Dominic Stone
Intercostal muscle strain refers to an injury to the muscles between the ribs, which help stabilise the upper body and assist with breathing. Straining these muscles can cause pain when breathing, and the pain may worsen during deep breathing, coughing, or sneezing. The pain may be sudden and sharp, or it may develop gradually due to repetitive motions or twisting. Treatment for intercostal muscle strain typically involves rest, ice, heat, pain medication, and breathing exercises, and most cases will heal within a few days to weeks.
| Characteristics | Values |
|---|---|
| Type of pain | Sharp, sudden, severe |
| Worsened by | Movement, deep breathing, coughing, sneezing |
| Cause | Overstretching, twisting, impact force, trauma, overexertion, repetitive motion |
| Treatment | Rest, ice, heat, elevation, compression, breathing exercises, pain medication, physical therapy |
| Healing time | Mild: a few days, Moderate: 3-7 weeks, Severe: 6-8 weeks |
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What You'll Learn
Intercostal muscle strain symptoms
Intercostal muscle strain refers to an injury affecting the muscles between two or more ribs. The intercostal muscles help stabilise your upper body and help you breathe. There are three layers of intercostal muscles: the external intercostals, the internal intercostals, and the innermost intercostals.
- Pain: Intercostal muscle strain can cause sharp, direct pain that worsens when an individual breathes, moves, coughs, or sneezes.
- Swelling: A partially torn or strained muscle will become inflamed. You may see some swelling between and around the affected ribs.
- Muscle tightness: The injured muscles may feel tight when you breathe, reach, or twist.
- Bruising: Swelling and bruising may occur when the strain is severe.
- Muscle twitching or spasms: You may experience muscle twitching or spasms.
Intercostal muscle strain is almost always the result of some event, such as overexertion or injury. Trauma to the chest, sudden twisting movements, reaching overhead, or repetitive forceful movements can cause muscle strain. Poor posture can also lead to muscle strain when standing or sitting for an extended period.
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Treatment for muscle strain pain
Muscle strains are common but painful injuries. Most muscle strains can be treated at home, but severe tears might need medical care or even surgery. The treatment depends on the grade of the strain. A mild strain (grade 1) might only break tiny fibres within the muscle, while a severe strain (grade 3) can tear through it.
Mild strains usually heal within a few days to a few weeks. Moderate strains (grade 2) may take three to seven weeks to heal, and severe strains that involve a complete tear of the muscles can take longer, from several weeks to months to heal.
If you have a mild to moderate muscle strain, the best first line of treatment is RICE (rest, ice, compression, and elevation).
- Rest: Stop any activity, especially those that cause you to pull your chest muscle.
- Ice: Apply ice packs or cold packs to the injured area to help reduce pain and swelling.
- Compression: If necessary, wrap an elastic bandage to help reduce swelling. Make sure the bandage is not too tight, as this can cause additional pain.
- Elevation: Keep your chest elevated, especially at night. You can use pillows or a wedge to help.
You can also take over-the-counter pain relievers such as ibuprofen or acetaminophen to help with inflammation and pain. As your pain lessens, you may slowly return to your previous level of physical activity.
If your strain is severe or does not improve with rest, your provider may recommend physical therapy or a change in your exercise routine to build strength in the surrounding areas. Your doctor may also inject the area with lidocaine and corticosteroids to reduce pain and swelling.
If you are experiencing symptoms of a heart attack, such as pain radiating down your left arm, nausea or vomiting, shortness of breath, dizziness, fainting, sweating, fatigue, or an irregular heartbeat, call emergency services.
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Potential causes of muscle strain
Muscle strains are common but painful injuries. They occur when the muscle fibres are stretched beyond their limit and tear apart. This can happen in several ways, including:
Acute injuries
Acute muscle strains are sudden injuries that cause immediate symptoms. They are often sports injuries caused by sprinting, twisting, or jumping. They can also be caused by a sudden, forceful movement or a twisting motion. For example, twisting while lifting weights or pulling an arm back quickly or holding it overhead for a prolonged period.
Chronic injuries
Chronic muscle strains develop gradually, and so do their symptoms. They are caused by overusing the muscle without allowing it to rest and repair. This can happen through repetitive strain injuries, where the same movement is repeated over and over, or by overtraining, where muscles are trained or laboured too hard or too long without rest.
Other causes
Undertraining can also cause muscle strains, as low flexibility and strength can lead to strains with ordinary use. Not stretching or warming up before exercise can also cause strains, as the muscles are overstressed before they are ready.
In addition, intercostal muscle strains, which affect the muscles between the ribs, can be caused by a direct blow to the ribs.
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Breathing exercises for muscle strain
Intercostal muscle strain refers to an injury affecting the muscles between two or more ribs. It may cause sharp, direct pain, stiffness, and mobility difficulties. This type of injury often results from overexertion or injury during exercise, such as twisting while lifting weights, prolonged overhead reaching, or a direct blow to the ribs.
Deep breathing exercises can help improve shallow breathing. Long-term shallow breathing can lead to complications such as pneumonia. Diaphragmatic breathing is a technique to help strengthen your diaphragm and fill your lungs with air more efficiently. It offers several benefits, including helping you relax, improving muscle function during exercises and preventing strain, increasing the amount of oxygen in your blood, making it easier for your body to release gas waste from your lungs, and reducing blood pressure and heart rate.
- Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs.
- Tighten your stomach muscles, so that your stomach moves back in, as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.
- Practice this exercise for five to ten minutes about three to four times per day. Gradually increase the amount of time you spend doing this exercise, and perhaps even increase the effort of the exercise by placing a book on your abdomen.
- Shoulder rolls: In a circular motion, bring your shoulders forward, up, backward, and down. Repeat 5 times. Try to make the circles as big as you can and move both of your shoulders at the same time. If you have some tightness across your chest, start with smaller circles and make them bigger as your muscles get looser.
- Overhead chest stretch: Sit in a supportive chair or lean back in bed. Gently squeeze your shoulder blades back and down. Hold your hands together and slowly raise your hands as high over your head as comfortable while taking a deep breath in. Slowly lower your hands back down while breathing out. Relax for one to two seconds, then repeat 5 times.
- Deep breathing 4-8-8: Sit in a supportive chair or lean back in bed. Breathe in through your nose for 4 seconds. Hold your breath for 8 seconds, if you can. Breathe out through pursed lips for 8 seconds. Relax for one to two seconds, then repeat 3 times.
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When to seek medical attention
Muscle strains can be treated at home in most cases, but severe strains may require medical attention and even surgery.
- Difficulty breathing: If you are experiencing difficulty breathing, seek medical attention immediately. Shallow breathing can lead to complications such as pneumonia.
- Pain does not subside: If the pain does not improve after a few days or a week, you should see a doctor.
- Numbness: If the injured area becomes numb, seek medical attention.
- Bleeding: If there is bleeding from the injury, you should seek medical care.
- Inability to walk or move: If you cannot walk or move your arms or legs due to the injury, seek medical attention.
- Traumatic injury: If you have sustained a traumatic injury, such as a rib injury during an accident, seek emergency medical treatment.
- Other symptoms: If you are experiencing symptoms similar to a heart attack, such as pain radiating down your left arm, nausea, vomiting, dizziness, fainting, sweating, fatigue, or an irregular heartbeat, call for emergency medical help.
It is important to note that these guidelines are general, and you should always consult a medical professional if you have concerns or if your symptoms persist or worsen.
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Frequently asked questions
Intercostal muscles are the muscles between the ribs that help stabilise the upper body and assist with breathing. Straining these muscles can cause pain and difficulty breathing.
Strains can be caused by overstretching, twisting, or impact force. They are a common sports injury but can also occur in day-to-day life.
Mild strains can be treated at home with rest, ice, compression, elevation, and over-the-counter pain relievers. For more severe strains, a doctor may recommend physical therapy, muscle relaxants, or injectable medications.
A heart attack will usually cause other symptoms such as nausea, vomiting, dizziness, fainting, sweating, fatigue, and an irregular heart rate. If you are experiencing symptoms of a heart attack, call emergency services immediately.
