Can I Do Martial Arts After Rib Removal Surgery?

Q: Dr. Eppley, With my surgery approaching, I wanted to reach out with a couple of very specific questions. On the phone we discussed that I would still be about to practice martial arts (specifically Brazilian jiu jitsu) following rib removal surgery. You explained that the ribs removed really aren’t shielding anything and so it’s totally safe to resume all activities after healing. Now that I’ve decided to have the operation, I just wanted to confirm this and explain a little more about the sport. It’s basically wrestling with submissions, and it can get pretty rough. Along with striking, its the main martial art used in the UFC and training often involves people far heavier than me putting maximum pressure on my abdomen, crashing into me, taking me down hard, etc. While there is no striking, human beings lifting each other and hurling their bodies through the air can create a lot of impact and the sport can get a little extreme. At my gym, we try to be as safe as possible in training but not everyone has a high level of body awareness and this can lead to injuries. I also wanted to share that prior to scheduling my surgery. I talked to another surgeon about rib removal and he seemed nervous/hesitant when I asked if I’d be able to train Brazilian Jiu Jitsu afterwards. He explained that he trains the sport himself and said he was nervous I’d get hit in the kidneys. I forgot to share this with you at the time of our consult so I am trying to understand why he might have that hesitation–whether it’s overly cautious or warranted due to his knowledge of the sport. Martial arts is my passion, and I wouldn’t want to lose the thing I love to do most. At the same time, if it’s safe, then I absolutely want to do it—but since the operation is not reversible, I am feeling the need to clarify and explain in depth. 

Secondly, I wanted to ask about child birth. Is it possible to have a child after this operation? I don’t even know if I plan to have kids, but I read that the model Sophia Vegas suffered complications after having the child and having the rib surgery. From what I read, it sounds like her organs shifted and she required an operation. I was wondering if you heard about this story and if you think it is a risk factor as long as the operation is done correctly. 

Sorry for the long winded email. Because there isn’t a lot of information online about this surgery, it’s hard to look things up and do the level of research I normally would. The martial arts question is my main one, and I basically just want to make sure I’m emphasizing how rough it is, so you can advise whether that activity would still be absolutely safe post op–of course once I am healed. 

Thank you so much for your time.

A: In rib removal surgery the portions of the ribs that are removed do not affect the medial portion of #12 which is what is covering/protecting the kidney. So in theory this should not be an issue from an anatomic perspective. That being said I have never performed this surgery in someone who is exposed to this degree of physical activity or trauma. And since this physical activity is your passion, and rib removal surgery is purely elective, the absolute safest choice is to not do the surgery. If, however, one wants to take a ‘riskier’ or unknown outcome choice, do the surgery and leave #12 rib alone which has the least impact on the outcome due to being the shortest of all ribs.

As for child delivery after rib removal, I have never heard the story to which you refer nor do I believe it. Subtotal rib removal of the lower ribcage would have no bearing on pregnancy or delivering a child either vaginally or by C-section.

Dr. Barry Eppley

Indianapolis, Indiana