Exploring The Muscles Attached To Our Ribs

what muscle side of ribs

The muscles on the side of the ribs are called intercostal muscles. They are part of the rib cage and link each rib to its neighbours. They have three layers: external, internal, and innermost intercostals. The external intercostals are the outermost layer and expand the chest wall during inhalation. The internal intercostals are the intermediate layer and help to collapse the lungs during exhalation. The innermost intercostals cross more than one intercostal space and assist the internal and external intercostals in their functions. Intercostal muscle strain is a common injury that occurs when these muscles are stretched, pulled, or torn.

Characteristics Values
Name Intercostal muscles
Location Between the ribs
Function Linking ribs together, changing the size of the ribcage, and assisting in breathing
Layers External, internal, and innermost
Types External intercostal muscles, internal intercostal muscles, and innermost intercostal muscles
Symptoms of Strain Pain, tenderness, difficulty breathing, swelling, muscle tightness, muscle tension and stiffness
Treatment of Strain Rest, ice therapy, heat therapy, breathing therapy, physical therapy, elevation of the upper body
Recovery Time Mild strain: a few days, Moderate strain: 3-7 weeks, Severe strain: several weeks to months
Other Related Muscles Serratus posterior superior, serratus posterior inferior, quadratus lumborum

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Intercostal muscles

The intercostal muscles are a group of intrinsic rib cage muscles that occupy the 11 intercostal spaces between the ribs. They are divided into three groups, from superficial to deep: external intercostal muscles, internal intercostal muscles, and innermost intercostal muscles. All three groups of muscles support the rib cage and participate in the process of forced breathing.

The external intercostal muscles, or intercostalis externus, aid in quiet and forced inhalation. They originate on ribs 1–11 and have their insertion on ribs 2–12. The external intercostals are responsible for elevating the ribs and bending them more open, thus expanding the transverse dimensions of the thoracic cavity. The muscle fibres are directed downwards, forwards, and medially in the anterior part. The blood supply to the external intercostals comes from the anterior and posterior intercostal arteries.

The internal intercostal muscles, or intercostalis internus, aid in forced expiration. They originate on ribs 2–12 and have their insertions on ribs 1–11. Their fibres pass anterior and superior from the upper margin of the rib and costal cartilage. The internal intercostals are responsible for the depression of the ribs and bending them inward, thus decreasing the transverse dimensions of the thoracic cavity. The muscle fibres are directed downwards, forwards, and laterally, forming a right angle with the external intercostal muscle.

The innermost intercostal muscles, or intercostalis intimus, are deep layers of the internal intercostal muscles, separated from them by a neurovascular bundle. They originate from the costal groove of one rib, posteriorly to the origin of the internal intercostals, and course in the same fashion, inserting to the superior border of the immediate rib below. The innermost intercostal muscles support the internal intercostals during exhalation. The vascularization and innervation of the innermost intercostals follow the same pattern as the internal intercostals, with blood supplied by the anterior and posterior intercostal arteries.

Intercostal muscle strains occur when the muscles between the ribs become overstretched or torn due to overexertion, injury, or twisting the torso. Symptoms include sudden severe pain, muscle tension and stiffness, and gradual worsening pain. Treatment includes rest, ice therapy, and gentle stretching exercises.

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Serratus posterior muscles

The serratus posterior muscle is an intermediate layer of back muscles, consisting of the serratus posterior superior and serratus posterior inferior. The serratus posterior superior originates from the C7-T3 vertebrae spinous process and nuchal ligament, inserting at the upper border of the 2nd-5th ribs. The serratus posterior inferior originates from the T11-L2 vertebrae spinous process, inserting at the lower border of the 9th-12th ribs.

The serratus posterior superior is a thin, rectangular muscle located in the upper back, lying deep to the rhomboid and trapezius muscles. It receives its nerve supply from the intercostal nerves T2-T5 and its blood supply from the posterior intercostal arteries. The serratus posterior inferior, on the other hand, is innervated by the anterior rami of the T9-T11 spinal nerves and the subcostal nerves (T12), with additional vascular supply from the subcostal and upper lumbar arteries.

The main function of the serratus posterior muscles is to facilitate respiration. The serratus posterior superior elevates the ribs during inspiration, while the serratus posterior inferior depresses the ribs during expiration. However, the role of these muscles in respiration is still debated due to a lack of conclusive evidence. Nonetheless, they are believed to contribute to myofascial pain, particularly in the shoulder and back.

The serratus posterior muscles can be targeted for self-massage using a massage ball or trigger fairy. To expose the serratus posterior superior, one can manoeuvre the shoulder blade by crossing the arm to the opposite side and using the contralateral hand to hold the trigger fairy. Once a trigger point is found, slow and precise movements can be applied to alleviate muscle tension.

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Quadratus lumborum

The quadratus lumborum (QL) is a muscle in the posterior inferior trunk lateral to the spine. It is the deepest muscle of the posterior abdominal wall, and it is often mistakenly referred to as one of the muscles of the back. The muscle is generally located medial to the aponeurosis of the transverse abdominal muscle. Its shape is irregular but is generally quadriangular, which is why it is described as 'quadratus' in Latin.

The quadratus lumborum originates from the iliolumbar ligament and the iliac crest. It runs craniomedially, attaching to the inferior border of the 12th rib and the transverse processes of the 1st to 4th lumbar vertebrae. The muscle is innervated by the subcostal nerve (T12) and anterior rami of spinal nerves L1-L4. The blood supply to the quadratus lumborum comes from the branches of lumbar, subcostal, median sacral, and iliolumbar arteries.

Anatomy texts describe the quadratus lumborum as a lumbar spine extensor, stabilizer, and lateral tiltor, and an accessory muscle for inspiration. The muscle works with the multifidus and erector spinae to antagonize the abdominal muscles. The forces exerted by the erector spinae and multifidus in the lumbar vertebrae are about 1800 N and 2800 N, respectively, while the quadratus lumborum exercises only 200 N. Thus, the muscle does not appear to be a significant lumbar stabilizer. As an accessory inspiratory muscle, the quadratus lumborum cannot transmit contractile forces to the diaphragm due to the mobility of the last rib.

Overuse and strain of the quadratus lumborum are one of the major causes of chronic pain in the lower back. One typical cause is the habit of sitting at a desk using a reclined seat, which releases the intrinsic back muscles and weakens them in the long term. The weak back muscles must now be compensated by the quadratus lumborum, leading to painful tension and stiffening of the muscle.

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Strains and tears

Intercostal muscles are the muscles that link your ribs together and contribute to your breathing. They lie between your ribs, attaching them to one another, and help stabilize your upper body. There are three layers of intercostal muscles: the external intercostals, the internal intercostals, and the innermost intercostals.

Intercostal muscle strain is a painful condition that occurs when the muscles between your ribs become overstretched or torn. This can occur from vigorous physical activity, such as sports and weightlifting, or simply twisting or straining your torso abruptly. A sudden increase in physical activity can also lead to an intercostal muscle strain, especially when a lack of exercise or poor posture may have led to weaker muscles.

The signs and symptoms of intercostal muscle strain may include:

  • Pain in the chest or rib area, which can be sharp or dull and worsen when you breathe, move, cough, or sneeze.
  • Shortness of breath.
  • Limited range of motion of the upper torso.
  • Muscle spasms of the intercostal muscles.
  • Swelling and bruising.
  • Tenderness in the area where the muscle is strained.

If you think you have an intercostal muscle strain, you should make an appointment with your doctor. They can identify which muscle has been strained and ensure that you haven't injured some other structure in your chest. Your doctor will give you a complete treatment plan, but in the meantime, you should avoid twisting and reaching activities that make the pain worse. You can also take over-the-counter anti-inflammatories like ibuprofen (Advil) or naproxen (Aleve), or simple pain relievers like acetaminophen (Tylenol).

In terms of home treatment, applying an ice pack wrapped in a thin cloth to the affected area can help reduce inflammation and alleviate pain. Use ice for 15-20 minutes at a time, several times a day, especially during the first 48 hours after the injury. After 48 hours, you may want to start using heat to help loosen and relax the muscles. You can apply heat for 20 minutes at a time with a heating pad or a warm damp towel.

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Breathing exercises

The intercostal muscles are the muscles that link your ribs together and assist in breathing. When these muscles are strained, it can cause a sharp pain in your side that can be treated with deep breathing exercises.

Diaphragmatic Breathing

This breathing technique helps you use your diaphragm correctly while breathing. It involves placing one hand on your upper chest and the other just below your rib cage. Breathe in slowly through your nose so that your stomach moves out against your hand. Keep your hand on your chest as still as possible. As you exhale through pursed lips, tighten your stomach muscles so that your stomach moves back in.

Belly or Abdominal Breathing

This technique involves inhaling through your nose and breathing out through your mouth. Sit or lie down on a comfortable, flat surface. Relax your shoulders, shifting them downward away from your ears. Put a hand on your chest and a hand on your stomach. Without straining or pushing, breathe in through your nose until you can't take in any more air. Feel the air moving through your nostrils into your abdomen, expanding your stomach and sides of your waist. Your chest remains relatively still. Purse your lips as if sipping through a straw and exhale slowly through your lips.

Numbered Breathing

Sit or stand upright and close or relax your eyes. Without straining or pushing, breathe in through your nose until you can't take in any more air. Exhale until all the air has been emptied from your lungs. Keeping your eyes closed, fully inhale again and hold the air in your lungs for a few seconds, then let it all out. Count that as breath one. Inhale fully again, hold for a few seconds, then exhale.

Imagery Exercises

These exercises involve visualizing your rib cage in different ways as you breathe. For example, you can imagine your inhalation expanding the muscles between your ribs, the intercostals, and then releasing them as you exhale. Another example is visualizing your rib cage as an umbrella that opens and widens all around as you inhale, and closes as you exhale.

Frequently asked questions

Intercostal muscles are the muscles that link your ribs together and support your rib cage during breathing and movement. They have three layers: external, internal, and innermost intercostals.

Intercostal muscle strain occurs when the muscles between the ribs are overstretched, twisted, or torn. This can be caused by a sudden increase in physical activity, twisting the torso, or trauma to the rib cage.

Symptoms include sudden or gradual worsening pain, muscle tension and stiffness, difficulty breathing, tenderness in the affected area, and inflammation. Pain may increase with coughing, sneezing, or deep breathing.

Treatment for intercostal muscle strain includes rest, ice therapy, heat therapy, and breathing exercises. Stretching exercises should be done under the supervision of a healthcare professional. In severe cases, surgery may be required.

The healing time for intercostal muscle strain depends on the severity of the injury. Mild strains may heal within a few days, while moderate strains can take up to 7 weeks. More severe strains involving a complete tear of the muscle can take even longer.

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