A strained or pulled chest muscle may cause a sharp pain in your chest. A muscle strain or pull happens when your muscle is stretched or torn.
Up to 49 percent of chest pain comes from what’s called intercostal muscle strain. There are three layers of intercostal muscles in your chest. These muscles are responsible for helping you breathe and for stabilizing your upper body.
Classic symptoms of strain in the chest muscle include:
- pain, which may be sharp (an acute pull) or dull (a chronic strain)
- muscle spasms
- difficulty moving the affected area
- pain while breathing
Seek medical attention if your pain happens suddenly while you’re engaged in strenuous exercise or activity.
Go to the emergency room or call your local emergency services if your pain is accompanied by:
- racing pulse
- difficulty breathing
These are signs of more serious issues, like heart attack.
Chest wall pain that is caused by a strained or pulled muscle often happens as a result of overuse. You may have lifted something heavy or injured yourself playing sports. For example, gymnastics, rowing, tennis, and golf all involve repetitive motion and may cause chronic strains.
Other activities that may cause strain are:
- reaching your arms above your head for long periods of time
- contact injuries from sports, car accidents, or other situations
- lifting while twisting your body
- skipping warm-ups before activity
- poor flexibility or athletic conditioning
- muscle fatigue
- injury from malfunctioning equipment (broken weight machine, for example)
Anyone can experience chest muscle strain:
- Older individuals are at higher risk of experiencing chest wall injuries from falls.
- Adults may be more likely to develop chest pulls or injuries as a result of car accidents or athletic activities.
- Children are the lowest risk group for chest muscle injuries.
If you’re concerned about your chest pain, or unsure if it’s a pulled muscle or something else, talk to your doctor. Your doctor will ask you about your symptoms, your health history, and any activities that may have contributed to your pain.
Muscle strain is categorized as either acute or chronic:
- Acute strains result from injuries sustained immediately after direct trauma, such as a fall or car accident.
- Chronic strains result from longer-term activities, like repetitive motions used in sports or certain job tasks.
From there, strains are graded according to severity:
- Grade 1 describes mild damage to less than five percent of muscle fibers.
- Grade 2 indicates more damage: the muscle isn’t fully ruptured, but there is a loss of strength and mobility.
- Grade 3 describes a complete muscle rupture, which sometimes requires surgery.
In some cases, your doctor may order tests to rule out heart attack, bone fractures, and other issues. Tests may include:
Other possible causes of chest pain include:
- bruising as a result of injury
- anxiety attacks
- peptic ulcers
- digestive upset, like esophageal reflux
More serious possibilities include:
- reduced flow of blood to your heart (angina)
- blood clot in the pulmonary artery of your lung (pulmonary embolism)
- tear in your aorta (aortic dissection)
First-line treatment for mild chest muscle strains involves rest, ice, compression, and elevation (RICE):
- Rest. Stop activity as soon as you notice pain. You may resume light activity two days after injury, but stop if pain returns.
- Ice. Apply ice or a cold pack to the affected area for 20 minutes up to three times a day.
- Compression. Consider wrapping any areas of inflammation with an elastic bandage but don’t wrap too tightly as it may impair circulation.
- Elevation. Keep your chest elevated, especially at night. Sleeping in a recliner may help.
With home treatment, your symptoms from mild pulls should subside in a few weeks. While you wait, you may take pain relievers to reduce your discomfort and inflammation, such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
If you have chronic strain, you may benefit from physical therapy and exercises to correct muscle imbalances that contribute to strain. In more severe cases, surgery may be needed to repair torn muscles.
If your pain or other symptoms aren’t going away with home treatment, make an appointment to see your doctor.
You should avoid strenuous exercise, like heavy lifting, while you’re in recovery. As your pain lessens, you may slowly return to your previous sports and activities. Pay attention to any discomfort or other symptoms you experience and rest when necessary.
Your recovery time depends on the severity of your strain. Mild pulls may heal as soon as two or three weeks after injury. More serious strains can take months to heal, especially if you’ve had surgery. Follow any specific instructions your doctor gives you for the best results.
Trying to do too much too soon may aggravate or worsen your injury. Listening to your body is key.
Complications from chest injuries may affect your breathing. If your strain makes breathing difficult or keeps you from breathing deeply, you may be at risk of developing a lung infection. Your doctor may be able to suggest breathing exercises to help.
Most chest muscle strains can be treated at home. If your pain doesn’t get better with RICE, or if it gets worse, call your doctor.
To prevent chest muscle strain:
- Warm up before exercising and cool down afterward. Cold muscles are more vulnerable to strain.
- Take care when engaged in activities where you’re at risk of falling or other injury. Use handrails when going up or down stairs, avoid walking on slippery surfaces, and check athletic equipment before using.
- Pay attention to your body and take days off from exercise as necessary. Tired muscles are more susceptible to strain.
- Lift heavy objects carefully. Enlist help for particularly weighty jobs. Carry heavy backpacks on both shoulders, not on the side.
- Consider physical therapy for chronic strains.
- Eat well and exercise. Doing so may help you maintain a healthy weight and good athletic conditioning to lower your risk of strain.