If Rory McIlroy suffered the most common rib fracture for golfers, then the next four to six weeks are going to be very frustrating. A hairline fracture of a rib is not something that can be fixed with surgery or patched with a splint. The only remedy that is going to get him healthy again is time, meaning at least a month's worth of rest.
"Until it heals properly, you can't do anything strenuous or you risk further injury," says Golf Digest health advisor Dr. Ara Suppiah, who was the physician for the U.S. Ryder Cup team last fall. "Even something as simple as sneezing or coughing can hurt. You've got to shut it down for a while."
Although the specific injury has not been disclosed, it's likely, based on McIlroy's statement on Monday after withdrawing from the European Tour event in Abu Dhabi and his recent symptoms, that he fractured the fourth, fifth or sixth rib on the left side of his torso, Suppiah and Golf Digest fitness advisor Ralph Simpson agreed. Simpson is a former PGA Tour trainer who is certified in orthopedic manual therapy and a doctor of physical therapy. McIlroy complained of back pain this past weekend as he competed in the BMW South African Open. He went for an MRI after losing in a playoff to Graeme Storm, which revealed the stress fracture.
"It's often initially thought to be a back issue, because the fracture occurs on the posterior side of the body," Simpson says. "It feels like back pain. It's a frustrating injury for sure. And if he did fracture one of those ribs, he should shut everything down until he no longer feels pain when he swings normally. It's not a super long recovery time, but it does require the discipline not to come back too soon."
What typically causes the fracture is a tugging action on the rib by the serratus anterior muscle, which is attached to the rib cage. As a golfer swings back, the muscle stretches and pulls on the ribs while moving the scapula forward (like throwing a punch with your left arm). Stress also can occur as the body stops rotating after impact while the club keeps moving, Suppiah says.
Simpson added that amateur golfers typically suffer this type of injury by repeatedly hitting fat shots that crash the club into the turf. When a pro gets the injury, it's most likely because of a swing change or dramatically increasing time on the practice tee. McIlroy made several changes to his swing last summer after missing the cut at the U.S. Open, and said he spent a lot of hours working on those changes as well as testing equipment in recent months.
As far as whether McIlroy's vigorous strength-training program had anything to do with the injury, Suppiah said it's unlikely. "This is an overuse injury, it's pretty cut-and-dried."
The question then is when might we see McIlroy back in action? If he were to take at least four weeks off, that would keep him from playing the remaining events on the European Tour's Desert Swing. He has previously committed to playing again on the PGA Tour at the Genesis Open at Riviera Country Club outside Los Angeles, which would be five weeks out, and then was expected to compete at the Honda Classic a week later. With proper healing, McIlroy could still make those two starts, but any setback could cause him to withdraw from more events down the road.