It is possible to pull a chest muscle from coughing, which is a common, though often alarming, musculoskeletal injury. The intense physical effort required generates a forceful cough, leading to a muscle strain in the chest wall that manifests as sharp pain. This condition is generally benign, but understanding the mechanism helps differentiate this muscular pain from more serious underlying health conditions.
The Force Behind the Injury
A cough is a powerful, involuntary reflex designed to clear the airways. The expiratory phase requires an explosive contraction of accessory respiratory muscles to generate high pressure and velocity. During a vigorous cough, the intrathoracic pressure can momentarily spike, forcing the chest wall to compress with significant speed.
These repeated, violent contractions place immense strain on the muscles responsible for breathing and stabilizing the rib cage. When coughing is prolonged or repetitive, such as during a respiratory illness, the muscles become fatigued. This fatigue increases the risk of overstretching or tearing muscle fibers, leading to a strain felt as a “pulled muscle” in the chest.
Identifying the Strained Structures
The anatomical structures most vulnerable to strain from forceful coughing are the intercostal muscles, which are located between the ribs. These three thin layers of muscle connect the ribs and are responsible for moving the rib cage during respiration. A strain here causes localized pain that worsens noticeably with deep breaths, twisting motions, or another cough.
Another common source of pain is costochondritis, inflammation of the cartilage where the ribs meet the breastbone. The mechanical stress from chronic coughing can inflame these small costochondral joints, mimicking the sharp pain of a muscle pull. In less frequent cases, the force can also strain the pectoral muscles or the upper abdominal muscles that assist in forced exhalation.
Recognizing When It Is More Than a Pull
Differentiating a simple muscle strain from a more serious condition is important, although a healthcare professional should always evaluate persistent chest pain. Musculoskeletal pain is typically localized, meaning a person can often point to the exact spot that hurts. The pain is also often reproducible; pressing on the sore spot or changing position, like twisting the torso, will intensify the sharp sensation.
In contrast, certain symptoms serve as red flags that suggest the pain may stem from cardiac or pulmonary issues, requiring immediate medical attention. These include a crushing or squeezing chest pressure that does not change with movement or pressing on the area. Pain that radiates to the jaw, the left arm, or the back should be promptly evaluated. Furthermore, the presence of shortness of breath, dizziness, cold sweats, or fever accompanying the chest pain indicates a potential emergency.
Management and Recovery
A strained chest muscle from coughing is treated similarly to any other muscle strain and generally responds well to self-care measures. The initial step involves reducing activities that exacerbate the pain, which includes attempting to suppress forceful coughing when possible. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage both the pain and the underlying inflammation.
Applying cold therapy, such as an ice pack, for the first 48 hours helps reduce immediate inflammation and dull the pain sensation. After the initial inflammatory period, switching to heat therapy, like a heating pad, can help relax the strained muscles and improve blood flow to the injured area. For a mild intercostal muscle strain, relief is often noticeable within a few days, with a typical recovery timeline ranging from one to three weeks.