Twisting of the torso is necessary to generate force in many sporting events such as baseball, tennis, and cricket. Unfortunately, the muscles in between the ribs are vulnerable to strain from these forceful movements. An intercostal muscle strain is a common occurrence to witness in sports.

Each year, strains in the muscles of the ribs take many players out of the game for days to months. But what is an intercostal muscle strain exactly?

What Is an Intercostal Muscle Strain?

Muscle strains occur when overexertion extends muscle fibers beyond their limits. If one tears the intercostal muscles of the chest, an intercostal muscle strain occurs. Other common names for intercostal muscle strains are rib cage strain and side strain.

Intercostal muscle strain causes a microtrauma and a subsequent inflammatory response. A sign of an intercostal muscle strain is intense pain that is made worse by breathing or coughing.

The medical community divides the severity of the strain into three categories.

Grade I strains

A Grade I strain tears a few muscle fibers. However, the fiber maintains its original strength. Also, the rib cage area is tender to the touch and sore.

This injury is a minor strain. It will typically heal in a matter of days.

Grade II strains

A Grade II strain involves more injured muscle fibers. This class of injury is a moderate strain. Consequently, these strains cause more severe muscle pain.

There is also a tenderness to the touch. And the injured person finds noticeable swelling. Lastly, a perceptible decrease in muscle strength occurs.

Grade III strains

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Grade III strains are severe. That means the muscle is torn throughout. This level of strain can cause a pop sensation as the muscle completely rips into two pieces. Unfortunately, a Grade III strain causes the muscle to lose function completely.

As you can imagine, they also come with intense pain, swelling, and bruising.

What Are the Intercostal Muscles?

The intercostal muscles are several groups of muscles woven between the ribs. They are woven in between ribs 2 through 12 on each side. The muscles collectively help to form the chest wall and also connect the ribs.

The primary function of the intercostal muscles is to move the chest during breathing. These muscles expand and shrink the rib cage to allow the flow of breath.

There are three layers of intercostal muscles: external, inner, and innermost. The external intercostal muscles assist with forced inhalation and quiet breathing. They perform this function by bending the ribs outwards.

The internal intercostal muscles, on the other hand, help in forced exhalation by bending the ribs inward.

Collectively, the intercostal muscles are engaged to stabilize the torso during twisting movements. Overextension of the muscles during twisting movements is one of the causes of intercostal muscle strains.

How Does an Intercostal Muscle Strain Happen?

Intercostal muscle strain is more likely to occur during excessive muscular activity. For example, returning to a strenuous exercise routine after a long period of rest may result in a strain.

Notably, intercostal muscle strains commonly occur in baseball, tennis, golf, rowing, and other sports that require repetitive, forceful movements. Here are some of the culprits:

  • A direct impact to the rib cage from, for example, a car accident
  • A blow from a contact sport such as boxing or football
  • Forcefully twisting the torso farther than its normal range — this may occur in golf or baseball
  • Twisting too far when lifting weights
  • Forceful movements for a prolonged period like swinging your arm in tennis
  • Raising a heavy object above the shoulders

Symptoms of an Intercostal Muscle Strain

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The combination of symptoms is unique to each injury. Usually, pain is the first symptom. Additionally, the pain is commonly exacerbated by breathing, coughing, or twisting the body.

The location of the pain is in the rib cage area. Here's what to look for:

  • Sharp rib and upper back pain
  • Intercostal muscle spasms
  • Soreness in the areas between the rib bones
  • Pain from breathing or coughing
  • Gradual worsening pain after physical exercise or repetitive movements
  • Stiffness and tightness in muscles that brings about upper back pain
  • Muscle rigidity when twisting the upper body

How Do You Treat Intercostal Muscle Strain?

Before we get started on treatment, please note that this content is informative. It is not intended to be a substitute for a diagnosis or medical advice from a professional doctor. Seek the expert advice of a physician if you have questions about your health.

So, how could you treat this particular muscle strain?

Any chest pain or difficulty breathing warrants a visit with a health-care professional. If the pain becomes intolerable or you experience numbness and tingling, you need to see a doctor.

What you can do to cope

If the strain is mild, then home treatment may be enough. The injury will likely recover after a couple of days of rest. Without rest, the problem will only get worse. If you try to keep up your regular exercise routine, you will likely regret it.

It is especially crucial to avoid the sporting activity that gave you the injury in the first place. Only time will bring about the necessary healing, but you can do some things to cope with the pain and inflammation.

Below are some options you may consider.

Cold therapy

First, cold therapy is applied immediately after pulling the muscle. Treatment with cold will reduce pain and swelling. The injured person should use a cold pack for 48 hours after the initial injury.

Heat therapy

Then, after 48 hours of cold therapy, the injured person should try heat therapy. The heat is used to increase blood flow to the site of injury, bringing needed nutrients.

This therapy is intended to accelerate healing by bringing blood flow to the area to help repair tissue. Additionally, heat therapy can reduce muscle tension. You can consider a hot bath, heating pad, or an adhesive heat wrap.


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Of course, take a couple of days to rest from all physical activity, avoiding all heavy lifting.

Pain medications

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Next, over the counter, medications such as ibuprofen will help to reduce swelling. A doctor may prescribe pain medications or muscle relaxants, if necessary.

Breathing exercises

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Generally, breathing into the lungs will cause more pain to the muscles. Focusing on breathing into the abdominal area may help to reduce pain

Physical therapy

Seeking out the help of a physical therapist is an option to speak about with your doctor. More severe conditions may warrant physical therapy. A physical therapist can prescribe you stretches and breathing exercises to heal the muscle more quickly.

Now, it's important to note that this area of the body is tricky to repair because these muscles are always engaged, helping us to breathe. Learning breathing exercises is vital to healing rapidly.

A physical therapist may also teach methods for coping with pain with movements. For example, holding a pillow close to the ribs to compress the area and support the muscle can reduce the pain when sitting up or laying down.

Also, you should not attempt any stretches or exercises without the guidance of a professional physical therapist.

How Is Intercostal Muscle Strain Prevented?

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Generally, there is not much you can do to prevent intercostal muscle strains, except not overexerting yourself. Performing stretches that target the intercostal muscles before exercise can help to loosen them up and prevent tearing.

Specific exercises are performed to help strengthen the intercostal muscles.

What Is the Outlook?

The pain of a mild strain will likely subside in a matter of days. More moderate strains can take weeks. Severe strains that involve a complete tear of the muscle may take months to heal completely. The time of recovery really depends on the severity of the strain.

Remember, speaking with a doctor is the best option whenever you are experiencing chest pain. They can give you the best guidance and provide a treatment outlook.

Treatment will involve resting and ceasing activity. If a doctor prescribes it, physical therapy can help in the healing process. Complete recovery will occur with time, so be patient, and you will be back to playing the sport you love.

Have you ever experienced an intercostal muscle strain? How did you recover? Leave a comment below and tell us your story.

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