Can You Develop Intercostal Sprain with Bench Press?
Yes, you can develop intercostal muscle strain or injury from bench press exercise, though the evidence specifically documenting intercostal sprains is limited. The bench press places significant mechanical stress on the chest wall musculature, including the intercostal muscles, particularly when performed with improper technique, excessive loading, or inadequate recovery.
Injury Mechanisms During Bench Press
The bench press exercise creates substantial forces across the thoracic cage and shoulder complex that can injure intercostal structures:
- Musculoskeletal shoulder loads during bench press generate significant forces that transmit through the chest wall, with variations in technique substantially affecting injury risk 1
- Repetitive high-load training places excess strain on multiple joints and surrounding soft tissues, including the intercostal musculature that stabilizes the rib cage during the pressing motion 2
- Acute chest pain following bench press has been documented in case reports, though these often represent more serious pathology like coronary dissection rather than simple muscle strain 3
Technical Factors That Increase Risk
Specific bench press technique variations significantly influence chest wall stress:
- Wider grip widths (>1.5 bi-acromial widths) increase acromioclavicular compression and alter force distribution across the chest wall, potentially increasing intercostal strain 1
- Shoulder abduction angles and scapular positioning affect musculoskeletal loading patterns, with non-retracted scapulae and excessive abduction (90°) increasing rotator cuff activity and potentially chest wall stress 1
- Mediolateral barbell force components vary considerably between athletes and substantially affect shoulder and chest wall reaction forces 1
Fatigue and Overtraining Considerations
Muscular fatigue compounds injury risk:
- Training methods that push to failure increase overexertion risk compared to velocity-based training or autoregulatory approaches 2
- Consistent high-load training without adequate recovery creates cumulative microtrauma that can manifest as intercostal strain 2
Clinical Presentation
While intercostal injuries from bench press are not extensively documented in the literature, they would typically present as:
- Sharp or aching pain along the rib cage, worsened by deep breathing, coughing, or trunk rotation
- Tenderness to palpation along the intercostal spaces
- Pain reproduction with resisted chest wall movements
Important Caveats
Do not assume all chest pain from bench press is benign muscle strain. The differential diagnosis must include:
- Scaphoid fractures can occur during bench press from wrist hyperextension under load 4
- Acute coronary events, including coronary artery dissection, have been reported in seemingly healthy young adults performing bench press 3
- Pectoral muscle tears, aortic dissection, and other serious pathology must be excluded before attributing symptoms to simple intercostal strain 3
Risk Mitigation Strategies
To minimize intercostal injury risk during bench press:
- Use grip widths of 1.0-1.5 bi-acromial widths to reduce excessive chest wall loading 1
- Maintain scapular retraction throughout the movement to optimize force distribution 1
- Avoid training to failure; prioritize velocity-based or RPE-based programming to prevent overexertion 2
- Monitor for mediolateral barbell drift, which substantially increases aberrant shoulder and chest wall forces 1