Intercostal muscle strains are muscle tears Trusted Source Merck Manual First published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers. See Full Reference in the intercostal muscles. These types of strains are a common cause of musculoskeletal chest pain Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference .
Pulled Chest Muscle Or Cracked Rib
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The intercostal muscles have different layers that are attached to the ribs to help build the chest wall and assist in breathing. When an intercostal muscle gets twisted, strained, or stretched too far, it can tear, causing intercostal muscle strain.
The chest wall is made of bone, cartilage, ligaments and tendons and covered by muscle and soft tissues. The chest wall is designed specifically to protect the organs it surrounds and support respiration.
Intercostal musclePectoralis muscleLatissimus dorsiSerratus muscleWeight training (side to side against resistance)Weight training (bench press)Weight training (bench press)Weight training (heavy weights)Heavy lifting with side bending, twisting or turningHeavy lifting from front to chest heightHeavy lifting with upper bodyRepetitive motions against resistanceBowlingRugbyClimbingSwimmingCricket, Baseball (bowling, throwing)SkiingCricket, baseball & throwing activitiesTennisRowingWrestlingRowingTennisHockeyTennisHockeyParachuting
Larger chest wall muscle groups can also be strained. The Pectoralis major muscle is a large muscle at the front of the chest. It used to rotate the arm inwards, pull a horizontal arm across the body, pull the arm from above the head down and pull the arm from the side upwards. Pectoralis Major strain can happen during vigorous sports activity classically weight training. Its weak point is where the pectoralis or pec muscle tendon attaches to the upper humerus (arm bone) though rarely its tendinous insertion to the upper ribs and sternum can also tear. Symptoms of a pec major sprain include a sudden sharp pain at the front of the upper arm, near the shoulder and depending on the grade of muscle strain, swelling (haematoma) of the front of the shoulder and upper arm. Tests which reproduce pain help confirm the diagnosis and include getting the patient to pull their arm across the front of the chest or rotate it inwards against resistance. A visible gap or lump in the muscle may appear.
Though not strictly a chest wall muscle, the upper Rectus abdominis muscle and External oblique muscle can also be strained, torn or even ruptured leading to pain, which depending on the site of injury can lead to lower chest wall pain and pain when pain twisting from a seated position or when rising from a bed particularly if flexing (bending).
Sternalis syndrome presents with anterior chest pain associated with localised tenderness over the body of the sternum or overlying sternalis muscle; palpation often causes radiation of pain bilaterally. It is an unusual cause of anterior chest wall pain as it appears to be associated with an accessory muscle, the sternalis muscle which is present in only around 5-10% of people and sit in a variable position in front of the main pectoralis muscle. When symptomatic, it is another form of myofascial pain syndrome.
Systemic diseases can cause chest wall pain. Sternocostoclavicular hyperostosis is a chronic inflammatory disorder which presents with erythema, swelling, and pain of the sternoclavicular joint. See other associated problems. Other conditions such as systemic lupus erythematosus, or SLE can cause chest pain on deep breathing. When this pain is not caused by pleurisy (inflammation of the lining of the chest cavity), it is commonly caused by inflammation of the chest muscle, cartilage, or ligaments, or of the joints that connect the ribs to the breastbone (costochondral joints). Septic arthritis of the sternoclavicular joint is an unusual infection, that can lead to chest wall pain. See other associated problems. Relapsing polychondritis is an immune-mediated systemic disease characterized by recurrent episodes of inflammation of cartilaginous and proteoglycan-rich tissues. It typically affects the cartilage of the ears and nose but potentially all types of cartilage may be involved including rarely the costal cartilage, so is a rare cause of chest wall pain.
Angina Myocardial Infarction (heart attack) Pericarditis (inflammation of pericardial sac) Myocarditis (inflammation of heart muscle)Pneumonia (chest infection) Pleurisy (inflammation of pleural lining) Pulmonary embolism (blood clot to lung)Oesophagitis or Gastroesophageal Reflux (Heartburn) Oesophageal Spasm (swallowing difficulties) Peptic ulcer (stomach ulcer) Gallbladder (gallstones) Pancreatitis (inflammation of the pancreas)
Treatment options for isolated musculoskeletal chest wall painReassurance & explanation of diagnosis Avoidance of aggravating activities & restriction of certain activities Passive thoracic mobility exercises (stretching)Application of heat for muscle soreness / spasm or cold for swelling Simple analgesia (see Treatment)If symptoms persist, consider physiotherapy assessment & treatment. May include biomechanical assessment with targeted stretching and strengthening exercises, mobilization & soft tissue therapyTrigger point injections of local anaesthetic +/- corticosteroid (see Trigger Point, Peripheral nerve and Joint Injections)
The pain experienced from a pulled chest muscle can be either sharp or dull and it can be more pronounced with deep inhales and exhales. Other signs of chest muscle strain include swelling, bruising, and muscle spasms. If your chest pain occurred during strenuous activity and it is accompanied by dizziness, nausea, sweating, or racing pulse, it could be a heart attack. Call 911 or go to the emergency room immediately. If you aren't sure, try putting your hands on your pectoral muscles (your chest cavity) and apply pressure. If you feel increased pain as a result, then it's more likely to be a muscle injury than a heart attack.
Several different situations cause a pulled chest muscle. Those with weak chest muscles often injure themselves from heavy lifting, especially if the muscles aren't warmed up first. Females who experience breast pain may be surprised to discover that their discomfort is actually due to a pulled chest muscle. And anyone, male or female, who lifts too much weight or moves heavy furniture is at risk of injury. Other common causes of a chest muscle strain are contact sports and athletics that require forceful or repetitive motions. Tennis, golf, and rowing are prime examples.
Outside of physical activities, a pulled chest muscle can easily occur from excessive, hard coughing. People who suffer from bronchitis or a bad cold can injure and inflame chest muscles from incessant, deep coughs.
Most of the time, a pulled chest muscle is a minor injury. Depending on the severity, it can heal on its own within a few days or a few weeks. Get plenty of rest and avoid strenuous exercise. If there is swelling, try icing the chest area for at least 20 minutes at a time. Pain relievers, like ibuprofen or acetaminophen, can also help reduce muscle inflammation and pain. For chronic muscle strains, physical therapy can be very helpful. It aids in reducing pain and while restoring strength and motion in the pectoral muscles. Depending on the patient's needs, a physical therapist may utilize massage, special exercises, and stretches as treatments.
Intercostal muscles are muscles that present within the rib cage. Consist of three layers of muscles external, internal, and innermost layer they combine to fill the space between the ribs. External intercostals muscle are the outermost layer lies directly under the skin originate from the lower border of rib above run obliquely and insert into the upper border of the rib below. It expands the chest wall during inhalation. Internal intercostals the intermediate layer originate from the costal groove near the inferior border of the rib above to the upper border of the rib below, help to collapse the Lung during expiration. Innermost intercostals muscle, cross more than one intercostal space, and assist the internal and external intercostals in their function[1].
Intercostal muscles strain vary according to the type and intensity of injury, strain of intercostal muscles causes rib/chest pain, upper back pain, and affect the breathing pattern the patient will present with shallow short breathing pattern due to pain. It is an injury affect the muscles between two or more ribs[2]
When a chest muscle becomes strained, it can cause a sudden, sharp pain that radiates throughout the chest area. Fortunately, a strained chest muscle is usually only a minor injury that heals within a few days or weeks.
Anyone can develop a strained chest muscle. However, certain people may be at higher risk, such as older adults who fall frequently. Adults who play contact sports like soccer or are in auto accidents are also often at increased risk for a strained chest muscle.
A Grade 1 injury refers to mild damage to the chest that affects less than 5% of its individual muscle fibers. Your strength and motion may be mildly affected, and recovery usually only lasts between two and three weeks.
A Grade 2 injury indicates more extensive damage to the chest that affects a higher amount of muscle fibers without completely rupturing the muscle. You may experience significant problems with strength and motion. Grade 2 injuries usually take between two and three months to heal. 2ff7e9595c
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