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Intercostal muscles are those that lie between your ribs and support your breathing. When strained, they can cause chest pain and shallow breathing. To release intercostal muscles, you can try home treatments such as applying ice packs, taking pain medication, and performing gentle breathing exercises. More severe strains may require heat therapy, gentle physical therapy, or myofascial release techniques performed by a trained therapist.
| Characteristics | Values |
|---|---|
| Treatment | Ice packs, cold packs, heat therapy (warm bath, heating pads, adhesive heat wraps), pain medications, gentle physical therapy, breathing exercises, myofascial release therapy |
| Prevention | Warm-up and stretching before strenuous exercises |
| Symptoms | Worsening pain, muscle stiffness and tension, shallow breathing, muscle rigidity, pain when coughing, sneezing, or breathing in deeply |
| Causes | Overexertion, injury, chronic cough, external force applied to the ribs, herpes zoster |
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What You'll Learn
Myofascial release therapy
Intercostal muscles are located between the ribs and support respiration. When an intercostal muscle gets twisted, strained, or stretched too far, it can tear, causing intercostal muscle strain. This can lead to symptoms such as pain and stiffness in the muscles, causing upper back pain and difficulty in breathing.
During myofascial release therapy, trained healthcare providers use various techniques such as tissue stretching, muscle shearing, and compression to help relieve rib pain. One such technique is "surfing the ribs," where the therapist places their hands on the ribs and gently moves with the client's inhalation and exhalation, providing comfort and deepening relaxation.
It is important to note that myofascial release therapy is a specialized technique, and seeking a skilled therapist is crucial to prevent long-term scar tissue buildup, which can interfere with breathing and cause future pain.
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Home treatment options
Intercostal muscle strain can be a painful experience. Here are some home treatment options to alleviate discomfort and promote healing:
Rest and Avoid Strenuous Activity
It is recommended to avoid strenuous activity, especially any activity that caused or contributed to the muscle injury. An extended rest period of more than a few days is generally not advised, as underusing the muscles can lead to weakness and a higher risk of further injury. Most cases of intercostal muscle strain can heal within a few days to 8 weeks with proper initial treatment.
Pain and Anti-Inflammatory Medication
Over-the-counter medications like acetaminophen or ibuprofen can help reduce swelling and pain associated with intercostal muscle strain.
Deep Breathing Exercises
Deep breathing exercises can help improve shallow breathing and prevent long-term complications like pneumonia. It is recommended to sit or stand with your back straight, then take a full breath from the bottom of your lungs. Focus on breathing from your diaphragm by slowly expanding your abdominal muscles while inhaling and pushing the air out of your lungs using these same muscles. Repeat this breathing stretch 5 to 10 times.
Yoga and Stretching
Gentle physical therapy and stretching of the tender muscles can aid in recovery. The Gate Pose, a common yoga position, can help stretch the intercostals at the side of the torso. Start by kneeling on a comfortable pad and extending your right leg to the side, with your kneecap facing up and the sole of your foot on the ground. Extend both arms to the sides, then bend your upper body toward the right so that your right arm rests on your extended leg. Reach your left arm overhead to feel a stretch in the left ribs. Hold this stretch for 15 to 30 seconds, then repeat on the other side.
Heat and Cold Therapy
For the first 48 hours of pain, apply an ice pack or cold pack to the affected area to reduce inflammation and alleviate pain. After this initial period, switch to heat therapy to reduce muscle tension and increase circulation to the injured muscles, aiding the body's natural healing process. Common heat applications include adhesive heat wraps, heating pads, or warm baths.
Myofascial Release and Massage
Myofascial release is a type of manual therapy that treats pain and dysfunction in the muscles and fascia. It involves specialized stretching, muscle shearing, and/or compression techniques to release tension. This should be performed by a trained therapist to avoid further injury. Trigger points in the intercostal muscles can be treated through massage using your thumb or fingers with techniques like ischemic compression, precise massage strokes, or the pressure-motion technique.
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Breathing exercises
Intercostal muscles are the muscles present between the ribs of a rib cage and help in the lateral movement of the chest. A strain in this area can cause pain and difficulty breathing.
Deep breathing exercises can help tone the intercostal muscles. One such exercise is deep chest breathing, which requires two yoga blocks. Sit on the floor and place the blocks behind you – one in a flat position and the other in a medium position. Lay your shoulder blades on the flat block and your head on the other. Relax your arms out to each side with palms facing upwards. Stretch your legs out in front of you. Inhale deeply and allow your chest to completely rise. On the exhale, allow your stomach to fall first, then your diaphragm, then your lungs, and finally your chest. Repeat this exercise nine times with a regular breath in between each repetition.
Another exercise is Bellow's Breath, which is a detoxifying breathing exercise. To carry out this exercise, you need to be in a seated position. Inhale naturally through your nose. On the exhale, snap your stomach muscles in, forcing the exhalation. Repeat this breathing pattern for 30 seconds, gradually increasing the pace.
You can also try an intercostal stretching breath. Stand and stretch both of your arms over your head. Inhale deeply and on the exhale, stretch your arms to the right, stretching your intercostal muscles on the left side of your body. Inhale and come back to the centre; on the next exhale, stretch your arms to the left, feeling your right intercostal muscles being stretched.
In addition, diaphragmatic breathing can be used to treat intercostal muscle strain. This technique helps to use the diaphragm correctly while breathing. It also offers several benefits to the body, including reducing blood pressure and heart rate, improving muscle function during exercises, and preventing strain. To perform this exercise, 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. Breathe in slowly through your nose so that your stomach moves out against your hand. Tighten your stomach muscles, so that your stomach moves back in, as you exhale through pursed lips.
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Yoga positions
Yoga can be an effective way to release and strengthen intercostal muscles, which are a group of muscles that lie within the rib cage, connecting the ribs and facilitating the movement needed for breathing. Strains in these muscles can cause chest pain and affect breathing patterns.
Gate Pose (Parighasana)
Gate Pose is a common yoga position that stretches the intercostals at the side of the torso. To do this pose, kneel on a soft, solid surface with your knees hip-width apart. Extend your right leg straight to the side, with the kneecap facing up and the sole of the foot on the ground. Align your foot with your left knee and turn your hips slightly toward the extended leg. Extend both arms to the sides, parallel to the floor. Then, bend your upper body to the right, allowing your right arm to rest on your right thigh, knee, shin, or ankle, depending on your flexibility. Continue to reach your left arm overhead so that you feel a stretch in your left ribs. Hold this pose for 15 to 30 seconds, then repeat on the opposite side.
Cow Face Pose
The Cow Face Pose helps improve the flexibility of the rib cage. To do this pose, bend your right leg and place your right foot beside your left thigh. Keep your left leg straight. Wrap your left arm around your left knee and hold your left hand with your right hand. When exhaling, press the left side of your rib cage against your left knee. Turn your head and look over your right shoulder.
Marichy-Asana
Marichy-Asana is another yoga pose that can help improve the flexibility of the rib cage.
Seated Deep Breathing
Deep breathing exercises, also known as pranayama in yoga, can help tone the intercostal muscles. For this exercise, sit on the floor with your legs stretched out in front of you. Place two yoga blocks behind you—one in a flat position and the other in a medium position. Rest your shoulder blades on the flat block and your head on the other. Relax your arms by your sides with your palms facing upwards. Inhale deeply, allowing your chest to rise, and then exhale, letting your stomach, diaphragm, lungs, and chest fall in that order. Repeat this exercise nine times, taking a regular breath in between each repetition.
Standing Intercostal Stretch
Stand with your feet hip-width apart and stretch both arms overhead. Inhale deeply, and as you exhale, stretch your arms to the right, feeling the stretch in your left intercostal muscles. Inhale and bring your arms back to center, then exhale and stretch your arms to the left, feeling the stretch on your right side.
It is important to note that while yoga and stretching can be beneficial, caution should be exercised when dealing with an injury. It is always recommended to consult a healthcare professional for guidance.
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When to avoid stretching
Stretching is generally recommended for intercostal muscle strains, but there are a few instances when you should avoid it. Firstly, if you are experiencing severe symptoms such as sharp and burning pain, difficulty breathing, or severe muscle rigidity, avoid stretching and seek immediate medical attention. Mild intercostal strains may only require home treatment, such as rest, ice therapy, and pain medication, without the need for stretching.
Secondly, avoid stretching if it increases your pain or makes your symptoms worse. Intercostal muscle strains can vary in severity, and in some cases, stretching can exacerbate the injury. If you experience a worsening of symptoms such as pain, stiffness, or difficulty breathing during or after stretching, discontinue the exercise immediately and consult a healthcare professional.
Thirdly, refrain from stretching if you have not properly warmed up or if you are performing strenuous exercises without supervision. Intercostal muscle strains often occur due to overexertion or trauma, so it is crucial to warm up adequately before engaging in physical activities. Supervised stretching under the guidance of a physical therapist or healthcare provider is generally recommended for intercostal muscle strains.
Additionally, avoid stretching beyond your comfort level. Never push yourself beyond what feels comfortable, as it may worsen the injury. Listen to your body and only stretch within a pain-free range of motion. The recommended stretching time for intercostal muscles is between 15 and 30 seconds, and stretching beyond this duration is not advised, as it is unlikely to provide additional benefits.
Lastly, avoid stretching if you have certain medical conditions or complications. For example, if you have pneumonia or other lung disorders, the source of pain can be challenging to pinpoint, and stretching without proper diagnosis and guidance can be detrimental. Always consult a healthcare professional before starting any stretching routine to ensure it is safe and appropriate for your specific condition.
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Frequently asked questions
The intercostal muscles are the muscles that lie between your ribs and support your breathing. They are subdivided into internal and external muscles.
Intercostal muscle strain is almost always the result of overexertion or injury. A chronic cough, for example, can cause the intercostal muscles to be strained due to constant deep inhalations.
Symptoms of an intercostal muscle strain include:
- Worsening pain after repetitive movement (e.g. rowing, swimming)
- Stiffness and tension in muscles, causing upper back pain
- Pain when coughing, sneezing, or breathing in deeply
Home treatment options include:
- Applying an ice pack for the first 48 hours to reduce inflammation, followed by heat therapy (e.g. heating pads, warm bath) to reduce muscle tension and increase circulation
- Resting and limiting physical activity for a few days
- Taking pain medications to reduce swelling and pain (e.g. acetaminophen, ibuprofen)
Some exercises to help release intercostal muscles include:
- Forward stretch: Sit with one leg straight and the other bent, then lean forward and rotate your torso slightly, touching the floor with both palms if possible. Hold for 15-30 seconds, then repeat on the other side.
- Gate pose: A common yoga position that stretches the intercostals at the side of the torso. Kneel on a comfortable surface and extend your right leg to the side, then bend your upper body toward the right, resting your right arm on your leg. Reach your left arm overhead and hold the stretch for 15-30 seconds, then repeat on the left side.
