Understanding an Intercostal Injury
If you are an athlete or simply someone who loves working out on a regular basis, you may have experienced chest pain, which could be some type of intercostal injury. Although you would never want to assume chest pain is nothing serious, there are times when it is connected to the anterior chest wall structure that has nothing to do with a heart attack. Within this wall is where the heart and lungs are located, a core group or location comprised of the chest, back, neck, and shoulder areas.
Inside the chest wall are 12 ribs, along with two layers of muscles, known as the intercostal muscles. These muscles are found in between the ribs and below each rib is what is referred to as a neurovascular bundle that consists of an intercostal vein, nerve, and artery. Again, for athletes or people who are extremely active, the nerves in this neurovascular bundle can become irritated, inflamed, or pinched. When this occurs, pain radiates to the chest wall.
When talking about an intercostal injury, it could be connected to the joints, ribs, or sternum although most often the ribs and sternum are involved. Keep in mind that while injury to the sternum is certainly possible, it is rarer than injury to the ribs in that this particular bone is extremely strong. For this reason, a fracture to the sternum would require tremendous force. For instance, a person in a car accident who was not buckled in may have the chest area hit the steering wheel, causing a facture.
On the other hand, injury to the ribs would be more likely for someone who is active, whether involved with a direct or indirect contact sport. In other words, whether you play football, basketball, play tennis, etc, an injury of this type would be possible. Usually, an injury involving a fracture of the ribs would be on the level of a stress fracture, meaning only a very thin crack has formed from overuse. However, rib fractures can also be acute whereby the ribs have actually cracked to a greater degree. When acute, the thoracic aorta, subclavian vein, and/or brachial plexus could also be involved.
When the intercostal injury involves an acute fracture of the ribs, sharp, stabbing pain would be felt and breathing would be difficult. Unfortunately, healing of a rib fracture requires time. Other than something to help with the pain, and perhaps inflammation, this type of injury heals on its own with rest, immobilization, and time. Depending on the number of ribs involved and the severity of the intercostal injury, healing could take anywhere from two to twelve weeks.
Another possible intercostal injury involves the costal cartilages. In this case, if the ribs were fractured on the front side where the costal cartilage is located, you would notice discomfort and localized tenderness over the area injured. An injury such of this type is usually caused by a sudden and forceful contraction of the external oblique muscles, which are the muscles on the side of the abdomen. Interestingly, people who experience injury to the costal cartilages often state they heard a clicking sound. A CT scan would confirm the injury and in some cases, surgery would be needed for repair.
While there are other possibilities for an intercostal injury, we wanted to mention Costochonditis. Actually, this condition is common, involving the cartilaginous areas of the ribs that attach to the sternum. When these areas become inflamed, chest pain would be noticed and in some cases, the pain would be so severe that it could easily be mistaken for a heart attack. The chondrosternal joints would be sore and tender, as well and although frightening, pain medication would help speed up the healing time so you can get back to the activity you love most.