Breathing Easier After Trauma: How Osteopathy Supports Pneumothorax Recovery

When comedian Dave “Hughesy” Hughes ran out in last night’s AFL Legends Game for Prostate Cancer at Marvel Stadium, he likely expected some laughs and light-hearted competition. Instead, after several heavy collisions with former AFL players, Hughes sustained multiple rib fractures and a pneumothorax (punctured lung), landing him in hospital intensive care.

This type of chest trauma is not uncommon in contact sports, but it highlights an important condition - pneumothorax, and the longer-term musculoskeletal patterns osteopaths often see in recovery.

What is a Pneumothorax?

A pneumothorax occurs when air leaks into the pleural space, the thin cavity between the lung and chest wall. This air pocket prevents the lung from fully expanding, making breathing painful and restricted.

Causes include:

• Blunt chest trauma (such as fractured ribs piercing the pleura)

• Medical procedures (e.g. chest port or drain insertion)

• Spontaneous rupture in individuals with weakened lung tissue

In Hughes’ case, fractured ribs likely punctured the pleura, allowing air to collapse part of the lung.

Immediate Management:

• Medical stabilisation is critical: chest drains, imaging, and hospital monitoring ensure lung re-expansion and prevent further complications.

• Pain management is essential: both for comfort and to allow effective breathing, which helps prevent pneumonia or infection.

Once medically stable, however, secondary musculoskeletal consequences begin to play a role. This is where osteopathy can assist.

Osteopathic Considerations in Pneumothorax Recovery:

Following a pneumothorax, patients often present with characteristic biomechanical findings that can persist long after the lung itself has healed.

1. Rib Restrictions

• Rib fractures, scar tissue, and protective muscle splinting reduce thoracic cage mobility.

• Common findings: stiff costovertebral joints, “held” ribs with poor bucket-handle movement, and asymmetry between sides of the ribcage.

• This can create compensatory tension in the thoracic spine, shoulders, and even neck.

2. Intercostal Scar Tissue

• If a chest drain (intercostal port) was required, scar tissue may form in the intercostal muscles.

• This restricts local rib glide and can cause pinpoint tenderness.

• Scarring may also tether fascial planes, limiting rotation and expansion through that region.

3. Breathing Pattern Dysfunction

• Pain often leads patients to adopt shallow, upper-chest breathing.

• This reduces diaphragmatic motion, weakening the diaphragm over time and reinforcing poor postural mechanics.

4. Functional Movement Impairments

• Decreased thoracic mobility affects:

• Overhead reach (important for sports and daily activity)

• Rotation (common in running, swinging, or throwing)

• Posture, with patients adopting a protective kyphotic or side-bent position

Osteopathic Approach to Rehabilitation:

Early Recovery (once medically cleared):

• Gentle rib and thoracic mobilisations to restore expansion

• Breathing retraining: diaphragmatic breathing, lateral costal expansion, pursed-lip breathing

• Soft tissue techniques to reduce muscle guarding (intercostals, scalenes, pectorals)

Mid-Phase:

• Scar tissue mobilisation around the chest drain site

• Restoring symmetrical rib glide with functional techniques

• Encouraging thoracic extension and rotation through graded movement retraining

Long-Term Functional Rehab:

• Integrating rib and thoracic mobility into whole-body movement patterns (e.g. reaching, rotation, sport-specific actions)

• Correcting compensatory patterns in cervical, lumbar, or shoulder regions

• Gradual return to exercise with emphasis on breathing efficiency under load

Hughes’ fractured ribs and pneumothorax serve as a timely reminder: even after the lung has healed, the musculoskeletal system needs attention. Osteopathy can help patients regain rib mobility, reduce scar-related restrictions, and retrain functional movement so that recovery is complete - not just medically, but mechanically and holistically.

Complete Care Osteo – Lilydale

📞 (03) 7036 6525

💻 Book online: www.completecareosteo.com.au

📍 Suite 2, 355 Main Street, Lilydale, 3140