Massage for an intercostal muscle strain

Massage can help a strained muscle between the ribs feel easier by relaxing the back, shoulder and breathing muscles that tighten up to guard it, but only once something more serious has been ruled out. We work around the sore spot, not on it, and never press on a rib that might be cracked. Chest pain that is new, unexplained or comes with breathlessness, sweating or nausea is a 9-1-1 call, not a massage booking.

Massage for an intercostal muscle strain is a supporting treatment, and it comes second. The first job with any pain in the chest wall is making sure it is a muscle and not the heart, a lung or a broken rib. Once that is settled, gentle massage of the muscles around the strain can ease the guarding that makes every breath feel cautious, while time heals the muscle itself.

The intercostals are the thin layers of muscle that run between your ribs and help move the rib cage as you breathe. When one is overstretched or torn, the pain is usually sharp, on one side, and caught by breathing in, coughing, sneezing or twisting.

Strain, rib injury or something else

Pain along the ribs has several possible sources. The pattern of how it started and what makes it worse is the best first clue, though only a clinician can confirm it.

	Chest wall strain	Bruised or broken rib	Costochondritis
How it starts	After a chest injury or chest exercise	A fall, a blow to the chest or severe coughing	See our separate page
Where it hurts	Along the side or back of the ribs, over the muscle	Over the injured rib, tender to touch, may swell or bruise	The front, where the ribs meet the breastbone
Clues	Worse breathing in, better when the muscle rests	Strong pain breathing in or coughing; sometimes a crack felt or heard	Pain sits at the front, not the side
Usual course	Settles with rest and gentle movement	The NHS says ribs usually heal in 2 to 6 weeks	Covered on our costochondritis page

Two less common causes are worth knowing about. A hard sneezing or coughing fit can, rarely, tear an intercostal muscle along with the diaphragm; one published case involved a 69-year-old man with a chest infection. And repeated loading, as in rowing, can produce a rib stress injury: in an Australian national team cohort of 151 rowers, 19 rib stress injuries were recorded over four years and time lost was a median of about 10 weeks. If your side pain built up gradually over weeks of training rather than starting with one moment, ask your doctor about that possibility.

When chest pain needs a doctor or 9-1-1 first

Some symptoms rule out a massage until you have been seen. The Heart and Stroke Foundation of Canada lists the signs of a heart attack as:

• chest discomfort: pressure, squeezing, fullness, pain, burning or heaviness;
• discomfort in the neck, jaw, shoulder, arms or back;
• sweating, nausea, shortness of breath or light-headedness.

Women may have a heart attack without chest pressure, instead feeling breathless, pressure in the lower chest or upper abdomen, dizziness, upper back pressure or extreme fatigue. Any of these means calling 9-1-1.

After an injury, the NHS advises emergency care for a serious accident, shortness of breath or chest pain that is getting worse, pain in the tummy or shoulder, or coughing up blood, because these can signal damage to the lung, liver or spleen. A high fever or coloured mucus after a rib injury needs a same-day call to your doctor, since a chest infection can follow when breathing is shallow.

If your pain started after a fall on the ice or a hockey check and you heard or felt a crack, have it assessed before booking massage. The NHS notes an X-ray is often not needed, but your doctor should decide that.

What massage does for a rib-side strain

There are no trials of massage for intercostal strains specifically, so we will not promise a faster recovery. What we can offer is practical comfort based on how people move when their ribs hurt.

When a muscle between the ribs is sore, the body splints it. Shoulders hike, the upper back stiffens, breathing becomes short and high in the chest, and the muscles at the base of the neck work overtime. A session focuses on that surrounding tension:

• The upper and mid back. Broad work beside the spine and around the shoulder blade, staying off the painful patch.
• The shoulder girdle. The muscles linking the arm to the rib cage tend to feel tight when you have been holding the sore side still.
• The neck and accessory breathing muscles. Easing these can make slow, deeper breaths feel more possible.
• Positioning. Side-lying on the comfortable side with a pillow to hug is often easiest; we avoid any position that loads the sore ribs.

We do not press directly on a suspected rib fracture, and we keep pressure over the strained area itself light or skip it entirely in the first days.

What helps at home in the meantime

The NHS advice for rib injuries suits a strain too, because the goal is the same: keep breathing well while the area heals.

• Take slow, deep breaths regularly, and do not hold back from coughing; hold a pillow against your chest when you do.
• Keep walking and moving your shoulders rather than lying still for long.
• Sleep more upright for the first few nights if lying flat hurts.
• Use ice in the first few days and simple pain relief if it suits you.
• Avoid heavy lifting, straining and painful sport until breathing is comfortable. In a Calgary winter that includes handing off the snow shovel for a while; our page on back pain after shovelling snow covers that season’s other strains.

How this works at Renu

Book massage therapy with any of our Registered Massage Therapists through Jane. A 30-minute session ($80) is enough for a focused visit to the back and shoulder on the sore side, and suits the early days when lying still for long is uncomfortable. A 45-minute ($100) or 60-minute ($120) session leaves time for the neck, both shoulders and the mid back, which helps when the guarding has spread.

In your booking notes, tell us how the pain started, which side it is on, and whether a doctor has checked it. If the pain sits more in the middle of the back between the shoulder blades, our page on thoracic back pain may fit you better. Golfers easing back into their swing can also read about massage for golfers.

Questions people ask

How long does a pulled muscle between the ribs take to heal?

We could not find good studies that track intercostal strains specifically, so be wary of anyone quoting a precise number. A strain that is easing steadily over the first couple of weeks is on track. If it is getting worse, or a deep breath still stops you short after several weeks, see your doctor.

Can I massage a pulled rib muscle myself?

Gentle heat and light rubbing beside the sore area are fine if they feel good. Avoid pressing hard into the spot itself, especially if there is any chance a rib is bruised or cracked. Slow deep breaths and moving your shoulders, as the NHS suggests for rib injuries, will do more than kneading.

Should I lie on my sore side during a massage?

Usually not at first. Most people are most comfortable side-lying on the uninjured side with a pillow to hug, or face down with support under the chest if that does not hurt. We will try positions with you and change them as soon as anything pinches.

Is it a pulled muscle or my heart?

You cannot tell for certain on your own, which is why new or unexplained chest pain needs a medical check. Pain that began right after a cough, a swing or a lift and sharpens on a deep breath fits a strain. Pressure, squeezing or heaviness, or pain with sweating, nausea, light-headedness or breathlessness, means calling 9-1-1.

Sources

1. NHS: Chest pain
2. NHS: Broken or bruised ribs
3. Heart and Stroke Foundation of Canada: Signs of a heart attack
4. Annals of Thoracic Surgery 2013: Diaphragmatic and intercostal muscle tear after an episode of violent sneezing
5. British Journal of Sports Medicine 2020: Rib stress injuries in 151 Australian Rowing Team athletes

Page reviewed October 5, 2026. This page is education, not a diagnosis. For your own situation, talk to your doctor, surgeon or care team, or ask us.