5 tips for strength training after an injury | post intercostal muscle strain exercises

When you exercise regularly, being side-lined by an injury sucks.

Not only does it derail you from your fitness goals, it messes with your head. You start to doubt your ability to return to your previous level of fitness, wondering if you’ll ever be back at 100% again.

Some people push too hard, too quickly and end up re-injured. Others give up entirely. There’s a fine line between challenging the injury enough to aid recovery and over-doing it.

As a personal trainer and group fitness instructor, I’ve taught and trained many people recovering from soft tissue injuries. Torn ACL’s, tight IT bands, strained rotator cuffs and impinged shoulders. I’ve also had my fair share of injuries, including a recent (and very painful!) intercostal muscle strain.

My suggestions for strength training after an injury?

  1. Seek professional help immediately. Although many injuries heal on their own (given enough time) others require specific stretching and strengthening exercises to maintain range of motion and minimize further aggravation. In my experience, physiotherapy and chiropractic care are the best places to start.
  2. Follow the advice of your practitioner (you’d be surprised how many people don’t!). Your physiotherapist or chiropractor will give you specific exercises to do. Do them! Don’t stop doing them after a week or a month. Or even when your injury starts to feel better. Build them into your recovery training plan, gradually progressing them as you regain strength.
  3. Don’t expect to perform at the same level you did before for a long time. Turn off that little voice in your brain that constantly compares your current performance to what you used to be able to do. You’ll get there (or close to there) again.
  4. Go slow. Rehab and corrective exercises should not be performed to fatigue. You shouldn’t feel delayed onset muscle soreness the day after you do them like you might after a heavy chest and back day. The goal of rehabilitation is to REHAB the muscle, not build size.
  5. Don’t forget the rest of your body! ACL injured? You can still do pushups, pullups, bicep curls and core work. Biceps tendonitis? Squats and lunges and planks are for you. Work around the injury. Be creative with your workouts. Enlist the help of a personal trainer if you need ideas!

Do I follow my own advice? You bet!

Here are the 3 core exercises I’m doing daily to regain strength after injuring my intercostals:

(This video is part of a YouTube challenge to Vlog Every Day in August [VEDA]. Head on over to my YouTube channel to see what else I’ve been vlogging about!)

Have you ever suffered from an exercise-related injury?

How did you go about strength training afterwards?

Disclaimer: Although I am a BCRPA-certified Personal Trainer, I AM NOT a physiotherapist or chiropractor. The above suggestions are general and likely to apply to a broad range of situations. For recommendations specific to your own injury and rehabilitation, please make an appointment to see a local physiotherapist or chiropractor 🙂

Comments

  1. oh yes!! slow is key. My husband is learning that now with coming back from a knee injury.
    lindsay recently posted…30 minute Thursday: How to Relax?My Profile

    • Slow and steady and knowing the difference between how a muscle feels when it’s working vs how it feels when it’s strained… a very fine line!

  2. glad to see you are on the mend….;)

    • Thanks Tracey! I even made it to 8 am Flow last Saturday. Couldn’t do a few poses, but surprised myself!

  3. As always, you have provided such helpful, sound advice about dealing with injuries! I went through a rough patch with exercise-related injuries between 2008 and 2011. But even when the doctor wouldn’t let me do any regular cardio after breaking a toe, I still found ways to work around it with a hand crank exercise and strength training machines I could sit on that didn’t put weight on my feet. It’s all about ingenuity and perseverance!
    Shira recently posted…Three Tips for Successfully Shifting from Weight Loss into MaintenanceMy Profile

    • Hi Shira,
      Thanks so much for your appreciative comments! Injuries can only slow you down if you let them. You’re right; it’s all about being creative!

  4. Another great post. You can’t rush an injury, that’s for sure. If you do, you just risk reinjury, and then an even greater rehab battle.
    crubin recently posted…Hey, That’s Not Me!My Profile

    • Connie (that’s a joke, fellow readers, referring to Carrie’s recent blog post…),
      Thanks for your kind words! It’s nice to know that somebody thinks I’ve written more than one great post!
      I giggle every time I use the word ‘rehab’ to describe healing muscles; sounds like something hollywood actresses do!

  5. Elizabeth says:

    I sprained my ankle playing football in the midst of training for an 10k run in July, and it is still giving me twinges. I’m back to being able to ride a bike and walk longer distances, but it is hard to convince myself to get out of the house after such a long break (for me). Thank you for your advice! Your blog has been a constant reminder that it is ok to not over-exercise while injured and potentially re-injure myself.

    • Glad to help, Elizabeth.
      July isn’t very long ago (although it feels like forever, right?). Sometimes injuries stick around longer than we’d like. Makes me wish I were 20 again and healed overnight!

  6. All great tips! 3, 4 and 5 especially goo to keep in mind as you (general you) move forward in your training!
    Kierston recently posted…10 Weeks Out: A Pain in the Neck!My Profile

  7. Could not agree more: Do your rehab! Do it some more! Keep doing rehab! I wish both my daughter and husband had taken this to heart post knee surgeries!
    KymberlyFunFit recently posted…Bicep Curls: Wrong & Right WayMy Profile

  8. Such great advice Tamara!!! Yes, the biggest prob is so wanting to be were you were to soon & the re-injuring .. not good! We are so often are worst enemy – we can tell other people but when it comes to ourselves – well, 😉

    I have not had many injuries over my 30+ years – knock on wood! 🙂 I have had a couple & I am so bad at sitting still! If I could do nothing, I did that but I had times when I was able to work around it & that is what I did… find the thngs I could do yet not hurt the injury more.

    Thx Tamara – always great posts!!!
    Jody – Fit at 54 recently posted…Gardein Vegetarian Products & GIVEAWAY!My Profile

  9. Great tips! Love #2 (especially combined with #1 – ask for advice…then follow it). I’ve had numerous injuries over the years. I’ve been pretty smart about returning to exercise slowly (pretty smart :-)). It is the things that keep me from running that drive me crazy.
    Debbie@ Live from La Quinta recently posted…Product Review: ENERGYbitsMy Profile

  10. Sarah -45 says:

    Hi Tamara,
    I have just recently (about a week ago)strained my intercostal muscle on my left side whilst lifting heavy furniture (!) and it’s hurting like anything. Have realised i need to do very little for a while but as a busy mum that’s not easy. Do you recommend any stretching exercises to help things heal? I’ve still got my xmas shopping to do so I can’t be sitting around for too long!

    • So sorry to hear that Sarah. If you have strained your intercostal muscles (and only a chiropractor or physiotherapist can tell you for sure, upon examination 🙂 ), stretching is not what they need. A strain is really extreme over-stretching. They need time to heal and then they need to be strengthened.

      I was told to avoid lifting anything heavier than a gallon of milk for the first few weeks after my injury. Now, after 6 months, I am only just fully recovered, having re-strained it several times in the interim after over-doing it.

      I encourage you to seek professional help and make sure you’re doing the right thing for YOUR body!

      Keep me posted! I’d love to hear how your recovery is going.

  11. Hello Tamara,
    I just had a health visit and turns out I have strained my intercostal muscles on my right side. I’ve been feeling sore since NYE, but didn’t have severe pain until 2 days, when I sneezed after completing 5x deadlifts with 70lbs. 🙁 My PAC recommended exactly what you did last summer: rest, ice, and pain killers when needed.

    Your posts have been quite helpful regarding rib muscle strains and I look forward to taking on the Spartacus Workout after I’m healed. 😀

    I definitely want to follow Tip #5: Don’t Forget the Rest of your Body. My PAC said I can walk, not jog (which makes me super sad because I have a 5k coming up in March). I’m trying to be creative, but all I’ve thought up so far is stationary bicycling and perhaps assisted push ups (on knees).

    How did you keep moving with your injury last summer? Are there exercises you can recommend that do not utilize the intercostal muscles that you found easy to do? Thanks!

    • Hi Kimberly,
      So sorry to hear that you’ve got this injury too. It’s no fun.

      There are lots of exercises you can do that don’t require torso twisting. Both upper and lower body. You’ll have to try them out and see what does and doesn’t cause you pain. If it’s painful, don’t do it!

      Try things like body weight squats and lunges (holding core and bum tight throughout). Seated shoulder presses, bicep curls, side arm raises, bent over rows and reverse flys. You may find you have to limit the range of motion on some exercises (again, it depends on where your injury is and it’s severity).

      I found that seated upper body was more comfortable because I didn’t have to use my core as intensely. Of course, I ended up using lighter weights than normal, which is fine for maintenance.

      Let me know what you end up doing and how it feels!
      Hopefully you’ll be ‘spartacusing’ soon!

      Tamara

      • Hey Tamara! It has been a month since your reply of suggested exercises to try while sidelined with a rib injury and I’m here to report back my progress. 🙂

        I tried body weight squats and lunges, however, my rib muscles were so sensitive that even the slightest jolt coming up through my feet (especially on the right side) would jolt me to the side. Decided to put these off for a while.

        Next I tried all the upper body work mentioned while seated. Being seated helped immensely! I had success with shoulder presses, bicep curls, and side arm raises. I wasn’t able to get into the bent over rows or reverse flys since it applied pressure to my ribs, even in the slightly bent, seated position.

        Overall, I was thrilled that I could still rock it in the gym! Thank you so much for the recommended exercises. And now I have another story to tell!

        After 2 weeks of taking things easy at home and in the gym, my ribs felt so much better. I had started to massage the muscles in between my ribs to relieve that pressure/tautness, in essence, the Graston Technique. So here I am feeling better and I decided I’m going to take up squats again. With weight. I should not have done that! After a week and half of even using low weight, I acquired another injury. ;_;

        This time it was a lumbar strain with (most likely) a small herniated disc. In addition, my right pelvic bone has shifted out of place, which is causing mild-severe sciatic nerve pain when sitting for long periods of time. I have a feeling my pelvic bone may have been out of whack since January and I definitely know now that I was not ready to return to even a small part of my normal routine.

        I’m working with physical therapists now and already the advice they’ve given me has helped tremendously. That and a great soft tissue massage! They are happy that I am still exercising, without the deadlift and squat for now. In fact, they said the upper body work I’ve been doing is perfect.

        As I make progress I will share the lumbar and core strengthening exercises/stretches as I learn them. Right now my ‘assignment’ is to complete the cobra pose (2 pillows under your chest) and cat & camel 10x each twice daily, piriformis stretch twice daily, and use a foam roller on my spine and glutes before bed.

  12. Pamela Blunt says:

    This was so helpful. I can’t do them yet because it still hurts! My injury is very high intercostal under the scapulae with some strain in the lower scapulae muscles thrown in. Bronchitis with lots of deep coughing made me vulnerable I think. When I felt better I did a volunteer day that included several hours of repetitive heavy scrubbing with my right, dominant arm. Brilliant!!! The chiropracter has helped so much. I used to do the side plank and all of these look like something that will be great–very slowly building up when I recover. I see that you posted about your injury a while ago–I hope you are better and strong again. I looked all over for something on this type of injury and yours is one of the few and the best. Thanks!

    • Thanks so much for visiting Pamela. I’m happy to hear that my posts have helped. I am much better, thanks! Although I do still feel occasional twinges when I lift too heavy or train too many days in the week. It really is a long, slow recovery!

      Pop back and let me know how you’re doing!

  13. Great job once again! Thanks.

  14. Thank-you! Very Helpful’ and very well demonstrated. I’ll bet you are a great trainer. Thank-you for your helpl!!

    Regards,
    Chris M.
    ( Currently Intercostally-challenged )

    • Thanks so much for your kind comments Chris. Hoping that you get better soon! (It’s a nasty injury, isn’t it?) ~ Tamara

  15. Starting off slow and having help from a professional is necessary after an injury. I’ve had to come back after an arm injury and it made some exercises impossible to do, but over time my arm muscles got stronger and I was able to continue making progress week by week. My advice is to do what you can, listen to your body and eat right so your body can recover from training as well as the injury.

    • I totally agree Dayna! And recognizing that it may take longer than you think is also important. All to easy to start pushing hard when you’re only 80% recovered and re-injure yourself in the process. Thanks for stopping by and commenting!

  16. I just wanted to thank you for all of this information. I just pulled my intercostal this week (doing a 21-15-9 of 110 lb. dead lifts and banded pull ups). Your site is the only one I could find on how to go about seeking advice, strengthening the area, and most importantly, what I can STILL do at the gym. I had made so many strength gains and am terrified of losing them. Thank you again!!

    • Tricia, you’re very welcome! So many people have suffered from this injury. I’m just glad that my blog has given us all a place to learn about it and check in as we recover. Come back and tell me how it’s going, okay? Tamara

  17. Renee Meister says:

    Hi, Tamara! I actually was diagnosed with an intercostal muscle strain just last week- i was running, didn’t pay attention, and fell face forward (gravity and myself are very good friends). Your posts actually really helped- I am coming off of a meal program/workout plan called Inferno 10 that a friend of mine created and I realized I can’t do half of the workouts in the videos! I just started the Shakeology 3-day refresh but realized that I am going to have to figure out something with strength training (what a blast). Thanks for your advice. They seem to not be as major as your injury- mine was right next to my breast, almost underneath. My first major injury. I’ll probably try to do the lower level rotation videos and a run and see how taht works.

  18. Luk Overmeire says:

    Hi Tamara,

    I am currently also suffering from an intercostal muscle strain, at approximately the same region as you did.
    It’s been three weeks now, and after some improvements after two weeks, it’s a bit set back again, so it might go on for a while I am afraid.
    Here my question – I am a recreational cyclist. Do you have any experience if light cycling (low wattages, souplesse) is something that can help or rather to be avoided during the healing process?

    Thanks in advance for your response!

    best regards,
    Luk.

    • Hi Luk,

      Argh. This injury is really a nuisance, isn’t it? So sorry that you’re suffering from it!

      While I don’t have any specific experience with cycling during recovery from an intercostal muscle strain, my general advice for anyone recovering from an injury is listen to your own body.

      Start slow. Limit the duration of your workouts. Continue with the stretches and strength exercises your primary care provider suggested and monitor how it all feels. No set backs? Keep doing what you’re doing and add a little bit more each week.

      I’d love to hear how you’re doing. Please stop back and let me know? ~ Tamara

      • Luk Overmeire says:

        Hi Tamara,

        thanks for the response and the good advice!
        I’ll let you know about healing progress, and how the biking goes once I am back in the saddle 🙂

        Luk.

        • You bet! Enjoy the holidays and speedy healing!

          • Luk Overmeire says:

            Hi Tamara,

            I promised to give follow-up info.
            After 7 weeks, it’s not healed yet.
            After some slow to steady improvements during the first 4 weeks, it went up and down (now) for the next 3 weeks. Evening opening doors at the wrong side, is something to be carefull at.
            Did you undergo a bone scan to see if something was damaged? In that case normal healing time would be 3-4 months.

            Going for longer walks are the only activities at the moment. Light cycling on a hometrainer would be possible as well I suppose.
            I wonder if a fitness crosstrainer would be appropriate (I still have my fitness abo). Any experiences with that? If I am correct you are a fitness coach?

          • Hi Luk,
            Yikes. Sounds like you might have something more serious than an intercostal muscle strain. I never did have a bone scan, as the diagnosis was soft tissues damage, not bone-related. Perhaps you might look into this?

            What does your primary health care provider have to say? I would say any type of movement that can be done pain-free is what you’re looking for. Perhaps an elliptical or treadmill or stationary bike; something that doesn’t jerk the arms back and forth as you move.

            And yes, I am a personal trainer, but still refer clients out to a physiotherapist if they report with an injury like this.

  19. Luk Overmeire says:

    Tamara,

    thanks for your kind reply!
    back in (early) december, the physical (home medical man) thought it was soft tissue related, and that it would heal in 3 weeks, which it did not. Although he did not exclude something rib-related, but with less probability.
    By chance, I had an appointment last week (i.e. after 7 weeks) with a specialist for new orthopedic arc support shoes, and asked his opinion on the injury as well.
    There was no room for a full examination, but based on what caused the injury (torso movement during a plank exercise in fitness) he said both soft tissue and something bone-related are possible, and the latter could only be determined by a bone scan. If not, it should be healed within a month from now. He admitted though that also a rib strain can take a long periode to heal.
    So I guess, the best I can do is to wait for another month and in case it’s not sufficiently healed yet, to make a new appointment with him. The bone scan could determine more precisely the expected healing period.

    I don’t suffer much pain in normal day activities (in my case: walking and sitting at an office desk), but it’s not always easy to avoid some movements that can make it worse.
    Yesterday, I did some (rather short) stationary bike exercising (at the lowest level), and that seems to be ok.
    Thanks for the tip for not going for exercises with too much arm movements.

    Luk.

    • I wonder if you should just go ahead and schedule the bone scan now? I’m guessing that these things may take awhile? While you’re hopefully healing, you could be getting ahead in the queue, just in case you need it down the road…

      Hoping it feels better soon Luk! Tamara

  20. hello Tamara,

    thanks for the thoughtful tip, but for the moment I’ll stay patient for a while, before considering a radio-active injection in my body 🙂 Let’s hope it’s just a slowly healing soft tissue injury – still the most probable case according to the doc.
    It’s not causing much pain at all in normal day activities (walking, desk work, commuting), but the slow healing is a bit annoying. It’s still a bit palpable (f.i. when waking up), but in general the pain seems to fade away slowly but surely – as long as no unwanted movements occur. As you experienced as well, it’s easily reactivated, so no bike trips yet for the moment.

    Luk.

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