Intercostal muscle strain: a surprisingly long and slow recovery

It’s coming up on the 4 month anniversary of my intercostal muscle strain. Not sure whether that’s cause for celebration or consternation.

While I no longer see my chiropractor regularly (a therapy called the Graston Technique seems to have helped), neither am I completely healed. I’m back to teaching and training, as before and am spending considerable time strengthening my core. In addition to the three exercises I was prescribed back in August (Chiropractor-approved moves for healing your intercostal muscle strain), I am once again doing rotational work and even adding light resistance to crunches and planks.

intercostal muscle strain

Yet, every ten or twelve days I feel that same tenderness under my ribcage and am back to icing and ibuprofen.

Usually, it’s precipitated by overexertion: lifting a 20-lb box of cat litter up and out of the trunk of my van, then twisting only my upper body to place it on the ground (note to self, always turn feet before turning arms…); demonstrating an exercise to a client, using the heavier weight that they need, rather than the lighter weight that my core can handle; an afternoon of vacuuming and window washing (what a great excuse not to do housework!).

That’s the thing about intercostal muscle strain. It takes a long, long time to heal completely. Your intercostals are used each and every time you take a breath. Turning your torso engages them. Unlike other types of muscular strains, you can’t stop using your intercostals while they heal; just hold your breath for a couple of weeks and you’ll be fine! Ha!

Perhaps the most difficult aspect of having an injury like this is the number it does on your confidence. I’m much more tentative in the gym that I used to be. Picking up lighter weights than I know I can lift. Afraid of ‘over-doing it’ and being in pain again.

The biggest challenge is finding that fine balance between strengthening weakened muscles and re-injuring them. A balance I’m working on each and every day.

Have you ever had a long healing injury like an intercostal muscle strain?

How do you deal with injuries that interrupt your training (and your life!)?






  1. as I sit here with my low back killing me πŸ™‚ I get this….
    MIz recently posted…Ahnu almost wordless Wednesday.My Profile

    • Ooh, what are you doing to make it feel better?
      Yoga? Heat? Ibuprofen? all of the above???

    • Hi, I injured my ribs after sneezing, I heard a popping noise and then couldent move without being in alot of pain. I went to the doctors and was prescribed panedine forte. My ribs seemed to be getting better but now after around four weeks they are feeling worse, muscle spasms and pain when laying down. Im now taking muscle relaxants, which help, but make me drowsy. I cant help but have the an occasional thought like, maybe Im dying of some sort of rare bone disease.

      • I feel exactly like you Kylie. I keep telling my husband maybe it isn’t a muscle strain maybe it is worse. I think it happened to me from lifting and carrying out 2 toddlers.

  2. Tamara – sorry this is such a long recovery but I know you know how to deal with it & work back to recovery in a balanced way… don’t we wish it were quicker but it has to be done right… HUGS!!!!!!!!!!!!!!!!1

    I have not had anything that has kept me out longer than a week in a long time. My teeth were the week & before that, 6 or 7 years ago, a dog attack that ripped open my leg.

    I am not good at patience BUT it pays to do it the right way.
    Jody – Fit at 54 recently posted…Comment on Diets, Dieting, Restriction, Willpower & More!My Profile

    • I’m heading to Yin this morning to release some super tight hip flexors. Sometimes that actually helps my ribcage too!
      Tell me more about the dog story; that sounds scary!

      • Hey Tamara,

        Any tips for a costovertebral sprain on my 3rd rib? the damage is right where it connects to my spine and its been agony, I have gone to a chiropractor for about 4 weeks and there has been a big improvement, but every time I try to even slightly return to my normal activities the next day its hard to even move. I had injured it in August doing some archaeology for a preservation project. The doctors for 5 months just kept giving me pain pills and said it was a “muscle spasm” the chiropractor was the only one who knew what it was and took some xrays. I just dont know how to strengthen that particular area since according to him its a rare place to get that particular injury (got it from throwing dirt over my left shoulder and above my head while down in a 4 foot hole.) starting to get discouraged and feeling like ill never be back to my old self, any tips would be much appreciated. been bed ridden for almost 6 months now πŸ™


        • Jay, since you’re already seeing several health professionals who are way more experienced than I (I’m a personal trainer who happens to have had the same injury), I can’t suggest any other things you might be doing. I’m assuming you took a look at the other two posts in this series about post-ICS strengthening exercises and using the Graston technique to get some pain relief?

          Hoping your recovery improves, Tamara

        • most injuries especially those with significant pain usually do not respond by doing one type of therapy. Sprain/strains not only involve the surrounding soft tissue (muscle, ligament, and connective tissue) but associated joints nearby. Thats why your chiropractor provided help to the dysfunctional joints and stretching,strengthening exercises and other forms of physiotherapy provided some help to the soft tissues although both in a temporary way. I would continue doing all of the above if they seem to give you some benefit and would also find an acupuncturist that has worked with soft tissue injuries. Your pain maybe coming from some of the deep soft tissue that can only be reached with an acupuncture needle hooked up to an electrical stimulation machine. By directly and specifically treating your injury this way hopefully the deep pain can be released. I’ve been retired for 5 years but was in private practice 20+ years as a Chiroprator, Acupuncturist and Exercise Physiologist. Good luck!

          • Thanks so much for this response Herb. The multi pronged approached is indeed what I did to heal my ICM strain a couple of years back. Graston, chiropractic, physiotherapy and acupuncture all helped. As did a slow and gradual return to my everyday workouts!

  3. Hi Tamara,

    This is helpful, and I understand your frustration. I’m a competitive rower, and I just competed in a big race in Boston (the Head of the Charles – largest 2-day regatta in the world). I had strained my intercostal before the race, and it is definitely more strained now. It hurts to flex my abs, at times when I breathe, and when I lie on my left side, where the injury is. I am entered for a race in Philly this weekend, but now I’m having second thoughts. Bummer because I entered late and it cost me twice as much! Also because I have a non-refundable hotel room (maybe just go down and watch?). But the main issue is that I was planning a month-long “journey of self-discovery,” in which I was going to bring my single scull and travel all around the Southern U.S. and write about different, off-the-beaten-track rowing clubs that I would seek out. Grr… anyway, it’s helpful to read about your experience and to discover your blog. Thanks and good luck!

    • John,
      So sorry to hear about your derailed plans. Your rowing trip sounds wonderful! I crewed in an 8 back in university. We weren’t very good πŸ˜‰
      All I can suggest re: injury recovery, is to take it slow and really be mindful of your movements once you start to heal. Are you seeing a physiotherapist or chiropractor? Mine really helped me.
      Best wishes!

    • Craig Hassler says:

      Just wondering how long it took you to heal. I’m a kayaker and was doing quite a bit last week plus portage and now feeling intercostal pain. What approaches did you use to heal?

  4. I haven’t had a muscle strain that lasted that long, but I was out for 6 months when I had knee surgery in the late 90s. I would think I was “better” only to discover that small movements exacerbated it all over again. I hope you can find a way to stop breathing! Or, more realistically, find a way to remember to hold light weights and turn carefully. Just think how bad it must be for people who don’t have your level of training & knowledge! Wow.
    AlexandraFunFit recently posted…Don’t Be a Pretender: Protein Satiates AppetiteMy Profile

    • You’re had your share of having to ‘wait and be patient while it heals’, Alexandra. I do try and pay close attention to my movements. Oddly enough, tweaking never happens in the gym (I’m very attentive there), only at home, while doing menial labour. Guess I know what the best solution to that problem is!

  5. I once had elbow tendonitis, and it limited what weight moves I could do for months. But eventually–maybe after 9 months–the symptoms resolved. Oddly enough, the only thing that re-exacerbates it is a heavy-duty vacuuming job. Guess it’s that constant extension and flexion pulling a heavy object. Vacuuming now falls to my children. This really doesn’t break my heart too badly…
    Carrie Rubin recently posted…Want To Publish A Novel? Better Toughen UpMy Profile

    • Ha! Vacuuming bugs my intercostals too. That’s my excuse for not doing it! Anyways, I have 3 kids; more than enough ‘in home’ help…

    • It helps to walk with both arms rigidly, stiffly straight by your sides for a few minutes each day. ======Also, I took a magic marker pen and outlined on my elbow the EXACT place it hurt.=====Then, a doctor injected the elbow with cortisone exactly all around the marker site on my elbow. It worked! ======Now if occasionally it acts up, walking with the elbows as mentioned above, really works.=====Good luck!!

      • I meant to say, walk with your arms straight down, rigidly by your sides, with elbows pointing out toward a wall on each side of your body.

        • Why point your elbow toward the walls, straight down and rigid would seem to be more relaxed? When I just tried it, I sort of made a lose fist and my thumbs were heading straight ahead of me – is that what you meant?

  6. Ive never had the injury you are suffering from but I do understand how it feels not to be able to train at the level you are used to or would like to be training at. Having had an injury to my hamstring almost a year ago now, I had to take 4 months off of running. When I slowly reintroduced it back into my routine…I could feel strain at times which made me fear I would reinjure myself. Everything h regulated itself in time…lots of time but I got there πŸ™‚
    Kierston recently posted…WIAW: Post-Fitness Competition Goodies!My Profile

    • Hamstring injuries are tough to rehab. I’ve seen several occur in step class over the years and have been amazed at how long it was before people could return to full on activity.
      Sometimes patience is hard, isn’t it?

  7. Sorry girl. It’s the same for my tennis elbow. My injury took over 2-1/2 months to heal and now, six months later, it still flares up after sitting at the computer too much. The fact is, once we’re injured, it DOES take a long time to heal. I am glad you are progressing though πŸ™‚
    Suzanne @WorkoutNirvana recently posted…How to Find the Right Training Split for YouMy Profile

    • Yikes! I remember you talking about that darn elbow before. The hardest thing about getter older is losing patience to wait while you recover! At least we’re persistent and try to find ways around the injury, right?

    • It helps to walk with both arms rigidly, stiffly straight by your sides for a few minutes each day. ======Also, I took a magic marker pen and outlined on my elbow the EXACT place it hurt.=====Then, a doctor injected the elbow with cortisone exactly all around the marker site on my elbow. It worked! ======Now if occasionally it acts up, walking with the elbows as mentioned above, really works.=====Good luck!!

  8. This –> “Perhaps the most difficult aspect of having an injury like this is the number it does on your confidence. I’m much more tentative in the gym that I used to be.”OMG yes!! I feel the same way about my knee. I hate feeling tentative but I am especially when I have to twist or change direction quickly. Well, I don’t really do it quickly because I’m afraid of hurting it again. I would like to get to the point where I am not consciously thinking about my injury all the time. Totally frustrating but I hope that one day soon, we will find the right balance.
    Christine @ Love, Life, Surf recently posted…A Riff on Friday Round-UpMy Profile

    • Only people who’ve had these nagging injuries get the psychological effect. I hate to think that some day I may not be able to work out at the intensity I love!
      Somebody suggested to me that I wear physio tape or a compression bandage, not to help the injury, but to trick my mind into not worrying about it when I train. What do you think about that idea Christine?

  9. Hi,
    I screwed up my intercostals about 4 weeks ago while I had bronchitis. I was in the middle of a coughing fit and decided that would be a good time to move the couch. Smart. I’m having a hard time making any healing progress because I have a two and three year old. A lot of lifting and bending. Anyway, I went for a massage and the therapist says there was a lot of scar tissue. Did you have problems with this? Did it make your side tight for quite a while? Also, what worked better for you, heat or ice?

    • Hi Stacy,
      So sorry to hear that you injured yourself. I have heard of people straining their intercostals due to excessive coughing (but never while moving a couch at the same time!).
      Yes, my chiropractor did notice a buildup of scar tissue. He did something called Graston technique, which was quite uncomfortable during the process, but helped in the healing.
      And yes, my side, and in fact my entire core, was tight and tender to the touch for quite some time. I am STILL dealing with this injury. Some days I notice it more than others.
      My chiropractor recommended ice over heat. The cold helps reduce inflammation. I also used a topical muscle analgesic called Voltaren. That helped as well.
      I was told to minimize lifting heavy objects (including children…) in front of my body and to avoid rotational moves for quite some times.
      Hope that helps! It really is a long term injury and only seems to heal a bit at a time.

      • Great advice. Thanks. And I’ll take a look at those exercises, too.

        It’s just such a frustrating injury. I have little patience with myself and after I pop a couple of advil I assume I’m remarkably healed and then go about my day normally, only to find that the next day I’m back to square one. Lying down at night is the worst! Glad you’ve made good progress though. I’ll get there one day…

  10. Yep, me. I found this article by googling ‘intercostal strain still hurts’
    I am 3 1/2 months out from my initial strain and 3 months from my second (jipped, right? I did two strains two weeks apart, all from a cough!!!)
    Have been fairly pain free for about a month now, but woke up yesterday and am in pain-ville again! The only thing I can think I did is a lot of push ups, normally I only do a few.
    Very frustrating as I really want to up my weights and push my self but nooooooo, had to hurt myself coughing haha.
    How is your strain now?

    • Ah, Jen, I feel your pain. Literally! My intercostals are acting up a bit this week; we were away over the holidays and the combination of a bad bed and too many hours in the car has made them hurt again.
      Pushups can certainly trigger re-injury of these muscles. In fact, one of the exercises my chiropractor had me do to strengthen them was a protraction pushups. If you follow the link in the thumbnail at the bottom of the post (at the top of the comments) you’ll find a video with a demo of this exercise and the others that I do regularly.

      Let me know how it goes!

      • So I’m baaaaaack. I’ve been getting notices of replies so thought I would check out how it all is. I am just approaching one whole year since my two intercostal muscle strains on my left, and glad to report that all is well there. I would say the niggling still does appear once every so often, generally after a hard swim set, or a class with a lot of floor work, push ups or crunches ( tend not to do these as I have two umbilical hernias) . I try and seek the chiro and physio once a month if I can, but not always possible.
        However….. I have a cough ( again) and have had said cough for 3 weeks now nearly… and my right side is killing me, just the same as before I busted up my last two sides. I don’t think I have strained them (yet) but I have done something, as they are killing, one week on since the pain started. So BOOOOO. I did a swim set today and it has definitely made it worse, this is the worst it has been so far. So maybe have to lay off the swimming wahhh… No good when I am training for an IM Swim in 11 weeks!!!
        FX it passes and is just a bruise from the Obstacle Race I did on the weekend… I hope!

        • Oh no! Intercostal strain is definitely one of those injuries that can easily be re-triggered. Mine still acts up from time to time. But I’ve learned to listen to my body and give it a few days rest when this happens.

          Hoping the same works for you Jen!

  11. I injured my intercostal just over a year ago rock climbing. It got somewhat better after about 8 months, and I resumed climbing, but it was always “tweaky”-well, I’m back in the same boat.

    You have to restrain yourself, don’t be tempted to do too much until you are pain free! (I.E. sledding down a steep hill or horseplaying with a rowdy, lively 3 year old daughter who does a 35 pound knee drop on you while you’re laying down). Frustrating, but better in the long run.

    • OH man, how frustrating! I’ve experienced a couple of relapses as well, although not doing the fun things that you’ve done!
      SLow and steady is the way to eventual recovery (or so I’ve been told πŸ˜‰ )

      • Definitely slow and steady! One big lesson from all this too is that the closer to 50 I get the longer the recovery, and the greater the need to warm-up pre-workout and maintain strength and flexibility. I discovered yoga relatively late. I wish I’d been doing it all along.

        Thanks so much for your posts on this!!! It gives great moral support to know that I’m not somehow psyching myself out about how persistent this is.

        • Rob, I’m so glad that my writing has helped you. That was my point. During the peak of my injury, I looked but couldn’t really find any information about how long it might take to right itself. I was really worried that I might have to stop teaching group fitness and working as a personal trainer. Please come back and let me know how things are going!

  12. I’m so thankful I came across this post. I took a dumb fall as well on thanksgiving day (tripped over my 3 year old toddler who was acting like a cat behind me), and when I landed…I was in a twisted angle to break my fall from landing on my back. It is now one month and a half later…and I’m still hurting. My chiropractor said I strained my ENTIRE rib CAGE! I’m a stay at home mom, and life has been difficult with this injury. At times it really messes with my head and makes me wonder if something else is going on because of how freaking SLOW this healing process is. MOst of the MD websites say rib strains should heal between 3-6 weeks. PSHHHH! Not me. NOt even CLOSE. THanks for posting your experience because I finally feel like I’m not alone.

  13. When I first injured myself I was going to a chiropractor that didn’t really know how to adjust the ribs well. I changed chiropractors and now that I have a good one…my muscles are going CRAZY. One day I will wake up with crazy pain under my lower ribs and the next day after getting adjusted my whole upper back feels locked up. He’s been doing ART on me as well, and boy am I hurting the next day when he does. At what point did you start getting the Graston Technique done? Were you hurting pretty bad after you got it done or did you have immediate relief afterwards? I seem to have a pattern…I will have 2 good days (normally at the end of the week) then 3 bad days (Mon-Wed). Did you have the same kind of pattern during your healing process?

    • Me too Tina! I was just frantic about how long this was lasting. Hang in there!

      • Rob, what has been your experience?

        • nevermind, I just read your previous posts. LOL

          • Rob as you were healing, could you notice a difference every week that went by? I’m going on week 10, and I’m sleeping better at night…BUt I seem to be spasming more throughout the day. Where as at the beginning I could NOT sleep well through the night, but as long as I was up walking I had more relief. I wouldn’t really say I feel Better than when the injury first occurred…just a different pain and less frequent towards the end of the week for some strange reason. What kind of healing process did you go through? I would appreciate any input you can give me as to what I have to look forward to.

          • Hey Tine,
            Sorry about the long delay responding. It may be helpful for me to clarify some information. My experience has been pretty similar though.

            First, I had a tear of the intercostal from rock climbing two years ago (not one as I originally stated). It improved after about seven months, and I started climbing again. It was never 100% though. Climbers are notorious for obsessively continuing to climb while injured.

            I could clearly see a tear on the ultrasound my doctor showed me. Although muscle “strains” often really mean at least minor tearing or overstraining, larger tears are different. They create strong, sinuous scar tissue which knits to the muscle and leaves the area susceptible to reinjury in the future. In short, the muscle will pull away from the stronger scar tissue if stressed too much. It seems to be what’s happening in my case, and perhaps some of the other posters.

            You get into a cycle where it starts to feel better and then something seemingly innocuous reaggravates the injury, when my case not nearly to the same degree as in the first instance.

            What to do? As Tamara has noted, it is very important to strengthen your core around the injury site, and the exercises as she demonstrated in her video are a good start.

            I found yoga to be just as effective as the physical therapy that I have had. My physical therapists tend to poo-poo yoga, only to give me exercises that are virtually identical how they affect the body! Full planks and side planks have been good for me, but be prepared to modify them. Perhaps do the full plank with knees on the floor until you feel strong enough to do it in the full position, or to the side plank with your elbow on the floor and try to hold for 15 to 30 seconds. A gentle rotational exercise to strengthen the obliques and core is also good. You can do this by taking a light resistance therapy band
            and slowly rotating your torso with your arms extended around abdominal level while you hold the band. Look straight ahead at your hands as you rotate– don’t rotate your head further than your abdomen.

            I also strongly recommend a topical painkiller, especially if you are tired of taking anti-inflammatories or painkillers. I still take these sparingly, but they are hard on my digestive system. I got a combination lidoderm/ketoprofuen cream from my doctor. You have to go to a “compounding pharmacy” to fill the prescription. It is very effective for 4 to 5 hours at a time.

            Last, remind yourself not to be discouraged. This is psychologically a difficult injury in that most of us on this forum are very active, and this type of injury is slow to heal and persistent. It can be depressing, and I found that finding substitutes (however lame they seem) are important. Just getting on the treadmill has helped me, as has yoga. I feel a lot better since I just accepted that it may take many more weeks to improve; and the grand scheme of things however, it is a temporary setback. So, be patient and keep your head up!

  14. I want to thank you and everyone for the posts about this.
    I was injured in Nov. 20th, 2012 today is Feb. 15th 2013
    I too and a group fitness instructor and personal trainer. The stress from this injury has been intense nausea, lack of sleep (it is 4:44A as I type this), and recently my right, bottom eye lid is twitching like crazy (from stress I assume).
    I have not lifted weights since the injury occurred, but I am now teaching Spinning and PiYo classes. Causing me severe pain, but mentally it is quite rewarding for those 60 Minutes.
    I have searched the web for months and it provides some relief to know there is a diagnosis. I have been to several doctors and they want to hand me pain killers with no diagnosis. They have no idea what is wrong,
    Just yesterday I picked up a bag of potatoes at the grocery store, how I now regret this.
    I do hope that everyone continues to post their progress as YOU ARE ALL CORRECT. This is a mental challenge for sure. I have never felt so helpless and hopeless before. I have fought through pain my entire life and shrugged it off. This one is really getting to my head and knowing I am not alone in this process does provide a sense of relief.
    I hope to read in the near future that someone is 100% healed.

    • I posted a while back about my progress so i thought I’d pop in and let you all know.
      It’s been 5 months (wow!) since my initial injury, so 4.5 months since my second. I am now nearly able to press/lift as much weight as I could prior to the strains. Laying on my back is not uncomfortable nor is my side or belly. However I do find the day after I’ve done any chest work I’m a bit tender. Push ups of all things seem to be worst as I am quite weak in the core. But I can swim fine again, and the dull ache I get from jumping in the cold water is out weighed by the stabbing ache I get in my ankle (yeah I rolled
      My ankle 6 weeks after my
      Strains…. Doh)
      Still yet to try Abdo specific exercises as I have 2 hernias on my right (strains on left) so am not sure what the impact of that would be. I got off ‘lightly’ with a 1stgrade injury, and it’s taken this long.
      Hope every one is well!

      • I hear you about the pushups Jen. My chiro advised me not to do them at first. Then, as I started to heal, we did protraction/retraction before full on pushups. The intercostals are involved in stabilization of your core and you can easily over do it if you start too soon!
        Sorry to hear about the ankle roll. Seems like when it rains, it pours.
        Check back in and let us know how it’s going. (and check out this past Wednesday’s post on the Graston Technique; it’s what my chiropractor used to start me on the road to recovery)

    • Monica, I am so, so sorry…. I totally understand. Ultimatley, the only ting that worked for me was to rest it. Also, I wore a chest/ab wrap under my shirt.

      Try resting it for 6 weeks if you can take the time off from work. Also, check with your doctor about getting a topical pain med, like ketoprofen/lidocaine compound.

      • Thanks Rob, I am going to make an appointment and try to obtain some!
        As for rest: I am injured in the back right, how do you find rest ?.
        The most comfortable position is for me to stand. Laying down, causes intense pain.

        LADIES: My injury in the back is right on the bra line.. Any suggestions, wearing any type of bra is painful.. If a thick blanket is laying on my right side, it gets quite intense.

        Thanks for the help. I hope this topical will give me some relief!! Now to try and get into the DR office.

    • Monica, I’m echoing Rob’s sentiments here. You need total rest to heal a severe intercostal strain. I did teach while I was recovering, but in the beginning, I coached and had my front row demo the moves. Clients had to pick up their own weights in the gym. Better to rest now that delay your recovery!
      Check out this week’s post on the Graston Technique. That’s the therapy I used to start the healing process.

  15. Tamara first I just want to say thank you for creating this blog. I have been searching high and low for information regarding the recovery period and could hardly find anything until I found your blog. I am glad to hear that I am not some freak of nature with intercostal muscles that wont heal. I initially injured my right side during dumbbell pullovers. It seemed to be getting gradually better after the first couple of weeks. However I never completely stopped working out, so I kept aggravating it. I have found that mine get particularly sore the next day especially after chest workouts,. I have also noticed that I can go though a full workout without much discomfort, only to initially start feeling it the next few hours and really feel tender the next couple of days. Hope everyone is feeling better and if you aren’t, hang in there you soon will.

    • Eric,
      Thanks for your kind comments.
      When I first wrote this post, I too was frustrated at the lack of information on the web. And I was a little freaked out to read that some people took up to a year to heal!

      Like you, I found that chest work also aggravated my injury. Anything that leads to thoracic expansion (including pullovers, chest presses, flys and pushups) will stretch the muscles of the rib cage. While it’s important to strengthen them, they will need time to heal, so go SLOW!

      Are you icing and using Ibuprofen after your workouts? I found that to really help reduce inflammation and tenderness.

      Make sure you come back and let us know how your recovery is going!

  16. Hey, I found your blog because a friend told me to look up intercostal muscle strain, and I wanted to THANK you for posting about this. I had the same pain come up in October of last year, and ended up having a SEVERE muscle spasm right at the end of the month (October). I went to the doc and they CT scanned me and ultrasounded me to make sure it wasn’t my kidney/liver/gallbladder/pancreas/etc., and the best they could come up with was muscle strain or costochondritis (not sure if I spelled that right).

    Your posts describe my symptoms exactly! While the pain with breathing/sneezing/coughing has subsided, I’m still tender to the touch in a specific spot on that side and certain movements still cause it to hurt. And I’m at 4.5 months. I’ve been really discouraged that it won’t go away ever again and it’s something I’m just going to have to live with.
    Melanie recently posted…Fat Tuesday and the Beginning of LentMy Profile

    • Melanie, so sorry that you’re going through this, but glad that you found this page and discussion. Many others have also reported that they were not completely healed until sometime between the 6th and 12th month post injury! Incredible! I think it’s because we use our intercostals constantly; unlike other muscles, which we can tape and refrain from using, the intercostals assist in breathing!

      Have you been to see a chiropractor? My chiro used something called the Graston Technique (I’ve written a post on this blog about it; search the term in my search bar). It helped me tremendously! That and adding some stretching and strengthening in once my body was able to.

      Please check back in and let us know how you’re doing?


  17. Thanks so much, Tamara, for your valuable information on your site. =============I strained all my ribs ROWING in the gym. Over a period of three months, I gradually upped my count to 150 rows. I felt ZERO pain or discomfort=========Then I woke one day last week (March 2013) to heavy pressure under my ribcage and thought it could be heart.======My husband rushed me to the emergency room . They sent me to a cardio guy. He said my EKG looked ok but is studying it — results in a few days.
    ==========I’m going to try the icing, ibuprofen (already was taking a few) and a topical. Then, we’ll see! The heavy pressure comes and goes === especially heavy when lying on my back.

    Thank you so much for your terrific site!!!


  18. I’m going on week 6 and im still feeling discomfort in my rib. I strained my right intercostal muscle in the gym and its really fustrating. I haven’t hit the gym or done any sports since the injury. I might try to bike but im worried i will strain it again and have the exact same the pain i had in day 1 which was brutal!.

  19. Craig Hassler says:

    For what it’s worth and very unscientific, I’ve been doing self-massage using hand from opposite side to run fingers along ribs while focusing on breathing as deep as possible just to where I feel pain. As a NC Licensed massage therapist from 2006 to 2011, I leraned that muscle spasms are often considered what’s called a negative feedback loop. In this case intercostal pain makes breathing difficult so our breath is more shallow thus less oxygen to the lungs and in blood so intercostal get less oxygen and get tighter. What self-massage does, at a pressure that is not painful, is increases the flow of blood to those muscles that are in spasm. Focusing on breathing as deeply as possible helps to increase oxygen to the blood so that massage delivers more oxygen to affected muscles. In also try to have a snack, like a home-made chocolate chip cookie. Also I find that a shot or two of rum also helps relax the muscles.

    • Craig,
      My chiropractor did exactly that with me, as well as performing the Graston technique. Did you see the post I wrote on GT?
      P.S. It took me about 4 months to be able to get back to my regular workouts and at 9 months, I can still feel twinges when I over-do it in the gym. Rotational work in particular. Hang in there!

  20. Craig Hassler says:

    Thanks for your response. I did read your early comments. Just thought I’d share what I was doing to heal mine to reaffirm you and your technique. Amazing how many other responses at other places I checked seemed to be trying to sell a solution that others could “buy” with money.

    My intercostal spasms started this past Sunday night, April 14th, 2013. Already by early Wednesday, I’m feeling much better but thankful for the wake up call from my body about being more mindful of how I’m treating it. I’d kayaked quite a bit the two days

    • Craig Hassler says:

      The two days previously plus a portage across a sand bar. We’re developing a kayak eco tour business where folks would come and stay with us at our place, the Oystercatcher, and learn simple techniques based on what we’re doing to create edible landscapes around the house, catch and use rainwater, etc plus visit fun, historical and environmental sites of interest here via kayak.

      • Craig Hassler says:

        I’m also gradually doing some slow and simple yoga moves to help the healing.

        Thanks again for your awesome advice and posts.

        Best wishes to you.

  21. Hi Tamara. Thanks for posting this.

    Avid cyclist here. I felt strange pains in my abdominal area and after a bunch of medical tests, the doctor stated it’s probably just a strain. Well it has been six months since my initial symptoms and I’m still dealing with this. While overall it has improved, it’s still bothering me in the rectus abdominus area (upper abs). I haven’t been able to train much at all without these symptoms getting worse. It’s a very frustrating injury and I understand what you and others are experiencing. I’m hoping that I find some magical exercise or cure to help out, but it seems nothing but rest helps. You’re right, it’s nearly impossible to rest this area completely.

  22. Update:
    It has been two years and I still get a “stitch” sometimes. If you actually tore the intercostal significantly, you have scar tissue that will seperate if you overwork it. Tamara probably did a lot to help herself by having her chiro break up that tissue before it could form.

    I do rock climg around the injury. I can do chest work in the gym very carefully, but DO NOT do deep presses. This flexes your rib cage out and pits enormous stress on the intercostal area.

    For back exercises, try mot to flex your rib cage out when doing pull downs for example. Seated rows are way less problematic, as are dumbell rows.

    In short, try to avoid flexing your rib cage out as you would in a deep press. I also STRONGLY recommend an elestic ab/lower back wrap. It will help hold your rib cage down/in place. I got one at the pharmacy and it has helped a lot.

    Ultimately, you MUST rest it before you start working out again. My PT person is verybagressive, and this only aggravated it. REST IT even if it takes six months.

  23. Enjoyed reading this blog and the comments: I’ve had what appears to be an intercostal strain which came on progressively, like a painful ninja, after 4 years of more or less incident-free training in martial arts. One year later and I’m still extremely limited in what I can do – I work at a desk, which makes it hard to stay loose – and though I’m just starting to push into exercise again (I’ve taken up swimming, but I’m thinking the flare-ups after might not be worth it) it’s extremely frustrating to work at a fraction of the level I used to and end up having to sit out for a few days while pain settles. In retrospect, I did try to rest it completely for longer than I perhaps should have, and now it seems like my entire ribcage area has tightened up and other things are starting to compensate. It’s the frustration and the ease of re-injury: the ‘not knowing’ if you’ll ever get back from it, that bugs me the most. Rant over πŸ™‚

  24. Jo Anna says:

    Hi Tamara,

    A million thanks to you for this informative website. NOW I know what my problem…make that …situation (I want to be more optimistic : )
    I just could not explain my pain/location adequately till I happened upon your blog. Now I know what to do. Mine isn’t bad….more discomfort than actual pain. Will not stop the torso twists w/medicine ball. Now I can add icing my rib area to my hips as well….am nursing a labrum tear….this is NOT what 56 is supposed to look like… me anyway. Have “played” all my adult life regularly….biking, inline skating, running (stopped 12 yrs ago when my knees told me to) and thought that would stave off stuff. But you can’t fight anatomy (hip bone spurs and slight bone overhang). Now that I know what my pain is from I don’t have to mention it to my sports orthopaedic doc (don’t wish to sound like I’m falling apart).

    So, Tamara, thanks again for you info and concern. You have made a difference, my dear!!

    • Thanks Jo Anna!
      You sound like somebody with an incredibly positive attitude; I truly believe that attitude plays a huge role in recovery from injury!
      Happy to hear that you listen to your body and seem to be healing well.

      Please come back and chat again! ~ Tamara

  25. I have read through every post, and am feeling better about my situation. As, I picked my 3 year old out of the bath and twisted to get him out, I had a terrible shooting pain through my chest. That was a year ago. Two months after this incident, I was having frequent aching in my chest, and sharp pain with noise when I sneezed. My GP did an EKG and noted that is was muscular/skeletal, and game me an anti inflammatory. It helped, but the achiness came back. I started going to a chiropractor and massage therapist team, but didn’t feel progress. They did tell me that they thought it was my intercostal muscles. I am craving a way to strengthen the area. I am now pregnant and really worried about the issue. My mom just said something to me recently about intercostal neuralgia, and now I’m really stressed!

  26. Hello, thanks for your post! I hurt what appears to be my right intercostal over a month ago and I have not yet recovered. Chiropractor thought it was a rib, but I guess symptoms are similar. Some days are great and I get optimistic, but then the next time I’m in excruciating pain again, like right now. Ultimately your advice is to take it easy on everything? I haven’t gone to the gym as I’d like in over a month and its killing me.

    thanks! Martin

    • Martin, I head what you’re saying (and in fact, am recovering myself from another injury right now!). The best advice I can give is to listen to your body. If it needs rest, rest it. If you can do some light activity without pain and without triggering re-injury, do it. Slow and steady is always the best way to recover. Can you find some other form of activity that you CAN do?

    • Martin, I hear what you’re saying (and in fact, am recovering myself from another injury right now!). The best advice I can give is to listen to your body. If it needs rest, rest it. If you can do some light activity without pain and without triggering re-injury, do it. Slow and steady is always the best way to recover. Can you find some other form of activity that you CAN do?

      • Rest and time is the only thing for the intercostal-that is my experience. Don’t be tempted to rush it Martin. It is very difficult to not work out when you feel like you are losing tone and fitness, but I would wait at least 4 weeks after your symptoms disappear before resuming activity.

  27. Hi,

    I just have quick question. I hurt an intercostal muscle about 2 weeks ago doing a tug of war. Since then I have rested and been to see the doctor worried it was something worse than a tear. The doctor checked me out and reassured me it was a severe strain and nothing else, and that rest was all that I could now do to allow it to heal. However the last day has been incredibly painful, any movement, no matter how small seems to send the muscle into a spasm. It is excruciating. I was just wondering if anyone else experienced this? I’m hoping this is a sign of it healing but that it is healing tight and thus when I move it stretches and spasms… Reckon my theory is right? I certainly hope it is and that it isn’t getting worse.

    • Colm, when I strained my intercostal, I was in pain and could only perform very limited movements for the first 4 or 5 weeks. Although it got better over time, I found it very easy to re-injure. I visited a chiropractor right from the start and believe that the range of motion work and Graston technique he performed were the reasons I healed as well as I did. It’s now been a little over a year and I rarely experience any ‘tweaks’ in that area.

      I encourage you to see a specialist, other than your doctor. You don’t want scar tissue to develop; it will impede your recovery. ~ Tamara

      • Luke Martin (@lukemartinvoxel) says:

        I tore mine about two years ago on the left side and still struggle with tenderness in that area. It took three doctors and a visit to A&E to figure out what the pain was (three days and nights of hell and worry) before a thorough examination identified what I’d done – I then connected it with a ‘disagreement’ I’d had with some 30Kg dumbbells a few days before. I was put on the maximum legal UK dosage of Tramadol to kill the pain and missed a week of work. Even today, two days after going to the gym, it’s sore and tender around there and usually is first thing on a morning. Probably doesn’t help that I always sleep on that side due to reflux! Hey ho. I assume that’s what the tenderness is anyway – makes sense, I suppose, especially after reading this!

        • Have you tried Graston technique to break up the scar tissue? I found it quite beneficial!

  28. Sara Doelger says:

    I’m very happy to have found this post. I was beginning to think I was alone with seemingly incurable back pain related to an intercostal injury, considering that how no doctors/specialists seem to be able to fix my problem or are even very knowledgeable about it. I injured my left intercostals 2.5 years ago due to a bad coughing spell while 7 months pregnant. At the time it was terribly painful and took over a month to heal. Immediately after having my first daughter, I β€œthrew out my back” – i.e. starting having awful muscle spasms in my mid left back – just from nursing and carrying a 7 lb baby. After a few weeks the pain got better, but then my back became very susceptible to injury and everyday activities such as carrying a purse, holding a baby, grocery shopping etc. would set it off, often in painful spasms causing me to have to lie down. I used to be very physically active and I had to limit my exercise to just walking, and I would wear a brace when I had to go out for a while with my daughter. The pain seemed to go away while I was pregnant with my second daughter, but after her birth this past March it immediately returned. I feel like I have tried everything- sports medicine doctors, Xrays and MRIs, physical therapy, chiropractic, acupuncture, massage. Graston definitely helped a bit after my first episode 2 years ago, but then I just hit a plateau with my recovery. In the past 5 months, I have taken a posture course which has helped a bit by teaching me to use my abdominal muscles and how to bend/sit/stand correctly. And recently I discovered trigger points and myofascial release, which I think describes my underlying issue. I believe that the restrictions in my left rib cage following the injury caused the rest of my muscles to get out of balance and overcompensate, and now those are tight/stretched as well. I am doing massage/myofascial release/physical therapy several times a week, but no real improvement so far. The only difference is that the pain is now mostly above my left hipbone in my back (QL area), rather than the mid back where it used to be. It seems impossible to find someone who really understands the whole picture and knows how to fix it, so I’m been trying to direct my treatments with my limited knowledge. I would love any suggestions for a strategy/approach, as I’m starting to feel a little hopeless about all this and it’s very frustrating. I would also like to know if anyone has had an issue persist for this long. Thanks!

    • Sara, you’re the first person I’ve heard from that has suffered from this injury for such a long time. Many of us report that it takes 6 to 12 months to be back to ‘normal’. Sounds like you’ve been re-injuring it over and over again.

      Does anybody else in this forum have experience with this length of duration?

  29. Hi Tamara,

    Hope that you have recovered well from your injury and going back to do what you love. I suspect I might have injured my intercostal muscles as well but the pain centred around the sternum area. It been 10 weeks since my injuries and it still hurt and as I am a parkour practitioner, it really affected me a lot . I think I re injure it this week again after going to the gym. I would like to know how long did it took for you to heal totally? Thanks πŸ˜€

    • Hi Edwin,
      So sorry to hear that you’ve experienced this injury. People who haven’t, don’t get how frustrating it is to heal.
      To be honest, I didn’t consider myself ‘fully recovered’ until about 8 months post injury. Probably because I was teaching and training clients and unable to let it completely heal. Most others report a similar time to lack of noticeable pain. And I know that even now, 16 months later, there are certain movements that trigger the old ‘twinge’ and force me to slow down and back off. Have you been to see a PT or chiropractor? Graston technique was what saved me. It broke up the adhesions and created more blood flow to the area to help healing take place. Let me know what happens. ~ Tamara

  30. not sure how to comment on here

    • ok I figured it out……I have been having a rough time with the same symptoms and seeing a chiropractor who is doing the same techniques you have mentioned. The picture of your bruising looks like mine. I was not sure if I had Costiochondritis since I have fibromyalgia but it seems more like a intercostal muscle sprain and it is going on 2 months. It is amazing how many people responded about your injury and thank you for posting it, it has given me some sense of hope. My whole back seemed to have locked up after the initial spasms started and nothing else was helping. That’s what sent me to the chiropractor after the family doctor and a PT this time it was more involved than sprains I had in the past.

      • Carol, so glad you found this post and the comments thread useful! It’s really an infuriating injury. Are you finding Graston to be helpful?

        • My Chiro is doing electro stim before treatment, then rubbing out the muscles by hand not the way the Graston Technique is described with the tools. Then the adjustment and having me do my stretches at home, watch posture, watch the side bending and anything that may have set all this off. The Myofascial therapist I used in the past this time was not able to loosen up those knotted areas but my Chiro rough as it felt by hand slowly loosened it. Its funny cause my side looked like your picture same side too. I was in spasms for over a month and that was the worst pain I have experienced and I have experienced a lot. After the first visit with the Chiro the side did not spasm but it was still trying to. I have had about close to 15 visits so far and thank God am heading in the right path. 3x week for 2 weeks, then 2x and should be going to 1. I am still using muscle relaxers, moist heat, pain meds which I’m on anyway and naproxyn but now went to Mobic. I do lots of self help at home. Sleeping was the worst too moving the rib area in bed. I use Biofreeze and hot showers but the physical loosening of the knotted areas and icing it after the treatment very important (learned that the hard way-set the spasm off bad for a day cause I didn’t do my stuff at home after the treatment. Sorry so long but happy to be getting relief. Is the Graston only done with tolls or by hand?

  31. Hey Tamara,

    Happened to stumble upon your site while searching for recovery timetables for this injury. It’s been a little over 4 weeks since i sustained my injury and its still as painful to breathe, sleep, and move as it was when i first injured myself. I’ve been weight training for the past 4 years and this is my first real injury that i have to overcome. The fire is still there to get back in the gym, but i just dont see light at the end of the tunnel with this injury after a month of healing. I know that health should be first and foremost above anything else. But, the inability to continue to train for what i have worked for in the past 4 years is really putting me down.

    The funny thing with this injury is that some days you can feel yourself getting a little better and then the following days after the pain comes back just as intense as when you first injured it. Anyways, good luck with your recovery and your determination is very inspiring!

    • Rick, so sorry to hear that you’ve experience this injury too. I do remember it being hard to sleep. Have you tried taking and pain meds at night? I found Tylenol and Aleve to be helpful.
      Chances are that it’s going to take you more than a month to get back to normal. I would say that at 8 months, I was back to about 90%. But it wasn’t linear. Good days and bad days, as you said.

      Please come back and let me know how you’re recovery is going. Have you tried physio or chiropractic? ~ Tamara

  32. I’m an aerialist and have torn my intercostals at least 6-7 times over the past two years. I’ve also torn the cartilage in that region, which was completely debilitating. The tears just keep happening now and I’ve become so stiff that I recently did it again by shifting to look at my cat while sitting on the couch.

    My biggest mistake was being unable to stop working and allowing the injuries the time to heal. I’m still battling it so I try to tell anyone who is experiencing this exactly what you say here: Don’t rush it and be patient. This condition can become chronic and is nothing anyone should have to live with, especially when it limits doing the things you love. I definitely have an extreme case, but working on it got me here. I’m kind of at a crossroads at this point, because it’s the aerial work that is causing it and I can’t bring myself to give it up for good. I’m forced to take almost a year off due to something else, so now I hope that this time will allow it to finally heal.

  33. Both glad and saddened to find this page. I did not know we had intercosal muscles till this past weekend. I was a little sore but did not think much of it. I went out rock climbing then splitting some wood in the back yard with a 10# Maul. Since I have been unable to lay down as the pain shoots through my body. I’ve been creative on the couch sleeping sitting up but that is not real sleep. One thing I found odd is the pain started on the right then was over shadowed by pain on the left a few days later. I want to get back into the gym and climb but afraid I would be unable to walk back out if I tried.

    Few years back I crashed on the bike landing square on my face needing many stitches and the skin glued back down. Nearly ripped my lower lip clean off. My daughter called me frankenstein for a few months after. What is odd is the pain from the intercostal muscles is worse.

  34. I am glad to have stumbled on your intercostal posts! I strained mine during a coughing fit while doing yoga, and the best I can think is that I exascerbated things by not coming out of my already expanded position properly. It’s only been 2 weeks, so I’m significantly sore. Driving and walking bother them, as does lying down. Morning is the worst, as I’m stiff as hell, then things ease up through the day and get a bit more doer at night again. Rolling over in bed was waking me up… But not as much now (I think I’m learning how to lift and roll hips first in my sleep). Can’t take NSAIDs because of stomach inflammation.

    After reading this post and comments, I’m trying ice and voltaren. Going to make an appointment for physio too even though the doc said there wasn’t much they can do.

    Thanks for this post. Sucks that it’s going to be a long haul, but good to know that’s what to expect and that my case is probably relatively minor.

  35. Tamara, I’m a 53 yr old male .I believe I’ve got the intercostal muscle strain. I drive tractor trailer and know I hurt it by cranking down and up the supports that hold up the trailer. Been over 6 months and no relief. Muscle spasms can be extremely painful starting under my right rib.Still working on the job wit h it. Will it ever end? I’m at a chiropractor for old injurys from 2 herniated discs. Every week. Can this last indefinately?

  36. Hi Tamara,

    I’m also dealing with an intercostal muscle strain, about two weeks so far. I’m wondering what types of exercise you tried as your recovery progressed? I’ve been using the upright bicycle and slow walking on the treadmill. Weight lifting definitely causes pain.

  37. Hi i think gym has caused my muscle strains for 4months in bed and now im seeing a physiciatric clinic where im given a muscle relaxer to help me sleep but my ques ion is am i suposed to go back to gym agen wil it help me im using hotwater bottle to relieve my pain

  38. Yes 6months have gone by and im still in pain i started back at the gym dont want to over do it and get into dat pain agen so is it wise to continue at the gym or should i stop coz i dont know wat to expect and how or what do i take for the pain plz help

    • Depending upon your initial fitness level cut back to around 20% and start building back up slowly from there. Any pain I’d stop immediately. If you don’t feel any pain then step it up a little at a time.

      • Just seeing this now. Andrew, you’re right, pay attention to pain. Better in the long run to extend the recovery phase and heal completely…

    • Ash, are you seeing any professionals? Chiropractor, physiotherapist? I think that’s your best course of action. Pain killers are only a bandaid solution. You want to heal!

  39. ohhh noo long recovery!!
    Last year I pulled it for doing extreme training and was like 2 months with pain
    15 days ago I got an awful injury in my ribs πŸ™ they are now a bit chipped. Breathing, coughing, sneezing, speaking loud was just impossible with a loooot of crying included.
    I can’t just be sitting and waiting to get better so I decided to resume training, only doing things that didn’t seem to hurt too much my ribs. Yesterday I felt how the muscle on the ribs pulled !! because of the injury in the ribs, everything was already swollen and in pain apparently the other parts were also under stress so I’m now worse than when I chipped my ribs !
    I don’t know what else to take apart from ibuprofen and non steroidal anti-inflammatory pills
    just want to cry all day long

  40. Hello Tamara, first, I want to say what a relief it was finding your blog, a ton of weight lifted off of me as I could not find answers anywhere to stop my worries. After changing a sump pump in a very uncomfortable position as the area was very tight to work in, I developed a pain on the right side of my back around the lower rib cage the next day. This was different for me because although I am very active and carry and lift very heavy things, this never happened to me before. About a month passed as the pain really did not go away, I went to the hospital and was taken x-rays and told I most likely had a pulled muscle. I took prednisone which is an anti inflammatory drug (I have for my asthma and I did tell the my doctor, prescription of muscle relaxants I took later does not do anything) and it was like magic, I felt no pain at all when I did take prednisone, which I rarely do anyway since I know it is not a good drug for a long term for many reasons. Well foolish me, yesterday I changed a 5 gallon water container for a water dispenser because I was free of pain at the time and about half an hour later, I felt the same pain as when the injury first happened. It’s now been about two months after the injury, I was not getting better since I was told that it would take 4-6 weeks to heal and to come back for more detailed tests if it did not go away, I started to think that it could be something else and started searching the internet, what I found only made me worry more and got me depressed, as it could be an organ failure, kidney stones, cancers and other diseases. Well this blog cleared up my worries, I see that a lot of people here had similar symptoms and did not heal for a very long time. What I’d like to know is, what kind of exercises I could do to speed up the healing process, I am not a fan of doctors, many times my issues became worse because of their treatments, even ending up in the ICU. Very happy I found your blog, thanks.

  41. So glad to have found your story. After resesrching, I believe this is exactly what I have in my mid to upper right side of my back. πŸ™
    My biggest concern? Not working out for 4 to 6 weeks!! It’s not my “job” like you, but it kills me as I’m on a great path in my fitness journey. I was thrilled to read from you what I was thinking, “my muscles are shrinking and my belly is expanding.” *sob*
    I’m watching your journey and starting mine. Thanks for the proverbial light at the end of the tunnel.

    • Sally, so sorry to hear that you’ve strained your intercostals. The good news is, if you give yourself time to heal and resist the urge to rush it, you’ll be better off in the long run. Just keep an eye on your nutrition while you’re being less active. Of course, if you’re in peri-menopause, the belly thing might not have anything to do with your intercostals πŸ˜‰

      • Slow & steady. Got it. Taking it easy and walking. I’m not peri-menopausal, but I do have PCOS. Makes it incredibly difficult to lose belly. It’s weird to see my tight arms, legs and glutes, and then my belly. :/
        It was shrinking though, until this. Tightening up the diet while I am not working out! I play basketball 2x/week in addition to weights & I’ll really miss it!

  42. Maggie M. says:

    Hi Tamara,

    After scouring the internet for info, i came across your blog – a great resource and reality check for realistic recovery times. I am also dealing with an intercostal muscle strain – going on 3 months now. the injury gets better very, very slowly as you say, but i’m certainly not out of the woods yet.

    My injury occurred in early March after doing a supposedly benign and very simple “release” on a foam roller under the advisement of my pilates instructor. how, i so regret that now.

    Well, it didn’t work out too well for me. i did a few sets at home and woke up 2 days later with a super tight chest and right side ribcage, sternum and upper abdominal pain. it affected breathing, eating, sleeping and overall functioning. this type of pain and immobility was nothing that i had experienced before. On top of that, i was in the midst of waiting for knee surgery, so now i had a huge double whammy to cope with and an already declining fitness level over the past 6-7 months due to my injured knee. the knee seems easy in some respects.

    Fast forward to post knee surgery in early May (still rehabbing) and found that the crutches rubbing my ribcage set off the same pain pattern once again. Doctors haven’t really been a help, and not a great resource for what to do, other than telling me i have a chest wall sprain and to wait and take painkillers. Clearly, waiting and patience is the general theme here in order for the muscles to heal. I see a great PT, but we’re prioritizing the knee now. As someone said in an earlier post, “this is a mental challenge for sure”.

  43. Pablo Muller says:

    Hi Tamara,

    Your blog entry has been something of great help, because it helps me self diagnose. According to doctors I have nothing significant. It’s not significant in the sense that you can keep on living, but it certainly affects you and I fully relate to what you described. I am amazed on how many people responded to your entry and apparently none of us gets a satisfying answer from physicians. Maybe you should write an ebook about it, with info, diagrams and exercises. You might be into something. This and your other entries have been inspiring to me, especially because what you describe immediately resonates with my case. I have had this nuisance for 2 years now.

    On another note, I started doing foot massage and found one particular muscle that was strained/painful. And I also noticed that as I walked I was clearly using my strained foot in a different fashion (my step had hyperpronation). Coincidentally it was the last interosseous muscle of the right foot, and my intercostal muscle that hurts is the last intercostal also of the right side. Have you heard before how a part from your feet is related to a part of your whole body? Well, I started treating my right foot with ice and cross friction massage, and somehow my intercostal rib muscle has been alleviated. Maybe it’s just a funny coincidence, but knowing how one is desperate when nobody seems to know about what affects you, I thought mentioning this. If anybody out there would inspect how their feet are doing, and if they found some funny asymmetry, I would love to have some feedback. In my case it rings a bell, because close before I strained my rib muscle, I had a tendinitis on my right leg, which presumably led to me changed the way i stepped on my right foot and so on.

    All the best and good luck to everyone that has posted comments. I read all your messages and I could identify with the frustration immediately.


  44. Hi Tamara,
    Last summer I strained the intercostal muscle on the upper left part of my rib cage, just about under my armpit area. It happened at work and was diagnosed by a worker’s comp doctor. I participated in physical therapy for three-four weeks and the injury healed. In early May, the same area started hurting again but it was minor and resolved itself without any further treatment. Two weeks ago, I strained the intercostal muscle on the OTHER side in the same spot while tubing on a lake (at least it was awesome…). I thought the first one was bad but this one is excruciating. It is hard for me to even drive a car (and I probably shouldn’t be). I am waking up in my sleep every time I change positions. I remember some of the exercises from physical therapy (but not many) and I have been trying to do them in addition to ice and rest (even thought rest is impossible). Unfortunately, I am allergic to Advil, Aspirin and Aleve and Tylenol does nothing for this injury. I am thinking it is about time I see a doctor (what specialty?) but I wanted to see if you had any advice as well. I cannot even imagine going through the healing process for this AGAIN. Thanks a ton!

    • Bryn, I’d suggest you see a physiotherapist or chiropractor rather than a GP. They tend to know much more about soft tissue damage and will prescribe exercises and stretches (rather than meds) to help you heal the injury. Ask about the use of KT tape, Graston Technique or ART (all therapies that are reported to help intercostal strain). Best wishes. Please come back and let me know how it’s going? Tamara

  45. If you google rraf and my name the photos of of the vehicle accident April 2012 should pop up. I had injured my lower ribs left side (an inch area?) in a car accident 35 years before this one. But this motor accident still gives me issues 2 1/2 years out. Major intercostal trauma. It began with ribs spasming and moving for a year. Before an episode I was one pant size. Afterwards another. I got used to a several hour time frame of feeling crappy but not emergency room sick. Just waited for the torso to do its thing and grew to realize I wasn’t dying. Now it has localized to mainly floating rib area but it starts above belly button and flares out in a v over chest. The lightning bolt pain feeling. But just pure tenseness around the entire torso a lot. Seatbelt spot above breast is secondary. I have a masseuse/napropath that Rolfe’s, takes care of acupressure points and spinal/hip adjustments (including IT bands) and is a godsend. I also believe in b12 sublingual. Due to a Liz Franc foot injury from the accident as well only normal walking is allowed due to balance issues. So exercise limited. Any input appreciated. Nice to know this isn’t just a me issue.

  46. Glad I’m not alone. I injured my intercostal muscle A year and a half ago. The intense pain lessened after a few weeks and I was able to resume exercise but not without painful consequences. I have also had two long periods (about two months) of not working out but everyday activities and sleeping or even sitting the wrong way have always aggravated the injury. I was at the doctor a few weeks ago for a regular check up and mentioned this pain to her ( new doc as I moved a year ago). I explained the injury, when I happened and that it still causes pain. She basically said there’s nothing you can do except take and anti-inflammatory.
    It doesn’t seem like it’s ever going to heal or go away. Any suggestions ?

    • Chrissy, I’m sorry that you’re experiencing this. It’s a nasty strain and can take considerable time to completely heal from. There are several other posts linked at the bottom of this one that talk about using Graston technique (done by a chiropractor) to help with the healing, as well as some stretches and strengths you can do to improve things as well. I invite you to take a look and see if there’s something there for you. Tamara

  47. Hi Tamara,

    Thank you for this information. You really should consider writing a book on this topic. Thanks to everyone for sharing.

    My initial injury did not happen with a dramatic injury and/or searing pain. It started months ago, after a six-month period of pretty much inactivity, followed by my going gangbusters getting back in shape and doing lots and lots of activities somewhat carelessly. I just don’t know what the initial strain was–skiing, a strength training class one day where we lifted weights in between doing push-ups, vigorous home Pilates or yoga, high-spirited soccer in the kitchen with my 14-year-old? I remember once breathing really, really hard while X-country skiing. Pushing myself too hard….

    Anyway, the constant rib ache I have now just crept up on me and it won’t go away. (Why I’m online today, looking for some answers before calling a doctor.) At times, it fades. Other times, I feel like I’m having chest pains. Sleeping is a lot of turning from one side to the next trying to get comfy. Lower left rib cage pretty much, but it “moves” around the left side. Sounds intercostal. I didn’t even know that was a word until I stumbled on all this.

    Now I can do something and see if it helps. I know Maggie M. said a foam roller caused her problem and I’m so sorry to hear that. But I’m wondering if a roller could help in some cases? I used one yesterday for the very first time, in an easy Pilates class. It felt like HEAVEN for me, releasing all the back and shoulder muscles that I’ve been clenching in the past few months. However, I will proceed with caution.

  48. Hi Tamara.

    It’s been 8 months now since I sustained my intercostal injury (while doing pull-ups of questionable form), and I’ve since been to see two GP’s, two physical therapists, a chiropractor, and most recently an acupuncturist. What are your thoughts on acupuncture/do you believe it has potential to help the healing? Also, the chiro and acupuncturist both believe I have costochondritis. Do you have any knowledge about this condition and whether it is a chronic condition? I’m a 24 year old guy and the thought of having these inflamed muscles hindering my breathing forever is painful.

    I’m also concerned that the job I’m at is re-aggravating the injury, as I’m standing for 8 hours a day, twisting often, and occasionally lifting heavier objects. Not sure what to do about that.

    Any help is greatly appreciated. Thanks for being there for all these people!

  49. Hi, I was diagnosed with intercostal muscle strain…first started in August after severe coughing…over 4 months later still in pain which is there 90 % of the time….had chest xrays and abdominal ultrasound, all fine, been to physio….but doctor says physio is a waste of money/time as it wont help with this, says just to do stretching excersises….but this is just getting me down as there is no improvement in sight….and as the mind gets carried away at 3am in the morning when the pain is severe, thinking it must be something more sinister….any help on some exercises would be much appreciated, or anything to get some permanent relief for this condition….thank you in advance

  50. Tamara,
    This communication stream has been sooo helpful. Mid November I fell – no crashed – on to a boat edge during a sailing trip and landed on my lower left side. Crushing pain, but everyone said it was a rib especially if I couldn’t breathe without pain. I had no problem breathing, no bruising and it would get better until we had an all day land tour in a rickety van, with hairpin turns. That next day I could barely move and the flight home was excruciating. Had to cancel my first mini-tri. Now it has been 8 Weeks. Gardening, vacuuming with the opposite hand, hanging Christmas lights, driving long distances kill it. Jumping, walking, seems to be okay but I am desperate to get back to my training. I will try to get into a physiotherapist and get some message going, but like others don’t want to be just medicated.
    After all this time is icing the area still affective? And if I feel a not is that the scar tissue? Obviously I haven’t been to the doctor yet, but sounds like a sports doctor would be best.

    • Hi Rhonda,
      Yes, this thread seems to be popular and has given a lot of people a place to talk about their injuries. Icing is general only effective fairly soon after an injury occurs; it’s primary goal is to reduce immediate inflammation. Sounds like you have some scar tissue built up. That can affect rehab and future range of motion. I saw a chiropractor who performed something called the Graston Technique to break down adhesions and scar tissues. It seems to have worked for me. Give it a try and let me know how things are going? Tamara

  51. shirley tan says:

    Hi Tamara,

    So glad to come across your blog on intercostal imuscle sprain. Mine was due to a gym class and its now 4 weeks.
    It seemed to come and go when you do heavy lifting.

    Practising tai chi and chi kong to help.

    • Shirley, thanks for stopping by. It’s a nasty injury but sounds like you’re doing the right things for you to heal!

    • Hi Tamara,
      So glad my comments and your advise to me is posted. Can you advise whether ice is better than heat in recovery as I applied deep heat and some massage and it seemed to get worse. I will stop doing this but honestly it is very discouraging especially when it seemed to recover so slowly and sometimes it plays you up again.

      I am now in my 5th week and feels like I will have to live with this forever…

      • Generally, ice really only works right after an injury. As it’s healing, heat is advised to bring blood flow into the area and reduce inflammation. It can take some time though. I know five weeks feels like forever, but this can be a long slow injury to heal. I’m sorry you’re experincig so much pain.

  52. So glad I found this thread! I strained the intercostal muscles of my first floating rib a little over 4 weeks ago…and I still can’t do any yoga except for hot yoga! I went to a chiropractor, got massages….Every time I think it’s almost all better, it starts hurting again. Meanwhile, I can’t do yoga sculpt with weights or any core exercises without pain the next day. I’m afraid that I am losing strength by the day! Anyway, this thread brings me some comfort. At least I’m not alone. πŸ™‚

  53. So I feel your pain. It’s been a year and a half since I strained my upper back and intercostal muscles trying to do physical therapy for my lower back. The PT had suggested these exercises using 30 to 40 lbs due to a burning shoulder blade pain. She is professional right? I should have known better. I wasn’t doing these exercises without any weights let alone starting out with 30 or 40. Later that night the pain in the ribs and right under my boob along with searing pain in my mid back near the vertebrae began. I think several things were injured. I got over the mid back pain but still had some rib tenderness. Thought I was better, then while driving home after work I began having muscle spasms in the intercostal muscles and thought it was a heart attack since I couldn’t breathe. Now they are milder but every time I try to plank or do push ups, I get the pain milder again and some tiny spasms. It’s a struggle and I just want it over with. I’ve tried rest, but who can rest forever. On top of that, I have 2 extra malformed vertebrae causing scoliosis and I have to stretch and exercise to try to balance out the muscles on both sides of my spine. I’ve been to numerous Orthopedics and my family doc with no help but to refer me to PT which is what caused it in the first place. I’m going to start easy yoga again. I think muscle has memory…bad memories. I hope you completely heal.

  54. I just had X-rays and an ultrasound as I have been getting stabbed by the same rib intermittently for 18 years. When I was pregnant with my daughter her door was lodged under my lower right rib. Move the wrong way and I get stabbed, and I just run the rib back into place. Crunches are out of the question for me. Finally told Dr about it and she wanted to do X-ray and ultrasound to make sure all the organs are okay. I might preface this to say that my daughter was 9.4 lbs at birth, and I am a very petite woman. I know there is not much I can do about it, I just know which way not to move or lay.

    • Sounds like your Doctor has a plan. I’m all for following the plan of a hands-on health professional. Good luck and come back and let us know how it resolves? ~ Tamara

      • Ultrasound showed nothing wrong with organs near ribs, and I assume xray was fine as well or Dr. would have me in office today or tomorrow. She wants to see me next month. Not much I can do right now except for find exercises that suit this problem. I am going to try pilates (slowly) to see if I can strengthen my core that way.

        • Deirdra, start with static core exercises; planks, hip bridges etc. I was advised not to add rotational work back in until I’d strengthened both anterior and posterior core muscles, as well as my serratus anterior. Good luck!

  55. Hi Tamara!

    It’s been so informative going through your blog! I recently started working out a year after having a baby ( sad I know!) After my workout I was bending over to stretch my calves and had a spasm like sensation right under my right breast! It lasted maybe 5 second and went away quickly when I rubbed at it gently. The next day the exact thing happened after ab crunches. Looking back I realized I did feel a dull achy feeling once in a while in that general area and this has been going on for maybe 2 months. I just attributed it to the ++ belly fat left over from the pregnancy. When I palpate it I do feel a slight bump under my fingertip where it is the most painful when there is a spasm. Does this sound like intercostal sprain? If it does I am confused if I should see a PT or Chiropractor. Thanks so much!

    • Sandra, I’m so glad that these posts and comments have been helpful. While it’s quite possible that you’ve strained your intercostal, I can’t really diagnose it over the internet :-). I’d suggest you start by seeing a PT; they’re more familiar with soft tissue injuries than many chiropractors. Once you have a diagnosis, it’ll be easier to decide which recovery path to take. Good luck! And please come back and let me know how it’s going.

  56. I’ve really “enjoyed” reading this blog. Two years ago I was diagnosed with stage 4 cancer. It had gone to all of my bones, including all my ribs. My back broke due to the cancer. Anyways, long story short, through prayer, supplements, juicing, I am cancer free. Quite exhilarating after being given 3 months to live. In the meantime, because of my injuries and weakness due to a compressed spinal cord, I lost all core strength, shortened hip flexors, etc. Just getting so i could walk up the stairs was amazing. Just recently I started walking a full mile. So 3 weeks ago I was sitting on my bed thinking how hard it was to get my leg up onto the bed. So I decided I’d lean back a little, and the jerk and twist both legs up onto the bed at the same time…dumb, I know. Ouch! Instant big time pain in my lower left rib cage. I felt it more in my back at first, but then in the side and front. I think I’m getting better and then wham. I haven’t seen a doctor or PT because quite frankly I’m terrified to. I know…dumb. At least the spasms have passed. The symptoms are exactly what I’m reading here. Thank you for this blog!

  57. Cathy J says:

    I coughed last winter, December. I fractured a rib. Since then I have had constant pain in my ribs on my left side. So much so I can’t sleep at night. I am uncomfortable every single day. The pain is always there. The doctor says my rib has healed but inflammation of my intercostal muscles are visible. It is now late June and I can’t get the pain to stop. Doctor’s won’t listen to me anymore. They say I am just feeling Ghost pain. I have no idea what that is. I have developed depression from the constant pain and I don’t know what to do.

  58. Hi Tamara,
    I’m a High school track athlete(Please excuse all of my poor grammar and bad spelling, English class is not my fortΓ©). Near the end of my my first season, I was training for the decathlon, and I was learning triple jump for the first time ever. Of corse, if you don’t use the correct form you could injure yourself, and that’s what happened to me. On my second jump in the event, I jumped too high, and landed on one leg preparing for the third leap. Unfortunatly, this cause my back to wrench outwards to the left. Too much downward energy I guess. Immediately I felt a terrible pain through out the entire right side of my back. So my season ended there, no biggy, only missed the decathlon. As the weeks went by, the sharp pain centralized to a smaller area on my back. My neighbor who is a PT diagnosed it as intercostal muscle strain(or)tear which I firmly agee, as every symptom matches everything I have read.
    Now, it’s been close to 11 weeks with absolutely no moderate exercise or anything beyond that(Only walk to the store and such), and I still get sharp pain in my back. It appears to happen come up randomly, sometimes under stressful situations like driving (I got my permit not too long ago). Sometimes, sitting down, or getting out of the car(never getting in the car though), putting my shirt on. A few times I’ve been watching tv on the couch and It hurts(I mean I probably adjusted how I was sitting or something). So basically, I’m frustrated that it still hurts after 11 weeks of doing nothing. The pain now is nothing compared to what it was first like, I’m just wondering how long I may have to deal with it, and should I start exercising?
    Thank you again!
    Sorry for the any poor grammar


  1. […] information about my long slow recovery (and what you might expect as you recover) and the 3 exercises my chiropractor prescribed once my […]

  2. […] since updated this post, sharing the exercises that my chiropractor taught me to help re-strengthen my intercostal muscles and overall core strength (you can find a video […]