiting arm movements. Some main ways to maintainsternal precautionsinclude:
These behaviors relieve the pressure and strain on the abdominal muscles and sternum.
Since sternal fractures often occur after a traumatic incident, there are often other injuries that are simultaneously treated. However, if you have no other injuries requiring hospitalization, you can successfully recover from a sternal fracture in the comfort of your own home.
Costochondritis:
Treatment includes rest, applying hot or cold compresses, and over-the-counter pain relievers to allow time for the rib cartilage to heal. Recovery time can vary from a few days up to a few months.
Digestive and respiratory conditions:
Treatment may include:
Other injuries:
Depending on the extent of the injury, the clavicle or scapula may be treated with:
Summary
The sternum, or breastbone, is a strong bone at the center of the torso that protects the heart, lungs stomach, along with all of their intricate blood vessels, muscles, and cartilage. The sternum also joins the upper ribs on each side of the body.
In addition to bone fracture, several other conditions can cause sternal pain. Treatment will depend on what is causing pain in the sternum and may include rest, immobilization, pain medications, cold therapy, or surgery.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kumar NS, Bravian D, More AB.Xiphoid foramen and its clinical implication. Int J Anat Res 2014, Vol 2(2):340-43.Gkantsinikoudis N, Chaniotakis C, Gkasdaris G, Georgiou N, Kapetanakis S.Morphological approach of the sternal foramen: an anatomic study and a short review of the literature.Folia Morphol (Warsz). 2017;76(3):484-490. doi:10.5603/FM.a2017.0006Khoriati AA, Rajakulasingam R, Shah R.Sternal fractures and their management.J Emerg Trauma Shock. 2013;6(2):113-6. doi:10.4103/0974-2700.110763Anderson BW, Holme MR, Alkhammash L, et al.Anatomy, Thorax, Xiphoid Process. [Updated 2023 Mar 26]. In: StatPearls Publishing.Proulx AM, Zryd TW.Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15;80(6):617-20. PMID: 19817327.Yoo WG.Effects of combined chest expansion and breathing exercises in a patient with sternal pain.J Phys Ther Sci. 2017;29(9):1706-1707. doi:10.1589/jpts.29.1706Khan MZ, Yousaf H, Dahiya DS, et al.Chest Pain: A Relatively Benign Symptom of Type IV Hiatal Hernia. Cureus. 2020 Nov 12;12(11):e11459. doi: 10.7759/cureus.11459Ayloo A, Cvengros T, Marella S.Evaluation and treatment of musculoskeletal chest pain.Prim Care. 2013;40(4):863-87. doi:10.1016/j.pop.2013.08.007El-Ansary D, Lapier TK, Adams J, et al.An evidence-based perspective on movement and activity following median sternotomy.Phys Ther. 2019. doi:10.1093/ptj/pzz126Mount Sinai.Costochondritis.Johns Hopkins Medicine.Hiatal hernia.Johns Hopkins Medicine.Clavicle fractures.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kumar NS, Bravian D, More AB.Xiphoid foramen and its clinical implication. Int J Anat Res 2014, Vol 2(2):340-43.Gkantsinikoudis N, Chaniotakis C, Gkasdaris G, Georgiou N, Kapetanakis S.Morphological approach of the sternal foramen: an anatomic study and a short review of the literature.Folia Morphol (Warsz). 2017;76(3):484-490. doi:10.5603/FM.a2017.0006Khoriati AA, Rajakulasingam R, Shah R.Sternal fractures and their management.J Emerg Trauma Shock. 2013;6(2):113-6. doi:10.4103/0974-2700.110763Anderson BW, Holme MR, Alkhammash L, et al.Anatomy, Thorax, Xiphoid Process. [Updated 2023 Mar 26]. In: StatPearls Publishing.Proulx AM, Zryd TW.Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15;80(6):617-20. PMID: 19817327.Yoo WG.Effects of combined chest expansion and breathing exercises in a patient with sternal pain.J Phys Ther Sci. 2017;29(9):1706-1707. doi:10.1589/jpts.29.1706Khan MZ, Yousaf H, Dahiya DS, et al.Chest Pain: A Relatively Benign Symptom of Type IV Hiatal Hernia. Cureus. 2020 Nov 12;12(11):e11459. doi: 10.7759/cureus.11459Ayloo A, Cvengros T, Marella S.Evaluation and treatment of musculoskeletal chest pain.Prim Care. 2013;40(4):863-87. doi:10.1016/j.pop.2013.08.007El-Ansary D, Lapier TK, Adams J, et al.An evidence-based perspective on movement and activity following median sternotomy.Phys Ther. 2019. doi:10.1093/ptj/pzz126Mount Sinai.Costochondritis.Johns Hopkins Medicine.Hiatal hernia.Johns Hopkins Medicine.Clavicle fractures.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kumar NS, Bravian D, More AB.Xiphoid foramen and its clinical implication. Int J Anat Res 2014, Vol 2(2):340-43.Gkantsinikoudis N, Chaniotakis C, Gkasdaris G, Georgiou N, Kapetanakis S.Morphological approach of the sternal foramen: an anatomic study and a short review of the literature.Folia Morphol (Warsz). 2017;76(3):484-490. doi:10.5603/FM.a2017.0006Khoriati AA, Rajakulasingam R, Shah R.Sternal fractures and their management.J Emerg Trauma Shock. 2013;6(2):113-6. doi:10.4103/0974-2700.110763Anderson BW, Holme MR, Alkhammash L, et al.Anatomy, Thorax, Xiphoid Process. [Updated 2023 Mar 26]. In: StatPearls Publishing.Proulx AM, Zryd TW.Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15;80(6):617-20. PMID: 19817327.Yoo WG.Effects of combined chest expansion and breathing exercises in a patient with sternal pain.J Phys Ther Sci. 2017;29(9):1706-1707. doi:10.1589/jpts.29.1706Khan MZ, Yousaf H, Dahiya DS, et al.Chest Pain: A Relatively Benign Symptom of Type IV Hiatal Hernia. Cureus. 2020 Nov 12;12(11):e11459. doi: 10.7759/cureus.11459Ayloo A, Cvengros T, Marella S.Evaluation and treatment of musculoskeletal chest pain.Prim Care. 2013;40(4):863-87. doi:10.1016/j.pop.2013.08.007El-Ansary D, Lapier TK, Adams J, et al.An evidence-based perspective on movement and activity following median sternotomy.Phys Ther. 2019. doi:10.1093/ptj/pzz126Mount Sinai.Costochondritis.Johns Hopkins Medicine.Hiatal hernia.Johns Hopkins Medicine.Clavicle fractures.
Kumar NS, Bravian D, More AB.Xiphoid foramen and its clinical implication. Int J Anat Res 2014, Vol 2(2):340-43.
Gkantsinikoudis N, Chaniotakis C, Gkasdaris G, Georgiou N, Kapetanakis S.Morphological approach of the sternal foramen: an anatomic study and a short review of the literature.Folia Morphol (Warsz). 2017;76(3):484-490. doi:10.5603/FM.a2017.0006
Khoriati AA, Rajakulasingam R, Shah R.Sternal fractures and their management.J Emerg Trauma Shock. 2013;6(2):113-6. doi:10.4103/0974-2700.110763
Anderson BW, Holme MR, Alkhammash L, et al.Anatomy, Thorax, Xiphoid Process. [Updated 2023 Mar 26]. In: StatPearls Publishing.
Proulx AM, Zryd TW.Costochondritis: diagnosis and treatment. Am Fam Physician. 2009 Sep 15;80(6):617-20. PMID: 19817327.
Yoo WG.Effects of combined chest expansion and breathing exercises in a patient with sternal pain.J Phys Ther Sci. 2017;29(9):1706-1707. doi:10.1589/jpts.29.1706
Khan MZ, Yousaf H, Dahiya DS, et al.Chest Pain: A Relatively Benign Symptom of Type IV Hiatal Hernia. Cureus. 2020 Nov 12;12(11):e11459. doi: 10.7759/cureus.11459
Ayloo A, Cvengros T, Marella S.Evaluation and treatment of musculoskeletal chest pain.Prim Care. 2013;40(4):863-87. doi:10.1016/j.pop.2013.08.007
El-Ansary D, Lapier TK, Adams J, et al.An evidence-based perspective on movement and activity following median sternotomy.Phys Ther. 2019. doi:10.1093/ptj/pzz126
Mount Sinai.Costochondritis.
Johns Hopkins Medicine.Hiatal hernia.
Johns Hopkins Medicine.Clavicle fractures.
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