So You’ve Strained an Intercostal…

image from wikimedia

Hi, folks. I am not a doctor, nor have I played one on TV, but I would like to take a minute to share a bit of info about a subject literally near to my heart. The intercostal muscles are a group of small muscles that run between the ribs and are responsible for helping shape and move the chest wall when you breathe. Despite the fact they are located in your chest, these muscles can be a major pain in the rear. When one is strained, usually by coughing or by a fall, it can be excruciating, and without an x-ray may be difficult to distinguish from a broken rib.

In the course of my life, I have managed to strain these muscles THREE times, each time from coughing. A strained intercostal, in my sad experience, feels like being stabbed through the ribs with a jagged object. My pain was inconveniently located deep inside my breast, just under the breast at the outer edge, and in my armpit.  In my case the pain was generally mild until I coughed. However, if I was coughing a lot, the injury would be aggravated to the point that it hurt when I breathed deeply, or pretty much all the time.

wpid-IMAG0916.jpgThe first time it happened, my doctor diagnosed either a pulled intercostal or broken rib, but didn’t offer to take an x-ray as the treatment was the same:  take ibuprofen to control pain and inflammation and reduce activity as needed. Exercise or lifting heavy items can make pain worse. Gentlemen, you have one up on us ladies because without bulky breast tissue it is much easier to bind your ribs, which I have heard can help with pain. Ladies, you will find that grabbing your breast and trying to push it in when you cough doesn’t help at all. One thing I discovered does help if coughing is a factor is to create a little traction. If you feel a cough coming on, grab the top rail of a door frame with the arm on the side of the injury and bend your knees until you feel a good stretch, then cover your cough with the inside of your other arm (because nobody wants your nasty germs, especially if they result in the blazing pain of a strained intercostal.) Take your ibuprofen, drink plenty of water, try not to swear, and in three to six weeks the worst will be over. I am sorry. I wish it would go faster. Primarily because I am nursing one myself right now.

Good health to us both!

32 thoughts on “So You’ve Strained an Intercostal…

  1. Carrie Rubin

    Yep, these are not fun muscles to get inflamed. Sometimes I’ll rotate a little too vigorously in yoga and pay the price for the next few days, but I’ve never had a more serious intercostal injury than that. But pain so sharp it inhibits a deep breath is no fun at all. I wish you a smooth recovery.

    1. lynnettedobberpuhl Post author

      Your injury sounds great! What an absurd thing for me to say. However, I have never had a mild version. I would have thought I’d have done something to the same area working with Kettlebells, and TRX and Rip Trainers, but nope, just coughing. Thank you for the good wishes, I think I am on the mend. Sigh. It has been a long winter.

  2. sillyliss

    Oh, I have had similar happen to me and I REALLY empathize. I am so sorry! This post was so well written, though, despite that I can now feel a tiny tremor of pain when I breathe…

    1. lynnettedobberpuhl Post author

      I don’t think ibuprofen will work for your twinge, but maybe a nice cup of tea? That usually helps me, regardless of my issue. Thanks for reading and the kind words, and I am relieved to tell you I am feeling better every day!

  3. Jewels

    Thank you for this article. I coughed really bad for over a week from a chest cold and now have a bad pain on my right side, almost where you described yours. The doc ruled out pleurisy and told me it was a muscle. It calms down some but when I cough, OMG, it is excruciating and then hurts to breathe, etc. The pain can take your breath away. Heat and ice cant seem to reqch it. Since I am still coughing I will try your method.

  4. Amelia

    Thank you for this. I have the exact same pain described here and it’s gotten worse in the past day just from all the coughing I’ve been doing. I’m the kind of person who freaks out at pains like this, so reading this makes me feel a lot better. I’ll definitely try your coughing method.

  5. Pneumonia Girl

    I’m currently in the hospital with pneumonia (today is my third full day here, not getting out until tomorrow… at the earliest), I coughed violently for some 36+ hours straight. Exhausting! Then, just as the coughing began to ease, WHAM! I thought I’d broken a rib a few inches below my armpit and just *to the rear* of my side midline, on the same side as the worst of my pneumonia! Oh! Coughing AND this pain? Aieee!

    Doc came in and listened both to my description – and to my chest. She asked if it felt better when I cough or breathe deeply, it feels better to rest on that side. Oddly enough? Yes! She said that it is common for the body to find a way to minimize the pain, and while it is absolutely not comfortable, it is *more* comfortable to have the pressure of the bed against my injured side *especially* when I cough. I have been working to stretch my arm along my ear with my right foot pointing to the end of the bed – and that seems to be helping! From what you describe, it would appear to be quite similar to the traction you create in the doorway.

    I’m still too weak to stand for long – and definitely not with my arm above my head, but you have given me some hope – and a good idea how to keep improving when I (finally!) return home.


    1. lynnettedobberpuhl Post author

      Ooh! That sounds miserable. Lying on the hurting side when a cough or deep breath is needed is great advice, and very counter intuitive. I hope someone will read this and be helped. If I ever experience this again (please Lord, no) I will definitely keep it in mind. I hope you heal quickly, although I doubt it will feel quick enough! Feel better soon, and thank you for reading and commenting!

  6. Lisa.

    Thank you for this article. I have that injury right now…fell down while horsing around (with my mini horses) had an xray which confirmed no fractures. I found out that when the doc says to do nothing he really means it…tried to at least do some of the farm chores and ended up with horrendous pain……and you describe it well as a stabbing with a jagged object. I now realize that I do have to rest and try not to do much of anything….good luck when you have a farm of animals to care for. Ouchy!

    1. lynnettedobberpuhl Post author

      Animals and kids. You can’t just leave them to fend for themselves until you feel well enough to do the work, right? I pray that you will find a helper, and be healed quickly! Mini horses are adorable!

  7. Jane Cullen

    Pure pain. I think I agree it’s easier to add some heat and be laying in the sore side when coughing. Unbelievably painful!!! And the coughing continues!!!

  8. Nikki tiffany

    Thank you for the peace of mind. I really appreciate you sharing your story. This is exactly what I have.

  9. mcurran92015

    Ugh. Glad to hear some familiar stories, not that I’m wishing this on anyone. In the hospital for pneumonia one week, back in the ER the next for a strained intercostal muscle from coughing. The doctor in the ER (after x rays, tests, etc) said this is basically what getting shot feels like. Ok, I can cross that off my bucket list? I guess? Going on week 3 and it’s just taking SO LONG TO HEAL and I’m not a patient patient. I have discovered that since it’s allergy season now, keeping on top of those with benadryl and on top of the pain with ibuprofen is essential. Since I teach high school, I’ve got to have an IV drip of caffeine though, so yeah. This is awesome. 🙂

  10. jimi_po

    I have very severe COPD & this is my second go round with strained intercostal muscles. I also have abdominal aortic aneurism, so the pain associated with this can be first thought as associated with the heart — stabbing pains under the left arm & into the chest, strained pulmonary functioning, etc, etc. Quite scary, but everything points to intercostal muscles. They take way too long to heal, but I tried your technique for self traction when coughing & that really helps a lot. Thank you. Riding the storm out.

  11. Genevieve

    Thanks for sharing your story. I felt like I was the only one suffering from a ripped muscle because of a bad cough. I can’t believe a cough actually caused this. When the pain started, I thought it was related to my heart. I was so scared. An electrocardiogram was done and my heart is fine. However, my muscle under my left breast is ripped and is causing constant severe pain when I breath, when I move, when I stand straight, when I sit down and lean on something, when I bend down, when I lay down, and so on. The pain is excruciating when I cough or sneeze. I’m taking vimovo, statex and Tylenol to relieve the pain but it’s still very painful. On top of that, I have post nasal drip due to a sinusitis which is causing my cough. I’m using a nasal spray to get rid of the sinusitis. If in a few days I’m still coughing, the doctor told me to start taking antibiotics. Hopefully the cough will stop soon in order to give a break to my muscle and allow it to heal. I feel like if my cough continues, the muscle is just going to keep hurting more and more.

  12. Kristal

    You described my pain perfectly. Thank you! I was really beginning to think I needed to see the doc yet again. Mine started with continued cough about 5 weeks ago. Cough is finally going away, but the pain in my left chest/breast area is not. Hopefully, once this cough is totally gone, my muscle will be able to heal! Literally, what a total pain!!

  13. SForhan

    Hi there, I pulled both intercostals TWICE last year so now that I have the nagging cough from the flu this year I hoped I would not pull them again. Wishful thinking — it absolutely hurts like hell when you cough for starters, but also when you get out of bed, turn, even reaching for the toilet paper…(use the hand from the side that’s NOT hurting)! Thanks for keeping your blog going with humor and pointers. That stretch is keeping me sane. I have tried almost everything to help rid myself of coughing and I’ve resolved that I have to stop it no matter what with cough syrup and drops or else my lungs will never be able to heal! Don’t know what’s the answer…lungs seem so weak and defenseless when I get sick. I can’t imagine having COPD (hope jimi_po got better). Thanks again and positive mojo for everybody’s health!

  14. Tracey Fenton

    Thank you, thank you, thank you for the stretching advice when coughing, something that finally works ! I have exactly what you describe after a viral infection. One week in and anti-inflammatories and gel from the doctor were just starting to ease the pain until this morning while during a coughing fit I felt a muscle pop/tear on the other side, OUCH !!! The pain is excruciating when coughing and was trying to hold the cough in only made it worse. Tried the stretch, tentatively, and WOW, the pain was bearable. Relief at last. Thank you again.

  15. Marie Courtney

    I tried robax platinum and a med stick topical roll on to help. It did relieve a little. I over coughed and have it right now also. So uncomfortable…


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