Strain of Intercostal Muscle: Causes, Symptoms and Recovery

A strain of intercostal muscle can be very painful. If you are a fairly active person, your ribs can take a beating in your day to day life. It is a strain of the muscles that lie between the ribs. While any muscle in the body can be strained, muscle strains anywhere in the chest area can be extremely painful. Since the lungs are housed in the ribcage, the pain can also be severe even with just breathing. Some people even think they may have broken a rib and your doctor may even give you the same treatment for a strain as a fracture. Following your doctor's advice can help your recovery.

What Causes Intercostal Muscle Strain?

You have 11 different groups of muscles in your ribcage. The intercostal spaces have about 3 different layers of muscle that are attached to the ribs. They help keep your chest stable with movement and hold your ribs together and in place. While they are able to move and stretch a good deal, they do have their limits. The causes of strains in this area are:

1. Blow to the Chest Wall

If you receive a direct blow to your chest, it is possible to suffer a strain to the rib muscles. This can happen with car accidents, injury while playing sports (football, karate, hockey), injuries received at work, or an assault (fight).

2. Twisting of the Upper Body

Twisting the upper body over its limits can strain the intercostal muscles. It can also "overstretch" the muscles and put pressure on the ribcage. This includes yoga postures, dance moves, turning around suddenly to see something behind you, wrestling, and other things that make you twist your chest area.

3. Arm Swinging with Force

If you swing your arm too far, it stretches the ribs toward the arm that is swinging. This can be worsened by twisting the lower half of your body away from the arm swing. It can even cause the muscles to tear with enough force.

4. Over Stretching

Even in gentle stretching, you can strain or even rupture the muscles in the ribs. Stretching and pulling the ribs apart too far can cause the intercostal nerves to become trapped between the ribs and muscles. This leads to severe spasms and nerve pain along with the strain. This type is common with some sport activities, such as tennis, golf, volleyball and badminton, where you need to reach high and exert force with the chest.

Symptoms of Intercostal Muscle Strain

The symptoms include pain, tenderness, swelling, muscle tightness, and sometimes shortness of breath. These can often be the same as something more serious, so it's important to be evaluated by a doctor before attempting self-treatment at home. The breakdown of the symptoms are as follows:


  • Sudden tearing pain in the rib muscles
  • Pain tends to be sharp, shooting and very intense
  • Tenderness when the ribs are touched or pushed on (chest wall pain)
  • Very severe and constant pain
  • Pain that intensifies with movement, twisting, coughing and sneezing
  • Pain that goes away by itself in mild strains within one or two days


  • Tenderness can be felt just over the ribs, instead of inside the chest
  • Painful bruising
  • Inability to wear tight clothing on upper body
  • Painful to turn over in bed or get up and down from a chair


  • Swollen areas where the injury occurred
  • Hematoma (swollen area filled with blood)
  • Swollen ribs in the same side as injury

Muscle Tightness

  • During pain and swelling, the muscles in the chest wall may feel tight
  • Tightness tends to be most severe in the area of the injury
  • Taking a deep breath may feel difficult.
  • It may be hard to move the chest area and even the arms

Shortness of Breath

  • It may be hard to breathe without pain
  • Breaths become more shallow in an attempt to avoid pain
  • Muscles may feel too tight to allow enough air in

How to Cope with Intercostal Muscle Strain

There are things you can do at home to make your recovery fast and comfortable. Try these tips:

1. Immobilize the Ribs

Use ace wraps to wrap the chest and give the ribs some compression. Only do this for the first couple of days and make sure it’s not too tight so that breathing is hindered.

2. Alternate Hot and Cold

Use an ice pack for the first day and then begin alternating hot packs with cold packs. The ice will reduce the inflammation and swelling quickly and the heat will promote blood flow to the area and increase healing. After the first day, alternate a heating pad with ice packs four times a day.

3. Take Deep Breathing

You are naturally going to take more shallow breaths with rib pain. This can lead to pneumonia and slow down healing time due to reduced oxygen to the injured muscles. Try these steps to increase your breathing:

  • Breathe in slowly and open your lungs as much as you can. Hold the breath for a few seconds and breathe out slowly.
  • To prevent pneumonia, try to do these exercises at least once every hour.
  • Try not to smoke if you have a rib injury. Smoking can make you more prone to pneumonia and lung problems.

4. Try Epsom Salt Soaks

One way to relieve an intercostal muscle strain quickly is to soak in Epsom salts. These are magnesium salts that can relieve muscle pain. Fill your tub with hot water and add in one to two cups of Epsom salts. Soak in the tub until the water cools.

How Long Does It Take to Recover?

The recovery time for a muscle strain in the ribs can take around two weeks for a mild strain, three to four weeks for a moderate strain, and up to eight weeks for a severe strain. Even if there is a muscle tear, these injuries usually don't take longer than eight weeks to heal. Your doctor may advise no lifting or strenuous activity for a few weeks. Also, bed-rest or quiet rest in a chair may be required. During the time, you may need anti-inflammatory medications (Ibuprofen) and muscle relaxers to relieve muscle spasms.

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