PULLED CHEST MUSCLE (MUSCULAR CHEST PAIN): FULL EXPLANATION AND CARE GUIDE

QUICK ANSWER

A pulled chest muscle—also called a chest wall muscle strain—occurs when the muscle fibers in the chest wall (most commonly the intercostal muscles between the ribs or the pectoral muscles at the front of the chest) become overstretched or torn. This can happen during lifting, twisting, sports, falls, or forceful coughing. Pain usually worsens with movement, deep breathing, or pressing on the affected area.
Because chest pain can also signal heart or lung emergencies, any new, unexplained, severe, or left-sided chest pain should be evaluated promptly. Mild muscular strains often improve with rest, careful movement, and supportive measures, while moderate or severe strains may require medical evaluation and a guided recovery plan.

OVERVIEW

A chest muscle strain is a common but often misunderstood source of chest pain. Many people experience sudden or gradual onset discomfort in the ribs, upper chest, or pectoral region and worry the symptoms may be heart-related. While muscular chest pain can mimic more serious conditions, its behavior is typically different: it tends to be localized, movement-dependent, reproducible by touch, and aggravated by deep breaths or coughing.

Understanding the structure of the chest wall and the typical patterns of muscular pain helps individuals recognize when symptoms are likely due to a benign strain and when they require urgent medical attention. This article combines consumer-friendly explanations with clinician-adjacent detail to match the range of real search intent seen in GSC queries, including left-sided chest muscle pain, pectoral discomfort, chest twitching, coughing-related chest pain, and pain triggered by exercise or specific movements.

CHEST WALL ANATOMY AND MUSCLE FUNCTION

To understand how a chest muscle strain occurs, it helps to know how the chest wall is structured and how its components interact during posture, breathing, and movement.

The chest wall includes:

• Intercostal muscles: thin layers of muscle between the ribs. They support breathing by helping expand and stabilize the rib cage.
• Pectoralis major: a large, powerful chest muscle responsible for pushing, lifting, pulling, and arm motion across the body.
• Pectoralis minor: a smaller muscle beneath the pectoralis major, contributing to rib stabilization and shoulder blade movement.
• Serratus anterior: a muscle along the rib cage helping with shoulder elevation and rib expansion.
• Supporting structures: cartilage, tendons, and connective tissue that keep the ribs and sternum stable during movement.

These muscles work constantly—every breath, every reach, every twist involves coordinated chest wall motion. When any of these muscles are strained, the pain can be sharp, movement-triggered, and surprisingly intense, especially during deep breathing, coughing, lifting the arm, or twisting the torso.

MECHANISMS OF CHEST MUSCLE STRAIN

Chest muscle strains happen when the muscle fibers experience sudden overload or repeated micro-stress without adequate recovery. Common mechanisms include:

• Sudden eccentric loading (e.g., lowering a weight during bench press or catching oneself during a fall).
• Rapid twisting or reaching movements (often seen in racket sports or throwing motions).
• Direct impact or collision affecting the ribs or chest.
• Forceful or repetitive coughing during respiratory infections or asthma flare-ups.
• Fatigue-related injury during physically demanding work or repetitive tasks.
• Incorrect exercise technique, poor warm-up, or improper equipment setup.

In milder strains, only a small number of fibers are overstretched. In more significant strains, a portion of the muscle may tear, leading to swelling, bruising, and noticeable functional limitation. Severe pectoralis injuries can sometimes involve partial or full tendon rupture, typically during heavy lifting.

HIGH-LEVEL SYMPTOM OVERVIEW

Chest muscle strains produce characteristic symptoms, although they can vary in severity and location depending on which muscle is affected.

Common early symptoms include:

• Localized tenderness in a specific area of the chest or rib cage
• Pain that increases with motion of the chest, arm, or upper back
• Pain that worsens with deep breathing, coughing, sneezing, or stretching
• Swelling or bruising after more significant strain
• Muscle tightness or spasms in the affected region
• Reduced range of motion, especially with overhead reaching or twisting
• Sharp or stabbing pain during certain movements, followed by an ongoing dull ache

These features form the foundation for more detailed symptom interpretation, which appears in Block 2—where WATCHDOG covers movement-specific pain, left-sided muscular chest pain, chest twitching/spasms, and pain that follows coughing or exercise.

SYMPTOMS IN DETAIL

Chest muscle strain symptoms vary depending on which muscle is injured, how many fibers are affected, and whether the injury was sudden or developed over time. Although symptoms can overlap with more serious causes of chest pain, muscular pain has several recognizable patterns.

Common signs include:

• Sharp, stabbing, or pulling pain during specific movements
• Pain localized to one spot on the chest or rib area
• Pain triggered or worsened by deep breathing, coughing, sneezing, or certain stretches
• Tenderness when pressing on the injured area
• Stiffness or tightness when lifting the arm or turning the torso
• Occasional swelling or bruising if a significant number of fibers were strained
• A dull ache at rest after a sharp pain episode
• Muscle spasms or twitching in the affected region

While these symptoms often indicate a chest wall strain, they must always be interpreted in context—especially if the discomfort is on the left side, appears suddenly, or is accompanied by systemic symptoms like sweating or shortness of breath.

SCENARIO-BASED SYMPTOM INTERPRETATION

The following non-diagnostic examples help illustrate how muscular chest pain often behaves. These examples do not replace medical evaluation but assist users in understanding typical patterns.

Pain during arm movement

If lifting your arm—especially across your body or overhead—causes a sharp pulling sensation in the upper chest or near the armpit, the pectoralis major or minor may be involved.

Pain when twisting the torso

If rotating your trunk (for example, reaching behind you in a car or twisting quickly during sports) triggers pain between the ribs or along the side of the chest, the intercostal muscles may be strained.

Pain that worsens with deep breaths

If a deep breath causes a sharp pinch or pull in one specific area, an intercostal strain or costochondral irritation is possible, because these structures stretch and compress during breathing.

Pain after lifting or pushing

If pain began during bench press, push-ups, heavy lifting, or moving furniture, the pectoral muscles may have been overloaded.

Pain after coughing

If pain developed following several days of forceful coughing or after one sudden, intense cough, the repeated contraction of the intercostal muscles may have produced a strain.

Pain that improves noticeably with position changes

Muscular chest pain often changes with posture (e.g., feels better when sitting upright or worse when leaning forward or twisting). Heart-related pain is less likely to change significantly with position.

If pain can be reproduced consistently by pressing on the same spot, or by repeating a specific motion, that strongly suggests a chest wall origin—though final confirmation always requires professional evaluation.

LEFT-SIDED CHEST MUSCLE PAIN

Left-sided chest pain generates the highest anxiety among patients and shows the highest search volume in GSC data. While many left-sided symptoms are muscular, the left side of the chest is also where heart-related discomfort can appear.

This section provides safe, clinically aligned distinctions without diagnosing.

Why left-sided muscular chest pain happens

Left-sided pectoral and intercostal muscles are commonly used during:

• Pushing or lifting with the dominant arm
• Rotational sports (tennis, golf, baseball)
• Weightlifting, especially barbell bench press or incline press
• Sudden twisting or reaching motions
• Coughing or forceful breathing

A strain of these muscles frequently produces:

• Localized tenderness on the left chest wall
• Pain that worsens with movement or arm use
• Pain triggered by pressing the area
• Sharp, intermittent pain on deep breaths
• Muscle spasms under or around the left pectoral area

Key features that often suggest a muscular cause

• Pain appears in one specific spot, not spread across the whole chest
• Pain is reproducible with movement or touch
• Pain worsens with twisting, reaching, or raising the left arm
• Pain worsens with deep breathing or coughing
• Pain improves somewhat with rest or changing position

Features that require urgent medical attention

These symptoms indicate that the evaluation should focus on potential heart or lung causes:

• Pressure, heaviness, squeezing, or fullness in the center or left chest
• Pain spreading to the arm, jaw, neck, back, or upper stomach
• Shortness of breath, difficulty breathing, or wheezing
• Nausea, vomiting, cold sweat, or sudden dizziness
• Symptoms triggered by exertion and not relieved by rest
• Feeling faint, lightheaded, or unusually weak

If any of these occur, emergency care is warranted.

CHEST TWITCHING AND SPASMS

Chest muscle spasms can be startling, especially when occurring on the left side or without obvious pain. Spasms are brief, involuntary contractions of chest wall muscles and can occur after strain, fatigue, irritation, or overuse.

Common causes of chest muscle spasms

• Local muscle fatigue after exercise or lifting
• Strain of intercostal or pectoral muscles
• Irritation from coughing or sudden twisting
• Dehydration or electrolyte imbalance (nonspecific finding)
• Poor posture that overworks certain chest wall muscles

How spasms typically feel

• Brief fluttering or twitching
• A small “jumping” sensation under the skin
• A tightening sensation lasting a few seconds
• Occasional sharp jolt followed by a dull ache

When spasms are muscular

Muscular spasms are more likely when:

• They are brief and located in a small, consistent area
• They occur after recent exercise, coughing, or awkward movement
• They accompany tenderness or soreness in the same area

When spasms require medical evaluation

• They occur alongside shortness of breath or chest tightness
• They happen with sweating, nausea, dizziness, or faintness
• They accompany worsening left-sided pressure
• They occur with fever or signs of systemic illness
• They continue despite rest and hydration

Spasms alone are often benign but should be monitored carefully when paired with other concerning symptoms.

CHEST PAIN AFTER COUGHING

Coughing is a powerful action. Each cough compresses and expands the rib cage rapidly, requiring forceful contraction of the intercostal muscles. When coughing becomes frequent or unusually intense, these muscles can become irritated or strained.

Typical patterns of cough-related chest muscle pain

• Sharp pain during coughing, sneezing, or laughing
• A pinching or pulling sensation in one area of the chest wall
• Post-cough soreness that worsens at night or early morning
• Pain when taking a deep breath after coughing
• Tenderness along the ribs where the intercostal muscles attach

Scenarios where coughing leads to muscle strain

• Viral infections with repetitive cough
• Asthma or bronchitis flare-ups
• One sudden, forceful cough that overstretches a muscle
• Chronic cough causing cumulative irritation

When cough-related chest pain needs clinical evaluation

• The pain is accompanied by fever, chills, or persistent shortness of breath
• Cough produces blood or foul-smelling mucus
• Breathing becomes increasingly difficult
• Pain appears on both sides or feels oppressive
• Symptoms worsen rather than improve over several days

A strained chest muscle from coughing is typically painful but localized and movement-related. Lung or airway problems often involve deeper breathing discomfort, systemic symptoms, or difficulty catching breath.

MOVEMENT-SPECIFIC PAIN PATTERNS

Movement patterns give important clues to the source of chest pain.

Pain when raising the arm

Often related to the pectoralis major or minor.
Pain may be sharp when the arm crosses the body or moves overhead.

Pain when twisting the torso

More suggestive of an intercostal strain or costochondral irritation.

Pain when bending or leaning

May involve a combination of intercostal tension and rib cartilage irritation.

Pain after gym exercises

Chest pain that appears during or immediately after bench press, dips, push-ups, or cable fly motions may point toward:

• Mild pectoral strain
• Tendon irritation
• Early-stage pectoralis minor overload
• Improper bench form leading to rib joint irritation

Pain with deep breathing

Often indicates strain of the intercostal muscles or inflammation of rib cartilage.

Pain with pressure on one spot

Strongly suggests a chest wall (muscular or costochondral) source.

CAUSES

Chest muscle strains develop when muscle fibers are pushed beyond their capacity during a sudden action or gradual overuse. The most common causes include:

Sports movements

Activities involving rapid pushing, rotation, or arm extension—such as tennis, baseball, golf, gymnastics, or rowing—may overload chest wall muscles.

Heavy lifting

Lifting or carrying awkward or heavy objects can shift strain to the chest wall, especially if posture or lifting technique is compromised.

Falls or direct impact

Accidental falls, collisions during sports, or blunt trauma to the chest may injure intercostal or pectoral fibers.

Overuse or fatigue

Muscles repeatedly stressed without adequate recovery become more susceptible to strain.

Insufficient warm-up

Beginning high-intensity exercise without preparing the muscles increases risk.

Repetitive or forceful coughing

A common but underestimated cause of intercostal strain, especially during respiratory illnesses.

Improper technique or malfunctioning equipment
Incorrect form during weightlifting or poorly adjusted exercise machinery may transfer unexpected force to the chest muscles.

RISK FACTORS

Chest muscle strains can affect anyone, but some factors increase susceptibility.

Sports participation

Repetitive upper-body motions or contact sports increase risk of acute or overuse strains.

Manual labor

Jobs requiring lifting, pushing, reaching, or twisting may strain chest muscles.

Poor conditioning or flexibility

Deconditioned muscles fatigue faster, and stiffness increases risk of micro-tears.

Persistent cough or respiratory illness

Chronic or forceful coughing repeatedly stresses the intercostal muscles.

Aging

With age, muscle mass and elasticity tend to decrease, making strains more likely during routine movements or minor exertion.

Improper lifting technique

Twisting while lifting, lifting beyond capacity, or using incorrect bench press form can overload chest wall structures.

EXERCISE-RELATED CHEST MUSCLE STRAINS

Strength training and fitness activities commonly appear in GSC search analysis related to chest pain, particularly bench press and push-up exercises.

Why bench press causes chest strain

During bench press, the pectoralis major handles significant load, particularly during lowering (eccentric phase). Excess weight, improper bar path, or flared elbows may cause sudden overload.

Common patterns of exercise-related strain

• Sharp pain in the upper or inner chest during the lift
• Pulling sensation near the armpit
• Pain after racking the weight
• Tenderness at the pectoral attachment points

Exercises that commonly contribute

• Bench press (flat or incline)
• Push-ups and dips
• Cable chest fly exercises
• Overhead lifts that stress the upper rib cage

When gym-related pain may indicate a more serious injury

• Sudden sharp tearing sensation
• Noticeable weakness pushing the arm forward
• Bruising in the upper chest or armpit
• Difficulty lifting the arm
  These symptoms warrant prompt evaluation to rule out significant pectoral injury.

CLASSIFICATION OF CHEST MUSCLE STRAINS

Chest muscle strains fall into two time-based categories and three severity grades.

Acute strains

Occur suddenly, typically during lifting, twisting, or impact.

Chronic strains

Develop slowly from repeated motion, poor posture, or inadequate recovery.

Severity grading

Grade 1 (mild)

• Minor fiber overstretching
• Mild pain
• Little or no strength loss
• Often manageable with rest

Grade 2 (moderate)

• Partial tear involving more fibers
• Noticeable pain, swelling, or bruising
• Reduced strength and range of motion
• May require medical evaluation

Grade 3 (severe)

• Complete rupture of a muscle or tendon
• Severe pain and dysfunction
• Bruising may be present
• Requires prompt clinical evaluation; may need surgical consultation depending on the muscle involved

DIAGNOSIS

Chest muscle strain diagnosis begins with a detailed medical history and physical examination.

A clinician may:

• Ask about recent activity, lifting, sports, coughing, or injury
• Locate tenderness or swelling by palpating the chest wall
• Evaluate breathing, posture, shoulder mobility, and rib movement
• Identify whether symptoms align more with muscular, cardiac, or pulmonary causes

Diagnostic tests

These are ordered only when necessary based on symptoms and risk factors.

Electrocardiogram (ECG) and blood tests

Used to assess for heart-related conditions.

Chest X-ray

Helpful for evaluating rib fractures or signs of lung disease.

Other imaging

Ultrasound, CT, or MRI may be used in complex cases or when another condition is suspected.

The primary goal is to distinguish benign muscular pain from serious cardiac or pulmonary causes.

RED FLAGS AND EMERGENCY GUIDANCE

Call emergency services immediately if:

• Chest pain feels like pressure, squeezing, heaviness, or fullness
• Pain spreads to the arm, jaw, neck, back, or upper stomach
• You experience shortness of breath or difficulty breathing
• You feel faint, dizzy, or unusually weak
• You develop sudden nausea or cold sweats
• Symptoms begin suddenly during physical activity and do not improve with rest

These signs may indicate a heart or lung emergency.

Seek prompt medical care (urgent but not emergent) if:

• Pain after injury is severe or worsening
• Pain restricts movement of the arm or deep breathing
• Symptoms persist more than a few days without improvement
• The area becomes warm, red, or swollen
• You felt a distinct “pop” during the injury
• Breathing becomes newly restricted

TREATMENT

Home care

Rest
Avoid movements that clearly worsen pain, including heavy lifting or strenuous upper-body activity.

Ice
Short cold applications during the early phase (typically the first day or two after an acute strain) may help reduce discomfort. Always place a cloth between ice and skin.

Gentle positioning
Resting slightly elevated may reduce discomfort during deep breathing or coughing.

Over-the-counter pain relief
Non-prescription medications such as NSAIDs or acetaminophen may help reduce pain when used according to label guidance. Anyone with underlying medical conditions should consult a clinician or pharmacist before use.

Compression
A clinician may recommend gentle support, but binding that restricts breathing should be avoided.

Medical treatment

Prescription medications
Short-term muscle relaxants or stronger pain relievers may be used when symptoms interfere with breathing or daily activity.

Treating an underlying cough
When coughing contributes to strain, managing the cough is important for healing.

Physical therapy
A physical therapist may guide exercises that restore strength, flexibility, posture, and breathing mechanics. Therapy may also address movement patterns that contributed to the injury.

Further evaluation
Imaging or specialist referral may be recommended if symptoms are severe, unclear, or unusually persistent.

Surgical consultation
Rarely required, but considered when a large pectoral tear or tendon rupture is suspected.

RECOVERY TIMELINE

Recovery varies depending on severity, age, baseline health, and whether re-injury is avoided.

Mild strains

Often improve significantly within a few weeks.

Moderate strains

May require several weeks to a few months for full recovery.

Severe strains

Can take many weeks or months; complete ruptures may require surgical evaluation and extended rehabilitation.

Returning to activity too soon can delay healing. A clinician or physical therapist can help determine when it is appropriate to resume exercise.

PREVENTION

Warming up

Gradually preparing the muscles before exercise reduces injury risk.

Strength and flexibility

Training chest, shoulder, and core muscles improves stability.

Technique

Using proper lifting form and avoiding twisting while lifting reduces strain.

Equipment

Ensure gym and sports equipment are properly adjusted and functioning.

Rest

Incorporate rest days and avoid pushing through notable fatigue.

Managing cough

Work with a clinician to treat persistent or forceful coughing.

FREQUENTLY ASKED QUESTIONS

APA REFERENCE LIST

American Heart Association. (2024). Warning signs of a heart attack. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack

Cleveland Clinic. (2019). Muscle strains: Causes, symptoms, treatment & recovery. https://my.clevelandclinic.org/health/diseases/22336-muscle-strains

Cleveland Clinic. (2020, May 7). How to cope with an intercostal muscle strain. https://health.clevelandclinic.org/how-to-cope-with-an-intercostal-muscle-strain

Cleveland Clinic. (2023). Sarcopenia (muscle loss): Symptoms & causes. https://my.clevelandclinic.org/health/diseases/23167-sarcopenia

Cleveland Clinic. (2024, January 24). RICE method: Rest, ice, compression & elevation. https://my.clevelandclinic.org/health/treatments/rice-method

Cleveland Clinic. (2024, June 11). Musculoskeletal chest pain: Definition, causes & treatment. https://my.clevelandclinic.org/health/symptoms/musculoskeletal-chest-pain

GoodRx. (2024, June 26). Intercostal muscle strain: Causes, symptoms, and treatment. https://www.goodrx.com/conditions/musculoskeletal/intercostal-muscle-strain

Guo, L. (2025). Intercostal muscle strain: What is it, causes, signs, treatments. Osmosis. https://www.osmosis.org/answers/intercostal-muscle-strain

Harvard Health Publishing. (2023). Muscle strain. Harvard Medical School. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Mayo Clinic. (2023). Heart attack: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106

Mayo Clinic. (2023, December 13). Pleurisy: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/pleurisy/symptoms-causes/syc-20351863

Mayo Clinic. (2023). Pulmonary embolism: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/pulmonary-embolism/symptoms-causes/syc-20354647

Medical News Today. (2025, April 17). Intercostal muscle strain: Signs, treatments, and remedies. https://www.medicalnewstoday.com/articles/320925

Medical News Today. (2018). Pulled muscle in chest: Causes, symptoms, and recovery. https://www.medicalnewstoday.com/articles/324534

Medical News Today. (2017). Rest, ice, compression, and elevation (RICE). https://www.medicalnewstoday.com/articles/321469

National Health Service. (2017). Sprains and strains. https://www.nhs.uk/conditions/sprains-and-strains/

National Library of Medicine. (2024). Acute pulmonary embolism. In StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK560551/

National Library of Medicine. (2023). Pleurisy. In StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK558958/

Physio-Pedia. (n.d.). Intercostal muscle strain. https://www.physio-pedia.com/Intercostal_Muscle_Strain

Rib Injury Clinic. (n.d.). Costochondritis & chest wall pain. https://www.ribinjuryclinic.com/conditions/costochondritis-other-inflammatory-problems/

SingleCare. (2024, January 10). What causes rib pain from coughing? https://www.singlecare.com/conditions/rib-pain-from-coughing-causes

WebMD. (2024). RICE method for injuries. https://www.webmd.com/first-aid/rice-method-injuries