Intercostal Muscle Strain

Dr Ozello's Sports Medicine Report: Intercostal Muscle Strain

Intercostal Strain
Intercostal muscular strain is the most common cause of muscular chest wall pain, accounting for up to 50% of cases. Risk increases during intense training or resumption after a prolonged period of rest (off-season). Among MLB players, strains of the intercostal or external/internal oblique muscles accounted for 92% of trunk muscular strains.

Intercostal Muscles: Anatomy
Mainly involved in the mechanical aspect of breathing. Function to expand and decrease size of chest cavity to facilitate breathing. Three layers.
External Intercostal Muscles: Aid in normal and forced inhalation.
Origin: Ribs 1-11. Insertion: Ribs 2-12. Action: Ribcage expansion through elevation and separation of ribs.
Internal Intercostal Muscles: Aid in forced expiration. Origin: Ribs 2-12. Insertion: Ribs 1-11. Action: Decrease transverse dimensions of ribcage through rib depression and inward bending.
Innermost intercostal muscle: Deepest layer of internal intercostal muscles. Separated by a neurovascular bundle.

Intense sharp, stabbing, tight, spasm, stiffness, dull, deep ache and point tenderness in the intercostal space.
Shallow breathing due to inability to perform deep breathing.
Symptoms increased by stretching, deep inhalation, and coughing.
Limited range of motion in all planes due to pain and muscle guarding.
Slow and guarded motions. Apprehensive to move.
Altered posture and/or Antalgic position.

Mechanism of Injury: Sudden concentric contraction of intercostals in stretched position or during activities involving excessive or repetitive lateral flexion or rotation.
Baseball, javelin, rowing and ice hockey.
May occur traumatically due to direct impact forcing ribs apart.
Treatment is symptomatic with relative rest and conservative management.


Intercostal Muscles: Mainly involved in the mechanical aspect of breathing. Function to expand & decrease size of chest cavity to facilitate breathing. Three layers.

External Intercostal Muscles: Aid in normal and forced inhalation. Origin: Ribs 1-11. Insertion: Ribs 2-12. Action: Ribcage expansion through elevation and separation of ribs.

Internal Intercostal Muscles: Aid in forced expiration. Origin: Ribs 2-12. Insertion: Ribs 1-11. Action: Decrease transverse dimensions of ribcage through rib depression and inward bending.

Innermost intercostal muscle: Deepest layer of internal intercostal muscles. Separated by a neurovascular bundle.

Reference:
Trunk Injuries in Athletes https://journals.lww.com/acsm-csmr/fu...

***Disclaimer: Viewing this video does not take the place of seeing a medical professional, receiving proper training in the medical profession or working with a fitness professional. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Please receive proper medical training before attempting these medical procedures.

Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV
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