What Is an Intercostal Muscle Strain?

Medically Reviewed By Angela M. Bell, MD, FACP
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An intercostal muscle strain can happen when the muscles in your chest become overstretched. This can put pressure on your rib cage and cause pain when you breathe. Intercostal muscles sit between your ribs, helping you breathe during physical activity. Intercostal muscles can become damaged through incorrect posture and certain sports activities.

This article will discuss in more detail what an intercostal muscle sprain is and its symptoms. It will also explain the causes, diagnosis, treatment options, and ways to prevent future intercostal muscle strains. 

What is an intercostal muscle strain?

person lifting weights
David Prado/Stocksy United (person appearing is a model and used for illustrative purposes only)

The intercostal muscles consist of three layers. These include:

  • external intercostal muscles
  • internal intercostal muscles
  • innermost intercostal muscles

The intercostal muscles sit between the ribs, moving the ribs upward and outward when you breathe. 

The intercostal muscles can become strained if they become overstretched, which compresses your ribcage, 2017 research explains. This can happen if you twist your chest area more than it is capable of moving.

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What are the signs of an intercostal muscle strain?

You can look for certain signs of an intercostal muscle strain. These include:

  • Your chest or ribs may be tender and painful to touch.
  • You may have pain in your chest when you breathe, sneeze, or cough.
  • You may experience muscle spasms in your chest.

When should you contact a doctor?

If you are experiencing pain in your upper body and chest muscles or they feel tender to touch, you should contact your doctor for advice.

Your doctor can advise you on pain medication and home remedies. Ultimately, they can help you come up with a treatment plan that is right for you.

What are the causes of an intercostal muscle strain?

You may experience an intercostal muscle strain for several reasons, including:

  • having a sports injury, particularly from sports that require intense use of your upper body
  • having an injury from repetitive movements, such as painting a ceiling or chopping wood
  • overexertion

It is common for office workers and those who spend a lot of time sitting down and leaning forward to strain their intercostal muscles. This is because the position can lead to your upper body moving beyond its usual shape.

Sports that involve repetitive overstretching that can lead to intercostal muscle strain include:

  • baseball
  • basketball
  • weightlifting
  • rowing

This is because the activities need you to twist, pull, or place pressure on your chest area.

Visit our hub to learn more about sports medicine and injuries.

How do you treat an intercostal muscle strain?

Treatment of intercostal muscle strain can vary depending on how your injury happened and how severe the tear is. Treatment options can range from pain relief for a mild strain to surgery if you have a severe tear.

Physical therapy

To treat an intercostal muscle strain, you need to rest and stop doing the exercise or action that caused the strain to happen.

Your doctor may recommend stretching exercises to aid recovery. However, if stretching exercises caused the injury, your doctor may suggest muscle-strengthening exercises, according to the 2017 research mentioned earlier.

Home remedies

Other treatments that you can do at home may include:

  • resting to avoid putting further strain on the area
  • applying ice for 15 to 20 minutes at certain intervals, as directed by a doctor
  • using a heating pad after the first few days to relieve pain and speed up the healing process
  • speaking with your doctor about which medications you can take to relieve the pain

How do you diagnose an intercostal muscle strain?

Your doctor is likely to ask you questions about how you may have injured yourself if you think you have an intercostal muscle strain.

They will also ask you about your symptoms and how long you have had them. Your doctor may examine you and order an X-ray or an MRI scan to confirm a diagnosis. 

To diagnose how severe your intercostal muscle strain is, they may use a grading system:

  • Grade I — first-degree, or mild: This is a mild strain where some of your muscle fibers have become overstretched or torn.
  • Grade II — second-degree or moderate: This is a moderate strain or an injury to some of your fibers. You may also experience swelling and pain in your chest muscles.
  • Grade III — third-degree or severe: This is a severe tear of your chest muscles, causing swelling, pain, and discoloration.

How can you prevent an intercostal muscle strain?

You can prevent an intercostal muscle strain from occurring by:

  • strengthening the muscles around your chest area with exercises
  • slowly increasing the intensity of your exercise plan
  • warming up before you exercise
  • ensuring you use good posture daily when sitting and standing

Read more on how to improve your posture.

Summary

An intercostal muscle strain can happen when you overstretch, twist, pull, or place too much pressure on your chest. The strain can cause pain, tenderness, and swelling. It can also hurt to breathe.

If you have been experiencing muscle pain in your chest, contact your doctor so you can receive a proper diagnosis and a treatment plan.

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Medical Reviewer: Angela M. Bell, MD, FACP
Last Review Date: 2022 Oct 27
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Muscles of the trunk. (n.d.). https://training.seer.cancer.gov/anatomy/muscular/groups/trunk.html
  2. Varada, S. L., et al. (2021). Athletic injuries of the thoracic cage. https://pubs.rsna.org/doi/full/10.1148/rg.2021200105
  3. Yoo, W-G. (2017). Effect of a combined thoracic and backward lifting exercise on the thoracic kyphosis angle and intercostal muscle pain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574339/