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Two Years of Debilitating Pain in a Football Spearing Victim: Slipping Rib Syndrome


Medicine & Science in Sports & Exercise: October 2003 - Volume 35 - Issue 10 - p 1634-1637
doi: 10.1249/01.MSS.0000089249.00206.04
CLINICAL SCIENCES: Clinical Investigations

PETERSON, L. L., and D. G. CAVANAUGH. Two Years of Debilitating Pain in a Football Spearing Victim: Slipping Rib Syndrome. Med. Sci. Sports Exerc., Vol. 35, No. 10, pp. 1634–1637, 2003.

Introduction Blunt chest trauma can occur in a variety of sports, and lead to rib fractures and less commonly known and diagnosed injuries. We report the case of a 14-yr-old student athlete who was speared (helmet tackled) in a practice scrimmage sustaining a painful injury that eluded diagnosis and treatment for more than 2 yr.

Methods  The case history of pain treatments and radiological evaluations is presented.

Results Ultimately, a definitive diagnosis of “slipping rib syndrome” was achieved through a simple clinical manipulation (the hooking maneuver), combined with a history of symptomatic relief provided with costochondral blockade. Surgical resection of the slipping rib provided total resolution of the problem.

Conclusion Very few clinicians are aware either of the syndrome or the maneuver used to diagnose this condition. Although spearing has been outlawed in American football for years, it remains a commonplace occurrence, and sports physicians should be aware of the potential consequences to the victim as well as those to the perpetrator.

1Department of Pediatrics, Marshfield Clinic-Chippewa Center, Chippewa Falls, WI; and

2Department of General Surgery, Marshfield Clinic-Eau Claire Center, Eau Claire, WI

Address for correspondence: Dr. Laurie L. Peterson, Department of Pediatrics, Marshfield Clinic-Chippewa Center, 2655 County Hwy. I, Chippewa Falls, WI 54729; E-mail:

Submitted for publication May 2002.

Accepted for publication April 2003.

©2003The American College of Sports Medicine