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Intercostal Muscle Strain

An intercostal muscle strain is a common experience in which the pain caused can be bearable for some or it can be debilitating to others.

Intercostal muscle strain is the result of a forceful movement particularly a sudden twist of the torso. This condition involves the muscle located in between the ribs and the condition is characterized as a tear in the intercostals muscle.

The intercostal muscles are composed of several muscles known as the internal intercostals muscles, external intercostals muscles, subcostal muscles and the transverse thoracic muscles. The primary function of the intercostals muscle is to allow the up and down movement of the chest muscle during inspiration and expiration in the process of breathing. It functions also in stabilizing and forming the chest walls.

Intercostal muscle strain usually recovers fully over the course of four to six weeks if proper physiotherapy is applied and if muscle strain is mild. Severe muscle strain on the other hand, requires longer period for a full recovery.

Intercostal muscle strain can happen to anyone regardless of age and gender and without racial predilection. It is however more common in people who are engaged in sporting activities and those who are participating in vigorous activities where sudden twisting of the torso can happen.

Symptoms of Intercostal Muscle Strain

Intercostal muscle strain is marked by pain in the side of the chest often in the area of the lower ribs. The pain may come suddenly which can be described as sharp and may have a pulling sensation. In some cases, the pain may come in gradually such as during the course of sport training or other training session that requires too much body movement.

Mild case of intercostal muscle strain may still allow the affected individual to continue with the daily activities. The pain felt is usually bearable that movement is still possible. The symptoms however may increase when resting or when the patient is cooling down.

In severe cases of intercostal muscle strain, daily activity is often affected and the pain is usually debilitating. Athletes and other individuals with severe case of intercostal muscle strain usually have to refrain from engaging in sporting activities for some period of time or at least until the strain has recovered fully.

The sensation of pain in intercostal muscle strain usually increases with certain activities such as bending, turning from side to side, twisting and lifting of heavy weights. Sporting activities such as rowing, bowling, running, jumping and throwing also increases the sensation of pain.

Other symptoms that may accompany intercostal muscle strain may include the following:

  • Swelling
  • Muscle spasm
  • Bruising on the side of the chest
  • Weakness

The pain in severe case of intercostal muscle strain is aggravated with coughing, sneezing, laughing and deep breathing.

Intercostal muscle strain is graded accordingly and such are:

  • Grade I intercostal muscle strain is described as mild strain. Only a few of the muscle fibers are damaged or torn and recovery is usually over the course of two to three weeks.
  • Grade II intercostal muscle strain is described as moderate strain. The damage or tear in the muscle fibers are extensive although no complete rupture of the muscle fiber can be noted.
  • Grade III intercostal muscle strain is described as severe strain. Complete rupture of the muscle is noted and activity or movement is impossible as a result of severe pain. This grade of intercostal muscle strain requires surgery to correct the condition and recovery usually takes longer which may take about three months to six months at the most.

The degree of disability is related to the grade of the strain and recovery and time of recovery also depends on the grade of strain. The recovery time also depends on the presence of any medical complication.


Intercostal muscle strain occurs as a result of tear in the muscle between the ribs or known as the intercostal muscle.

The strain in the intercostal muscle may occur rapidly such as from forceful blow of the muscle, sudden twisting of the torso and engaging in sporting activity without warming up the body properly. The strain on the other hand may also develop gradually often from repetitive movement of the body or over movement such as during the training.

Intercostal muscle strain most commonly happen when there is a sudden contraction of the muscle particularly when the intercostal muscle is not in the proper position during a stretching movement of the body.

Athletes such as rowers, javelin throwers, ice skating hockey and cricket are more prone in sustaining intercostal muscle strain. Not all intercostal muscle strain however is due to activities that can put strain in the intercostal muscle. The strain can also occur when there is a direct blow or forceful impact applied on the ribs such as in vehicular accident and fall.

Several factors are also considered to contribute in the development of strain in the intercostal muscle and such factors may include the following:

  • Improper warm up prior to exercise or training
  • Excessive training
  • Excessive repetitive movement
  • Inadequate time for rest to allow the intercostal muscle for full healing and recovery
  • Improper sporting techniques and body mechanics
  • Presence of muscle and joint stiffness
  • Previous experience of lower back injury
  • Poor posture
  • Weakness and fatigue


The goal of treatment for intercostal muscle strain is to hasten the healing process at its optimal, relieve the symptom of pain and to prevent the recurrence of the injury.

Several physiotherapy treatments may be applied to allow healing of the intercostal muscle strain and restore the normal functioning of the affected individual.

Physiotherapy treatment may include the following:

  • Ice application over the affected side of the torso helps in reducing the pain and strain in the muscle. Ice is applied for 15 to 20 minutes at least 3 to 4 times a day.
  • Joint manipulation and mobilization helps in restoring the normal function of the intercostal muscle while reducing the strain and relaxing the muscle.
  • Anti-inflammatory drugs and pain relievers help to reduce the pain and inflammation.
  • Rest is generally advice to allow the intercostal muscle some time to heal and recover. It is best to refrain from the previous activity that resulted to intercostal muscle strain so as not to put additional strain and to prevent further damage to the injured intercostal muscle.
Intercostal Muscle Strain
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