It is natural to extend your arms above your head and stretch in the morning. It helps to wake you up and loosen tight muscles.
However, if this common morning ritual causes you pain, it is important to get to the bottom concerning why.
There are several reasons why pain in the chest can occur when you stretch. Once you know what these are, it can aid you in getting an accurate diagnosis.
Exploring the Chest Anatomy
Having a basic understanding of the anatomy of the chest is imperative to see why certain conditions can cause chest pain when you stretch.
The muscles in this part of the body are what you want to focus on.
This video provides valuable information and a solid visual representation of these muscles.
There are four primary chest muscles to know about. These include:
- Pectoralis major works to help move the scapula and upper limbs
- Pectoralis minor stabilizes the scapula
- Serratus anterior makes it possible to raise your arm more than 90 degrees
- Subclavius depresses and anchors the clavicle
The ribs can also be a source of chest pain when stretching, so knowing the basics helps you to see why pain may occur.
There are 12 rib bones that comprise the rib cage with costal cartilages and the sternum.
This video helps you to visualize the ribs and provides important anatomy information.
What You Need to Know About Costochondritis
In the United States, more than six million people go to the emergency room each year for chest pain and musculoskeletal causes like costochondritis are common culprits, according to Robert Oh and Jeremy Johnson.
This condition is characterized by inflammation affecting the cartilage that connects the sternum and rib bones.
In most cases, the pain is to the left of the sternum. It is often described as sharp, pressure-like or aching.
Doctors usually cannot identify an exact cause for this condition. However, it may be associated with an injury, arthritis, tumors, physical strain or a joint infection.
It typically resolves on its own, but this can take several weeks.
When the pain is especially severe, it may mimic a heart attack. Because of this, those who go to the emergency room usually have a heart attack ruled out before getting a costochondritis diagnosis.
Treatment is largely focused on alleviating pain. This often involves medications, including nonsteroidal anti-inflammatory drugs, antidepressants, narcotics and antiseizure drugs.
Certain types of therapy might also be beneficial. Gentle stretching might be recommended.
Some patients may also benefit from nerve stimulation using a TENS unit. This interrupts pain signals to reduce pain severity.
Get the Facts About a Muscle Strain
Muscle strains are common and may involve the chest or intercostal muscles. This injury is characterized by the muscle fibers either tearing or stretching.
There are two primary reasons strains occur: the muscle was forced to very strongly contract, or it was stretched past its limits, according to Harvard Medical School.
In addition to pain, patients may experience bruising, reduced range of motion, swelling, weakness, and spasms.
Trouble breathing is possible with an intercostal strain. There are three strain grades:
- Grade One: Mild with only a few torn or stretched muscle fibers.
- Grade Two: Moderate with considerably more injured muscle fibers.
- Grade Three: The most severe and characterized by a complete muscle tear.
Strains may occur as a result of poor conditioning or flexibility, direct trauma, improperly warming up before physical activity, fatigue and exertion.
Sudden and abnormal body movements may also contribute to a strain.
For mild strains, basic first aid is typically sufficient for treatment. This includes using ice, rest and compression. While sleeping, elevate the chest with pillows or by sleeping in a recliner.
For more severe strains, physical therapy and medications might be necessary to help alleviate pain and stiffness.
When there is a complete muscle tear, patients might require surgery to repair the damage.
What Are Sternoclavicular Joint Disorders?
The shoulder is made up of four joints, one of which is the sternoclavicular joint. A contact sports injury or a car accident can cause these disorders in this joint.
In most cases, these disorders are minor, according to the American Academy of Orthopedic Surgeons.
In addition to injuries, certain conditions are associated with these disorders. These conditions include osteoarthritis, infection and rheumatoid arthritis.
Pain where the sternum and clavicle meet is the most common symptom. Patients might also experience a reduced range of motion, bruising, swelling or a grinding or crunching noise when attempting to move their arm.
Doctors will start by assessing the joint and chest to look for the symptoms of these disorders.
They will also ask about when the symptoms began to determine the underlying cause.
Most patients can be treated with nonsurgical therapies. These may include:
Medications
Nonsteroidal anti-inflammatory drugs are common since they can decrease swelling and pain. Oral or injected corticosteroids might also be considered.
Activity modification
If certain movements, such as stretching, cause pain, modifying these can be beneficial.
Immobilization
When an injury is to blame, immobilizing the arm of the affected joint may help to promote healing. This generally involves wearing a shoulder sling.
While uncommon, surgery might be indicated in certain cases. For example, an open reduction for a dislocation of the joint or draining the infection if an infection caused the disorder. With an infection, antibiotics are also prescribed.
Looking into Muscle Spasms
Spasms can occur in any muscle, but one of the most common places for them is the ribcage area, according to MedlinePlus.
When they occur in this area, stretching or other movements may cause pain in the chest area.
The pain can range from severe to just mild twitching. When pressing down on the spasming muscle, it might feel harder than usual or there may be a visual distortion in the area.
A number of factors may contribute to muscle spasms in the ribcage:
- Not stretching properly before exercise
- Exercising in excessively hot environments
- Electrolyte imbalances with magnesium, potassium, and calcium
- Muscle fatigue
- Dehydration
Unless spasms are caused by a medical condition, conservative intervention can typically alleviate the pain.
Stretching the muscle can be helpful even when it causes pain. Simply do this gently and massage the muscle during the stretch.
Alternating ice and heat are commonly used for spasms. Apply each for 15 to 20 minutes and alternate between them.
What is Tietze Syndrome?
This condition is characterized by swelling and pain affecting at least one cartilage of an upper rib.
It is possible for more than one of the upper ribs to be affected. This inflammatory disorder is considered rare.
The pain may come on suddenly, or over time. The pain usually resolves after several months or weeks, but it is possible for the swelling to persist once the pain is gone, according to the National Organization for Rare Diseases.
It is unknown why people develop this condition. However, it appears to be most common in those under age 40.
It is not considered a serious issue, but the pain and swelling can be debilitating.
The symptoms usually resolve on their own. However, to help alleviate the pain and swelling, doctors may prescribe nonsteroidal anti-inflammatory drugs.
Home measures, including rest, using ice and heat and limited physical activity, may also help.
When drugs and home measures fail to control the pain, steroid injections into the painful area might be beneficial.
However, these can only be done a few times since there is a risk of joint damage if they are given too frequently.
What You Need to Know About Arthritis
Arthritis is an umbrella term to describe a joint disease and there are more than 100 different types.
In the United States alone, it is estimated that over 300,000 children and 50 million adults have at least one type of arthritis, according to the Arthritis Foundation.
It is possible for arthritis to affect the sternoclavicular joint. When this happens, it is usually the result of either osteoarthritis or rheumatoid arthritis.
Osteoarthritis is characterized by cartilage breaking down due to wear and tear.
Once the cartilage is significantly worn down, this can cause the bones associated with it to essentially grind on each other. This can result in restricted movement and pain.
Rheumatoid arthritis is an inflammatory condition. The synovial membrane that lines the joint capsule is attacked by the immune system.
Swelling and pain result. Eventually, the joint’s bones and cartilage can become destroyed by the disease.
The first step in treatment is getting underlying arthritis under control. For osteoarthritis, this typically involves anti-inflammatory medications, and in some cases, physical therapy.
Rheumatoid arthritis is autoimmune, so treatment can be more extensive and complicated.
Treatment is focused on reducing how badly the immune system is attacking the body.
This may include a combination of the following:
- Nonsteroidal anti-inflammatory drugs
- Disease-modifying antirheumatic drugs
- Steroids
- Biologic agents
Surgery can be used for severe damage to certain joints to replace them with an artificial joint.
Unfortunately, this is not an option for the sternoclavicular joint. For this joint, resection arthroplasty might be considered.
During this surgical procedure, a portion of the sternoclavicular joint is removed. As healing occurs, scar tissue fills the empty space.
This is done to alleviate pain. However, it is generally not considered unless the patient has fully exhausted all other options.
Exploring the Facts Concerning Sternal Instability
This is a condition someone may experience following a chest surgery where the sternum was separated.
This instability is an abnormal motion of the sternum. Left untreated, this may result in non-union, sternal pain, and infection.
Sternal instability can cause the sensation of clunking or clicking in the chest. This causes discomfort and pain when people are doing basic things, such as stretching their arms above their head.
This instability is highly associated with mediastinitis development. This involves an infection deep in the sternal wound that requires extensive drainage and debridement.
The survival rate among those with instability and mediastinitis 65 percent according to Donald Shaw, et al.
A number of factors may increase a patient’s risk of sternal instability:
- Obesity
- Large chest circumference or breasts
- Chronic obstructive pulmonary disease
- Diabetes
- Prolonged steroid use
- Prolonged mechanical ventilation
- Blood transfusions
- History of smoking
- Beta-adrenergic agonist medication use
- Osteoporosis
- Repeat or off-center sternotomy
- Renal failure
- a Persistent or a chronic cough
To reduce the risk of this complication following surgery, patients are often put under sternal precautions.
In addition, management may include:
- External bracing
- Wearing a supportive bra
- Trunk stabilization exercises
- Surgery
Those monitoring the patient will perform an assessment to determine the grade of the instability. This aids them in making the proper management choices.
Learning About Calcification of Cartilage in the Sternum
Calcification is characterized by calcium accumulating. This can cause a hardening of the body structure where calcification is happening.
As people get older, calcification of the costal cartilage happens. Under normal circumstances, the volume of calcified cartilage should increase at approximately seven percent per decade, according to S.A. Holcombe, et al.
Certain factors may increase the rate of calcification. These include:
- Infections
- High calcium levels in the blood
- Persistent inflammation
- Autoimmune or genetic disorders that affect the connective tissues and skeleton
It is important to note that consuming a calcium-rich diet is not believed to increase the risk of calcification.
Researchers have not found a link between calcium deposits and a calcium-rich diet, according to Harvard University.
To treat calcification, doctors will first determine why it is happening in the first place.
If it is due to aging and the volume is not considered excessive for the person’s age, they may elect not to prescribe treatment.
If the pain in the sternum area is difficult to cope with, patients may be prescribed nonsteroidal anti-inflammatory drugs.
Icing the area can also help. In rare instances, surgical interventions may be needed.
Those experiencing chest pain when they stretch should consult with their physician.
It is important to get an accurate diagnosis because from here you can work with your doctor to develop a plan to alleviate the pain.
