Intercostal muscle strains and how physiotherapy treats them


Intercostal muscle strains and how physiotherapy treats them

Your ribcage is supported by a number of complex structures, ligaments and muscles, including the muscles between the ribs; the Intercostal muscles.

“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. Your intercostal muscles are made up of three layers: the external intercostal, internal intercostal and the subcostal muscle.

Your intercostal muscles allow the ribcage to move up and down when you inhale and exhale and stabilise the chest wall by helping to keep each of your 12 ribs in the right place.

How do intercostal muscle strains happen?

Your intercostal muscles can be strained by any activity that involves extreme or forceful twisting of the body or swinging of the arms like cricket, golf and tennis. It can also happen as a result of a direct blow to the rib cage, such as from a fall or car accident, in which the ribs are forced apart suddenly and the intercostal muscles stretch or tear. Blows that occur from contact sports such as rugby league may cause intercostal muscle strain from one-time or repeated hits to the area.

There are also several biomechanical and physical factors which can contribute to suffering an intercostal strain. These can be assessed by your sports physio and sometimes corrected, including:

  • inappropriate warming up
  • poor technique
  • inadequate recovery periods
  • poor core stability
  • muscle weakness
  • poor flexibility (particularly the upper back or lower back)
  • fatigue
  • a lack of fitness or conditioning
  • inadequate rehabilitation from a previous abdominal or lower back injury

What are the symptoms of an intercostal muscle strain?

Symptoms of an intercostal muscle strain can vary depending on the mechanism of injury, however, they may include:

  • Pain:You may feel a sharp or gradual pain that gets worse when you twist, stretch, breathe in deeply or cough.
  • Difficulty breathing:Due to the pain when breathing in deeply, you may find yourself taking small, shallow breaths of air.
  • Tenderness:The area of the strain between your ribs will be sore to the touch.
  • Swelling:A partially torn or strained intercostal muscle can become inflamed, with some swelling between and around the affected ribs.

Physiotherapy for an intercostal strain

Physiotherapy treatment for an intercostal strain is vital to maximise healing, prevent injury recurrence and ensure an optimal long term outcome. During your first session here at Lane Cove Physio we will take an in-depth history and work together with you to find what caused the injury. Because this is an injury to your chest, we’ll also do a thorough screening to rule out any other causes of your pain.

Depending on the severity, most intercostal strain cases will take 2-8 weeks to recover with physiotherapy. Intercostal muscle strains can be notoriously painful because they move with every breath you take.

Treatment focuses on slowly 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.

Your sports physio may take you through the following treatments:

  • soft tissue massage
  • joint mobilisation
  • joint manipulation
  • stretching
  • dry needling
  • activity modification advice
  • technique correction
  • exercises to improve strength, flexibility, core stability and posture
  • hydrotherapy
  • education
  • a gradual return to activity plan

If you have any questions regarding your intercostal muscle strain (or any other condition), please contact our Lane Cove physio to discuss and organise an appointment to get your recovery on track.