Intercostal Muscle Strain

Intercostal Muscle Strain (Rib strain)

Rapid bending or twisting of your chest wall and ribcage can involve straining your intercostal muscles. This results in sharp, localised pain anywhere in your chest. Because of your chests’ proximity to other vital organs (I’m looking at you heart and lungs!) it can understandably give you a bit of a scare. So it’s important to see our expert physiotherapists that can accurately diagnose this condition and start a treatment plan immediately.

What is an intercostal muscle?

Okay time for some anatomy! “Inter” means within and “costal” means ribs, so the intercostal muscles are the muscles that lie in between your 12 ribs and help form the chest wall. There are three layers within the intercostal muscle: external intercostal; internal intercostal; and the innermost layer is the subcostal muscle.

The two main functions of the whole intercostal muscle are:

  1. Helping with breathing. When you take a breath in the external part of the muscle will contract helping to expand your chest cavity to fill your lungs. When you breath out the internal part of the muscle will activate helping to force the air out of your lungs
  2. Stabilising the chest wall. Because these muscles are attached to the rib above and below it helps keep each of the 12 ribs situated in the right place.

What caused me to strain this muscle?

Intercostal muscles are usually strained by sudden twisting motions. It can happen immediately, or sometimes repetitive movements can cause the strain over time. The most common movements that we see in the clinic here at Fixio that cause this injury are things such as:

  • Repetitive reaching with your hands e.g. painting a high wall or ceiling
  • Chopping wood
  • Athletes with sports with repetitive throwing or upper body twisting movements e.g. cricket, baseball, rowing.
  • Vigorous coughing or sneezing due to illness or allergies.

If you have had a significant force to the chest, we’d be more likely to suspect a rib fracture (Link). But an external force may also cause intercostal muscle strains, so it’s good to go through the proper treatment and diagnosis journey either way.

How does Physiotherapy Help?

We’re experts at intercostal strains and general muscle and joint injuries. During your first session here at Fixio we will take an accurate history and work together with you to find what caused the injury. Because this is an injury to your chest, we’ll do a thorough screening to rule out anything more sinister.

Next, we’ll get straight into treatment. Depending on the severity of the strain most cases will take 2-8 weeks to recover with physiotherapy. Intercostal muscle strains can be notoriously painful because they are moving by contracting every breath you take. Depending on your pain severity we may need to offer pain killers ( in conjunction with your G.P.) to ensure you can sleep and breath properly. to help with the pain may also use Ice therapy, soft tissue massage, and mobilisation of other stiff joints around the intercostal strain.

The next part of treatment focuses on restoring full active range of motion of your arms, ribs and middle and lower back movements whilst ensuring you get back to your everyday activities. We will also specifically strengthen the intercostal muscles by free weight exercises such as barbell pullovers and dumbbell fly’s. This will have the added bonus of helping strengthen the muscles that improve your breathing ability meaning you will get less shortness of breath during exertion.