Seun was afraid to breathe deeply after deadlifts left him with stabbing right rib pain. Two thoughts crossed his mind — pneumothorax and heart attack. Both were excluded quickly at Mascot Healthcare. The diagnosis was simpler and entirely fixable.
Fitness coach, Lekki. Presented with sudden-onset right lateral chest pain after a heavy deadlift session — stabbing, worsening with breathing, moving, or twisting. Breathing in caused a sharp catch. Chest X-ray normal. Oxygen saturation 99%. Diagnosed: intercostal muscle spasm.
Intercostal Muscle SpasmSeun had been deadlifting 140 kg — a personal best attempt. On the third repetition, he felt a sharp catch in his right ribs. He dropped the bar. Within ten minutes, breathing was painful enough that he was consciously limiting his inspiratory depth.
He had two immediate fears: pneumothorax (he'd read about spontaneous pneumothorax in athletes) and cardiac. He came to Mascot Healthcare within the hour.
The doctor was systematic: oxygen saturation (99%), chest X-ray (normal lung fields, no pneumothorax, no rib fracture on X-ray). Then the key examination step: direct palpation of each intercostal space along the right lateral chest. When the doctor pressed on the 6th intercostal space — Seun winced and said "that's it exactly."
"This is an intercostal muscle spasm — you've strained the muscles between your ribs. It's painful but not dangerous, and it heals within 1–2 weeks."
Intercostal muscle spasm produces sharp, well-localised chest or rib pain worsened by breathing and movement — easily confused with more serious causes. Reproduction on palpation and a normal chest X-ray are the key distinguishing findings.
Sudden-onset stabbing pain in the right lateral chest — onset immediately after a heavy deadlift set.
Each inspiration caused a sharp, catching pain — leading Seun to breathe shallowly.
Any trunk rotation or lateral bending dramatically worsened the pain.
Pressing on the right intercostal space reproduced the exact pain — the key diagnostic sign.
SpO2 99% — excluded significant pneumothorax or pulmonary pathology.
Shallow breathing to avoid pain — appropriate adaptive response; correct to seek assessment urgently.
No self-treatment — came to clinic within the hour of onset.
Pneumothorax excluded (SpO2 99%, chest X-ray clear). Rib fracture excluded (X-ray; no extreme point tenderness over the bone itself). Cardiac excluded (no ECG changes, no relevant history). Diagnosis confirmed: intercostal muscle strain with spasm.
Treatment: a short course of a painkiller taken with food; diaphragmatic breathing exercises to prevent basal atelectasis from shallow breathing; heat pack after 48 hours; rest from heavy lifting for 2 weeks with return to training guided by pain reduction.
Technique review: the injury likely occurred from excessive trunk flexion under load — a form cue for deadlift was provided.
Intercostal Muscle Spasm/Strain (right, 6th intercostal space — post-exertional; pneumothorax and rib fracture excluded)
A short course of a painkiller; diaphragmatic breathing exercises; heat after 48 hours; rest from lifting × 2 weeks; form correction for deadlift
At 5 days: breathing pain 50% improved; able to breathe normally. At 10 days: fully resolved; returned to light training.
Fully resolved within 10 days. Seun returned to training at week 2 with corrected deadlift technique. No recurrence.
Sudden lateral chest pain after heavy lifting in a fit young person is most commonly intercostal muscle strain — but serious causes (pneumothorax, rib fracture) must be excluded first before managing as musculoskeletal.
Intercostal spasm is painful but harmless and resolves in 1–2 weeks. Shallow breathing should be avoided — diaphragmatic breathing exercises prevent the complications of under-ventilation.
Stabbing chest pain after deadlifts — get assessed first, then reassure. It's probably muscle — but confirm that with a doctor.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.