Repetitive Strain Injury/Pain/swelling in ribs and back


QUESTION: Hi, I have been suffering from pain in the right side of my ribs and my back between my shoulder blades also on the right side. My ribs often swell and become hot, sometimes unable to touch them if they are swollen as its to tender. I also get strange cold sensation over my ribs sometmes, maybe twice a day. At its worse it effects my breathing and also my posture, to point where if both my ribs and back are hurting the pain makes me feel sick. I struggle to maintain a straight posture when my ribs are aggravated as the discomfort and pain becomes too much. I have been suffering from this for 3 months now. It hurts if am standing, sat or laid down. Sometimes sitting makes it feel worse and on a night I struggle to sleep as my ribs ache and feel tight. I've been unable to go to the gym for 3 months as a briske walk or a strong cough can aggravate my ribs. My job involves a lot of manual lifting, moving heavy boxes, sofas and metal racking. For the past few days I've had to stop doing any lifting as a result of advice from my doctors. Am currently waiting to see a physiotherapist. Any ideas what this could be? The conditions I suffer from seem to point to a repetitive strain injury, is there anything can do to help the pain. Any advice would be great as the discomfort and constant ache is starting to effect my mood and happiness, I love the gym and physical excersice and not been able to do anything is getting me down. Kindest regards, Dave.

ANSWER: Hi Dave,

Have you to your medical doctor yet?  While I agree that this could be a simple repetitive strain injury, and since you've had it for three months (and it just didn't start suddenly a few days ago) the odds are this is all it is. With that said, I want to tell you something that happened to me so you can ask your doctor about it.

I had the same symptoms (not the swelling, but all the other symptoms) and also thought it was a repetitive strain injury of the intercostal muscles between my ribs.  It turned out that I was passing multiple tiny (thank heaven!) blood clots and they were ending up in my lungs.  After telling a friend, who is a medical doctor, he took me to the hospital and it turned out that I was admitted for a week and put onto blood thinners.  

The only reason I would think that this isn't the case with you is because you've had it for this long, but it's definitely worth checking out.

When you are cleared medically, then you can consider the intercostal muscles.  Your work, and the fact that you like to exercise (therefore, you are breathing heavy after a strenuous exercise session) would lead to an RSI of the intercostal (and other) muscles.

I suggest you take a look at while you are waiting for your medical results.  There is a book titled "Treat Yourself to Pain-Free Living" that teaches how to do self-applied treatments for muscles from your head to foot.  Your work and exercise are straining more than just your intercostals, but you can easily release the tension in each of them.

After you have medical clearance, please feel free to return here and we'll go further into the muscles and how they can be causing this problem.

Wishing you well,
   Julie Donnelly

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QUESTION: I have been to the doctors and the women I saw said because I had a chest xray last year that came back clear it was unlikely to be my lungs, I had a similar pain and discomfort in my ribs and they decided I sore my intercostal muscles from lifting at work. After reading your comment I looked up blood clots in the lungs, I do have some similar symptoms, noticed a few times my hands turning blue and also near my biceps, often get numdness in my thumbs, pins and needles in my little fingers eccasionly. My chest is often wheezy on a night before I go to bed, also been getting light headed more often then usual. Kindest regards, Dave.

Hi Dave,

I don't think a chest x-ray would show clots, I know when I went to the hospital they did some kind of a scan.

The only muscle I can think of that could possibly impede your circulation to your hands is the pectoralis minor in your chest. The reason is because this muscle inserts into a small bone of the scapula (shoulder blade) called the coracoid process. The coracoid process crosses over your axillary artery, and also the nerves to your arm and hand.  

When the pectoralis minor is in spasm it will pull down on the coracoid process and can put pressure on the artery &/or nerve. This could cause the numbness in your thumbs and the tingling in your other fingers.

However, none of the muscles we've discussed will make you wheezy or light headed, so I think you might be wise to see a pulmonary specialist. If your oxygen level is off that would also affect the light headed feeling.

I don't want to alarm you, but I also don't want to make light of your symptoms.  You could certainly work on releasing the tension in your pectoralis minor muscle as it won't hurt to eliminate it from the mix.

Wishing you well,
    Julie Donnelly

Wishing you well,

Repetitive Strain Injury

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Julie Donnelly, LMT


I can accept questions that relate to chronic or acute pain caused by muscle spasms and contractions. Repetitive Strain Injury is actually Cumulative Trauma to muscles. Releasing the spasm &/or contraction will relieve the strain that is felt at the insertion point on the bone. I am the co-developer of the unique safe-stretching program "Focused Flexibility Training," which combines easy instruction for self-treating spasms throughout your body with proven yoga stretches. I have recently authored two new books: "The 15 Minute Back Pain Solution," and "The Secret to Your Best Golf Game EVER!


Since 1989 I have been working with endurance athletes and individuals suffering from chronic pain conditions. I have authored seven self-treatment books and three self-treatment DVDs and I have developed the Julstro System for the treatment of carpal tunnel syndrome, Trigger Finger, and other Hand/Wrist pain. I am a national and international presenter at conventions, seminars, and workshops. Principle topics are "Work Shouldn't Hurt," and "The Pain Free Athlete." In 2005 and 2006 I was the massage therapist for ultracyclists competing in the Race Across America (RAAM) 3000+ mile race from San Diego, CA to Atlantic City, NJ. I've taught the Julstro techniques to physical therapists at the Cleveland Clinic, to massage therapists in areas around the USA, and I've taught Julstro self-treatment clinics to dancers at Juilliard School of Performing Arts (NYC),the sprinting team at NC State, and I am working closely with several Olympic-hopeful. We have successfully eliminated the repetitive strain injuries that could keep them out of the Olympic Games, and the best part is they know how to do the self-treatments so they can stay pain-free and flexible.

Triathlete Magazine, Endurance Magazine, multiple national and international trade journals.

Swedish Institute of Allied Health, NY, NY - Initial education in massage therapy Licensed NYS Massage Therapist since 1989. SUNY Empire State College, Saratoga Springs, NY - B.Sc. degree in Interdisciplinary Health Education I was an Associate Professor helping to develop the massage training program for SUNY Rockland Community College

Past/Present Clients
Privacy prevents me from filling in this section without prior consent from my clients. Life Experience: I have been specializing in the treatment of chronic pain and sports injuries since receiving my NY massage license in 1989. A personal bout with carpal tunnel syndrome was the catalyst to my developing a self-treatment that heals the symptoms of carpal tunnel syndrome quickly and without surgery. My work with endurance athletes was the inspiration to teach people how to self-treat so they could stop pains even during a race or heavy training day. Both of these situations ultimately became the products that are sold on my websites: and I currently treat people in my offices in Sarasota, FL, Cary, NC, or Pearl River, NY

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