What is a Pulled Chest Muscle? The Symptoms & Treatment Options

Written by Nikita Mistry
Physiotherapist, Western Sydney University
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on July 21, 2022

Man at the gym with a sore chest muscle

A pulled chest muscle (intercostal muscle strain) happens when the muscles are stretched beyond their capacity, leading to a strain, and sometimes even a tear. A pulled chest muscle will result in sharp pain in the chest, especially when breathing or movement of the upper body.

What are the symptoms of a pulled chest muscle?

Individuals with pulled chest muscles complain of sharp or dull pain, swelling on the area, muscle spasm upon movement, leading to difficulty moving the chest, pain when inhaling (chest expansion), and apparent bruising.[1]

If you are experiencing dizziness, irritability, having fever, drowsiness prompting sleepiness, profuse sweating, a racing pulse, difficulty breathing, or fainting contact your doctor for advice.

Causes of a pulled chest muscle

A strained or pulled muscle is caused by overuse of the chest muscle through repetitive activities, contributing to strain or pulled muscles. For instance, tennis, gymnastics, rowing, and golf - sports where this is a repetitive rotation motion.

Overhead activities, incidents like vehicular accidents or falls, poor conditioning and avoidance of warm-ups, muscle fatigue, and using improper or defective equipment are contributing factors for having pulled chest muscles. In addition, illnesses like bronchitis, through excessive coughing, is another reason for intercostal muscle strain.

Are certain people at increased risk?

People are at risk of acquiring a pulled chest muscle at any point in their life. The elderly are at risk due to chest wall injuries from falls, adults who engage in sports or have car accidents. Ultimately, the children are at low risk.

Diagnosis of a pulled chest muscle

If you are worried about your chest pain, visit your physician. Your doctor will ask questions about what happened, any activities it aggravates, relieves, and any past medical conditions.

Categories of a muscle strain come into areas of issue from their mechanism of injury:[2]

Acute or injury after direct trauma is for strains caused by an interaction with an opponent or sport-related tool or lacerations. Diagnosis is timed and monitored, from the exact moment of occurrence from pain levels and the onset of swelling.

Chronic or injury after indirect trauma are strains that develop through time, especially if left neglected. They are caused by repetitive use of the chest, especially with contact sports and job tasks involving lifting.

In addition, a strained chest muscle is identified by its severity:

Grade 1

  • Individuals experience localised pain aggravated by movement with minimal disability, and less than 5% of function is lost.

Grade 2

  • Localised pain, moderate disability, visible swelling, bruising on the area, and tenderness. At least less than half of the range of motion and strength is reduced, and contraction can occur if not treated.

Grade 3

  • Pain, swelling, and bruising on the area is severe, and the function of the muscle and range of motion is lost either from muscle tear or rupture—surgery for reconstruction.

Tests like X-rays, magnetic resonance imaging (MRI), and electrocardiograms rule out any possibility of bone fractures in the ribs, activity on the chest, any visible organs or soft tissues contributing to pain, and the possibility of a heart problem.

Treatment of a pulled chest muscle

The first line of defence is to relieve the pain in the area by:

  • Resting the chest for at least two days after injury before engaging in light activities

  • Applying a cold pack for at least 10-20 minutes three times a day

  • Wrapping the area with an elastic bandage without putting it too tight

  • Elevating the chest with pillows or recliners, especially at night (elevation).

These treatments can be done at home. They can reduce your difficulty of movement and pain in a few weeks. Take over-the-counter painkillers to further decrease the discomfort and inflammation, like ibuprofen or acetaminophen.

In some cases like chronic strain, maintenance exercises from a physiotherapist can decrease the pain and increase your arm and chest movement. f you have a severe case, surgery may be an option to repair the torn muscle. If the chest pain does not go away with any of these treatments, book an appointment with your physician immediately.

Recovery

The recovery time depends on the severity of your pulled chest muscle. If it is mild, it may heal after two to three weeks, and if it is severe, and requires surgery, it can take months to heal.

It is best to avoid any strenuous physical activity or exercise while recovering with any strain to heal the muscle. You may also need to pay attention to any discomfort or other symptoms you feel. As the pain diminishes, physical activities can be introduced again.

Complications

Your doctor will insist on not doing any further activity, especially when moving the area in a certain way. By listening to your body, you will have no other complications.

It is essential to observe your breathing because it is sensitive to the movement of the chest. If the strain makes your breathing difficult, report it to your doctor to know if a lung infection causes it. From this, the doctor will advise appropriate breathing exercises.

Takeaway

Muscle strains happen in many people every day, and they can be treated through home remedies, exercises, and overall, resting of the area.

Below is some advice to prevent the likelihood of chest muscle strain:

  • Be mindful about exercising, and do your warm-ups and cooldowns consistently. Muscles that are not conditioned well are prone to strain.

  • See if any dangers increase the likelihood of injury or falling. Use handrails when ascending or descending the stairs, check your sports equipment for any defects, and avoid walking on varied slippery surfaces if possible.

  • Again, it is good to listen to your body, especially if you feel extra sore from exercising. Rest is part of any exercise programme.

  • Be careful when carrying heavy objects, and ask for help. If no support is available, hold or lift things properly and maintain a straight posture.

  • See a physiotherapist for treatment, especially if you suffer from chronic strains.

  • Lastly, keep yourself active and eat well. This will help decrease your likelihood of developing strain from having a well-conditioned body and healthy weight.

Written by Nikita Mistry
Physiotherapist, Western Sydney University
Published on July 21, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on July 21, 2022
Sources
Authors
Medical reviewers
Last medically reviewed on July 21, 2022
BookPhysio.com has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
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    Maffulli N, Del Buono A, Oliva F, Giai Via A, Frizziero A, Barazzuol M, Brancaccio P, Freschi M, Galletti S, Lisitano G, Melegati G, Nanni G, Pasta G, Ramponi C, Rizzo D, Testa V & Valent A. Muscle Injuries: A Brief Guide to Classification and Management. Transl Med UniSa. 2014 [cited 2022 July 13];12:14-8.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592039/
  • 2.

    Grassi A, Quaglia A, Canata GL & Zaffagnini S. An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints. 2016 [cited 2022 July 13]; 4(1):39-46.

    https://www.doi.org/10.11138/jts/2016.4.1.039
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