Intercostal muscle strains don’t usually occur during normal activity. Instead, they are caused by weakened muscles, overexertion, direct trauma such as a fall or car accident, or a blow such as a touch sport like hockey, or repetitive torso twists.
Learn the symptoms and how to manage this common issue by reading on.
What is an Intercostal Strain?
Your intercostal muscle is the muscle between your ribs. It runs between the inner and outer surfaces of the rib cage and is responsible for expanding and contracting your chest. The intercostal muscles have three layers: internal intercostals, innermost intercostals, and external intercostals.
A strain occurs when the muscle is torn or overstretched. It causes severe pain, stiffness, and swelling in the affected area.
Muscle strains often cause chest pain. Intercostal muscles account for between 21 and 49 percent of all musculoskeletal chest pain.
Different Activities and Intercostal Muscles
Different activities can cause you to pull or strain your intercostal muscles. They include:
- A direct blow to the rib cage
- Falling
- Coughing or sneezing
- Straining other muscles in the torso, such as those in the abdomen or back
- Sudden twisting of the torso
- Sustained bending from waist level
- lifting while twisting
- reaching like when you are reaching for overhead items
- heavy lifting boxes, bags, or purses
Grades of Intercostal Muscle Strain
Its grade determines the severity of muscle strain.
- Grad 1: Minimal loss of motion caused by a strain with less than 5 percent damaged muscle fibers. It takes two to three weeks for these injuries to heal.
- Grade 2: The muscle fibers are severely damaged, but it hasn’t ruptured completely. Having significant muscle loss and needing 2-3 months to heal will significantly cause loss of mobility.
- Grade 3: The muscle and tendon are entirely torn. In some cases, surgery is required.
What are the Symptoms of Intercostal Muscle Strain?
The symptoms of an intercostal muscle strain are:
- Tightness of the muscle: Whenever you reach, twist or breathe, the injured muscle may feel tight.
- Tenderness: The spot of the strain connecting your ribs will feel sore when it is touched.
- Pain: Pain usually occurs with movement and deep breathing. It gets worse during physical activity and increases in intensity within three to five days after you strain the muscle.
- Swelling: An inflamed muscle will become swollen and painful.
- Breathing: A muscle strain can make it difficult to breathe. You may feel short of breath and have difficulty taking a deep breath. You may also feel less air moving in and out of your lungs than usual.
How is it Diagnosed
If you feel you have hurt your intercostal muscle (or even feel any pain), you should go to the hospital. To be sure that your intercostal muscle is injured, the attending physician will use some tests.
Your doctor will first conduct a physical exam and ask you different questions. They will ask if you can remember twisting or falling when you first noticed the pain. The physician will like to know if you play any contact sport or sport at all. They will watch out for your response when they touch the tender area.
Depending on the outcome of the physical exam, your doctor may order a chest x-ray to ensure you have not damaged any other internal organs when you strain the muscle.
How Can You Manage it?
When you feel like you have strained your intercostal muscle, you will likely have to schedule an appointment with your doctor. But before you visit your doctor, how do you manage?
Over-the-counter painkillers
Anti-inflammatories like naproxen (Aleve) or ibuprofen (Advil), or plain pain relievers can help you manage the pain. However, you must ensure you are not overmedicating by consulting your doctor first.
Stretching Exercises
You can do these exercises at home. Your doctor will also prescribe an exercise program to help you work out the muscles in your chest.
Warm Compress
A warm wet compress can soothe the pain and reduce inflammation. It may also help get rid of the swelling.
Cardiovascular Exercise
Do cardiovascular exercises to restore blood flow, build muscle, and keep the muscles strong and supple.
Ice Packs
Ice can help reduce swelling, increase blood flow, and relieve pain.
Final Thoughts
It can take as long as 10 weeks for intercostal muscle strains to heal, which can be frustrating. The area may be injected with lidocaine and corticosteroids if you have a painful or swollen strain.
A rib stress fracture is sometimes associated with intercostal muscle strains. In any case, once you’ve been diagnosed with stress fractures, your treatment is unlikely to change. When you follow your therapy regimen, do your breathing exercises, you’ll feel like yourself again and be able to play again in no time.
It’s essential to warm up before beginning sports or physical activities and not overdo the exercises your body isn’t used to.