Tony Romo's Broken Rib/Pneumothorax and How He Could Still Play (Hint: Be Like Mike)

So Tony Romo's rib injury took a dramatic turn today when the Dallas Cowboys announced that the rib fracture itself punctured a lung and caused a pneumothorax that they discovered after the game.

What the heck is that??

So when Romo got hit just right in the game on Sunday against the San Francisco 49ers, one of his ribs broke.  The fractured end of the bone then moved into the space in his chest where the lungs are contained.

Inside that space, all of the air is contained within the lungs itself.  There is actually negative pressure (lack of air) that fills the remaining space that allows the lungs to inflate/deflate as you breathe.

Graphic: lung-symptoms.com 

When that rib penetrated that space and punctured the lung, air leaked out of the lung and filled that negative space around it.  That loss of negative pressure then prevents the lung from expanding when you breathe in.

Now, no one knows for sure when the pneumothorax began, but he apparently didn't have one that they diagnosed before he came back out in the third quarter of the game (I say that because I can't imagine he would have been playing if they had known that).  Simply playing with the broken rib might have caused the pneumothorax later in the game.

If it's a small pneumothorax and there's only a little air inside the chest, typically the area heals itself and no further treatment is needed.  The way you treat a larger, more serious pneumothorax is to actually stick a long needle into the space and suck out all the air inside the chest cavity that shouldn't be there.  That re-establishes the negative pressure and allows the lung to re-inflate again.

Next Generation Rib Protection 

The bigger issue with his injury is the rib fracture.  Typically, for one rib fracture you let it heal on its own.    Michael Vick missed a handful of games last season with an injury that involved multiple ribs, but came back wearing a custom-made rib shield like the one below.

EvoShield