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    Injured Chest
    voidmain26 posted:
    Last Tuesday, November 6th, I was at Brazilian Jiu Jitsu (BJJ) practice and noticed that the left side of my chest, just beneath my breast, was a little sore. I didn't think much of it. I went back to practice Thursday and called my wife afterwards as I always do. The problem was that I couldn't hold a conversation because it was so painful to breathe in and speak. It was excruciating pain all night long. It kept me up throughout the night and I could barely move in the morning.

    That Friday I went to a MedExpress to make sure I didn't break any ribs. They did a quick diagnosis, x-ray, and said that it was probably just a pulled muscle or bruise and gave me Vicodin and Soma. I haven't taken either of these yet, because I figured I could deal with the pain of a pulled muscle...I've done it plenty of times before without narcotics. Ibuprofen was also helping, a little.

    The pain has subsided a bit. I can sleep most of the night, however, breathing deeply still hurts quite a bit. Coughing, laughing, sneezing are all very painful.

    When I push on the area that is tender on my chest it brings me to my knees. However, I seem to have full range of motion with my left arm and that seems curious for a pulled muscle. It's painful to move but not nearly as painful as breathing or pushing on the specific, inured area.

    I'm afraid that it is a bruised lung, pleurisy, or torn rib cartilage. I understand that there isn't much to do for it, but I believe the supportive care for each injury is different. Should I have a second opinion from a different physician? I just want to be able to breathe comfortably and know when I can get back to training. Many thanks!
    Mary Ann Wilmarth, PT, DPT, OCS responded:
    Hello voldmain26

    Given the continued pain with deep breathing, coughing, laughing and sneezing, I would recommend that you see your primary care physician. You want to rule out any lung issues. If necessary, you could see an orthopaedist and or neurologist.

    With a pulled muscle or even a factured rib, there is overlap with the care and the treatment is generally conservative. You want to rest the area. Sometimes taping can help, for example with Kinesiotape. During the initial acute phase, you also want to decrease the inflammation with ice. You can have a Grade I, II or III muscle strain with the more involved strains taking longer to recover.

    With strains in this area the intercostal (between the ribs) muscles are often involved. These can be difficult to stretch appropriately. You would likely benefit from seeing a Physical Therapist who can guide you further and perform any manual therapy as indicated.

    You can go to and then search under Find-a-PT.

    Good luck with this. It can be frustrating because breathing is painful, but hang in there and you should have a good recovery.

    Dr. Wilmarth

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