The sternum is a flat bone, not a muscle, so you cannot pull it in the way you would pull a hamstring or a bicep. But several muscles attach directly to the sternum or run across it, and straining any of them produces pain that feels like it’s coming from the bone itself. Muscle strains are actually one of the most common causes of chest-wall pain, and the muscles around the sternum are frequent culprits. The confusion between “something wrong with my breastbone” and “something wrong with a muscle near my breastbone” sends a lot of people to emergency rooms unnecessarily, though ruling out serious causes is always the right call.
The Muscles That Surround Your Sternum
Your sternum sits at the center of your chest, and multiple muscle groups either anchor to it or pass right over it. When any of these muscles are strained, the pain localizes to what feels like the breastbone, which is why so many people describe the sensation as pulling a muscle “in” the sternum. The muscles most commonly involved are the intercostals and the pectoralis group.
Intercostal muscles fill the gaps between your ribs and help expand and contract your rib cage when you breathe. They’re the single most common source of muscular chest-wall pain, accounting for close to half of all cases. The pectoralis group, particularly the pectoralis major, is the next most frequent offender. The pec major is a large fan-shaped muscle whose fibers originate partly from the sternum itself, so when it is strained or torn, the pain often radiates right to the center of the chest.1Primary Care: Clinics in Office Practice. Evaluation and Treatment of Musculoskeletal Chest Pain
There is also a lesser-known muscle called the sternalis, a thin strip that runs vertically along the surface of the sternum. Not everyone has one, and those who do sometimes develop pain along the front of the chest that baffles clinicians. One case report describes a female athlete whose burning anterior chest pain from sternalis syndrome was initially misdiagnosed as cardiac in origin, resulting in a pacemaker being implanted before the real cause was identified.2PubMed Central. Sternalis Syndrome Misidentified by Multiple Specialties Responding to Botox Treatment: A Case Report and Literature Review
What Typically Causes These Strains
You don’t need to be an athlete to strain a muscle around the sternum. Everyday activities that load chest muscles in unfamiliar ways are a common trigger. Painting a ceiling, chopping wood, shoveling snow, or even a prolonged bout of coughing can overwork the intercostals or pectoralis fibers enough to cause a strain.1Primary Care: Clinics in Office Practice. Evaluation and Treatment of Musculoskeletal Chest Pain Any sport that demands intense upper-body effort, such as rowing, swimming, or throwing, also puts these muscles at risk.3PubMed. Musculoskeletal problems of the chest wall in athletes
The bench press deserves special mention. Among isolated tears of the sternocostal head of the pectoralis major, the majority occur during bench pressing. One surgical case series found that 57% of these tears happened while benching.4PubMed. Isolated tears of the sternocostal head of the pectoralis major muscle: surgical technique, clinical outcomes, and a modification of the Tietjen and Bak classification The reason has to do with how the lower pec fibers stretch during the bottom of the movement. As the bar descends in the final degrees of the lift, those shorter inferior fibers are stretched disproportionately. Applying heavy loads to fibers already at their maximum length is what produces the rupture.5PubMed. Ruptures of the pectoralis major muscle. An anatomic and clinical analysis This doesn’t mean casual gym-goers need to panic, but it does explain why sudden sharp pain near the sternum during a heavy press should not be shrugged off.
How Muscular Chest-Wall Pain Feels
The hallmark of a muscle strain near the sternum is pain that changes with movement or breathing. Taking a deep breath typically makes it worse. So does coughing, twisting your torso, or contracting the affected muscles, for example by pushing your palms together in front of your chest. The spot is usually tender when you press on it with a finger, and that reproducible tenderness with manual palpation is actually the most reliable physical finding a doctor looks for.1Primary Care: Clinics in Office Practice. Evaluation and Treatment of Musculoskeletal Chest Pain
A more severe injury, such as a partial or complete tear of the pectoralis major, announces itself more dramatically. You might notice visible swelling or bruising, a change in the shape of the chest muscle, thinning of the crease where your chest meets your armpit, and weakness when you try to squeeze your arm inward or rotate it.6PubMed Central. Injuries of the Pectoralis Major: Diagnosis and Management These signs point toward something that needs medical attention rather than rest alone.
Telling Muscle Pain from Something More Serious
The single biggest concern with any chest pain is whether it might be cardiac. Muscular chest pain and heart-related pain can overlap in location, which is why clinicians take every complaint of sternal-area pain seriously. A few features help distinguish them, though none are foolproof on their own.
Muscle strains tend to be sharp, localized, and reproducible: you can point to the spot with one finger, and pressing on it reproduces the pain. Heart pain tends to be more diffuse, often described as a pressure or squeezing sensation, and typically does not change when you press on the chest wall. Heart pain also tends to come with exertion and ease with rest, whereas a strained intercostal muscle hurts more during breathing or specific movements regardless of exertion level.
That said, these guidelines are not rules. Some heart attacks present with sharp, localized pain. Some muscle strains cause a dull ache that mimics cardiac pressure. If you have chest pain with shortness of breath, dizziness, pain radiating to your arm or jaw, nausea, or sweating, seek emergency care. The safest default is to get checked out rather than self-diagnosing a muscle pull, especially if you have risk factors for heart disease or the pain came on at rest.
Other Conditions That Mimic a Sternal Muscle Strain
Costochondritis is probably the condition most commonly confused with a muscle strain near the sternum. It involves inflammation at the joints where your ribs attach to the cartilage of the breastbone. The pain is in a similar location and also worsens with certain movements or deep breathing, but it originates in cartilage, not muscle. A doctor can sometimes distinguish the two by whether the tenderness is right at the rib-cartilage junction or spread across the muscle belly between ribs.
The sternoclavicular joint, where your collarbone meets the top of your sternum, is another potential source of pain in this area. Injuries to that joint usually result from direct trauma or a fall on an outstretched arm. Persistent instability and pain are the main long-term complaints after a sternoclavicular joint dislocation.7Orthopaedics and Trauma. The sternoclavicular joint: a review of anatomy, injury and management The pain localizes higher on the chest, near the base of the neck, and tends to flare when you move your shoulder rather than when you breathe deeply.
Stress fractures of the sternum itself are rare but not unheard of, particularly in athletes or people with reduced bone density. And gastrointestinal conditions like acid reflux can produce burning chest pain that people sometimes attribute to a pulled muscle. If the pain worsens after eating or while lying down, the stomach may be the real problem rather than anything musculoskeletal.
When Imaging Helps
Most muscle strains around the sternum are diagnosed based on history and a physical exam. A doctor asks what you were doing when the pain started, presses on the area to check for tenderness, and has you move in ways that stretch or contract the suspected muscles. If the pain follows those patterns, imaging is often unnecessary for mild strains.
When a more significant tear is suspected, particularly of the pectoralis major, MRI and high-resolution ultrasound become valuable. Both can show the location and severity of a tear, and that information directly affects whether surgery is needed or whether the injury can be managed conservatively.8PubMed Central. High-resolution ultrasound and MRI in the evaluation of pectoralis major injuries For more routine intercostal strains, imaging adds little and is typically skipped unless the pain is persistent, worsening, or accompanied by features that suggest a rib fracture or other structural problem.
Treatment and Recovery Timeline
Mild to moderate intercostal and pectoral strains follow the same playbook as most soft-tissue injuries. Rest from the aggravating activity is the foundation. Ice applied to the area for the first couple of days helps control swelling and dull the pain. Over-the-counter anti-inflammatory medications can manage discomfort, though they should be used for a limited period rather than indefinitely.
Because the intercostal muscles are active every time you breathe, complete rest isn’t really possible. What you can control is avoiding the specific movements that overloaded the muscle in the first place. If coughing triggered the strain, a doctor might recommend a cough suppressant. If bench pressing caused it, staying away from pressing movements for several weeks is the obvious step. Gentle stretching can begin once the acute pain subsides, and gradually loading the muscle again helps it rebuild properly.
Most mild strains resolve within two to six weeks. More significant partial tears of the pectoralis major can take several months of rehabilitation. Complete pec major ruptures, the kind that cause visible deformity and loss of strength, often need surgical repair, especially in younger or athletic individuals who need to return to high-demand activity.6PubMed Central. Injuries of the Pectoralis Major: Diagnosis and Management
The Role of Posture and Chronic Tightness
Not all muscle-related pain near the sternum comes from an acute injury. Chronically tight chest muscles can produce a low-grade ache or tightness along the front of the chest that people sometimes describe as a constant “pull” near the breastbone. This is especially common in people who spend long hours hunched over a desk or phone.
A well-described pattern called upper crossed syndrome involves shortening and tightening of the pectoralis major and minor on the front of the body, combined with weakening of the muscles in the upper back and the back of the neck. The tight pecs pull the shoulders forward and the upper back into a rounded posture, creating stress along the chest wall. Meanwhile the weakened upper-back muscles can’t counterbalance the pull.9PubMed Central. Treatment of Upper Crossed Syndrome: A Narrative Systematic Review The resulting discomfort is different from an acute strain: it tends to be bilateral, dull rather than sharp, and worse after long periods of sitting. Stretching the pecs and strengthening the mid-back muscles is the standard approach to addressing it.
When Sternum Pain Follows Heart Surgery
One less-discussed scenario involves people who have had open-heart surgery. The sternum is sawed in half during a sternotomy to give surgeons access to the heart. Over two million people undergo this procedure worldwide each year.10PubMed Central. Post-sternotomy pain syndrome following cardiac surgery: case report While the bone is wired back together and eventually heals, many patients develop persistent pain in the front of the chest afterward, a condition known as post-sternotomy pain syndrome.
This chronic pain is not just about the healing bone. Research has found that muscular tenderness in areas away from the incision site is significantly more common in patients who develop sternal pain compared to those who don’t, suggesting that muscles disrupted or stressed during surgery contribute to the problem.11Pain Medicine. Pain Symptoms Accompanying Chronic Poststernotomy Pain: A Pilot Study If you’ve had a sternotomy and are dealing with lingering chest pain, it is worth considering that the muscles around the sternum, not just the bone itself, may be the source.
Preventing Muscle Strains Near the Sternum
For people who train their upper body, the most straightforward prevention strategy is controlled progression. Jumping to a heavy bench press without adequate warm-up or conditioning is one of the fastest routes to a pec strain. Warming up with lighter sets, maintaining controlled movement through the full range of motion, and avoiding the temptation to bounce the bar off your chest all reduce risk. Since the lower pec fibers are most vulnerable at full stretch, limiting the depth of the movement when using very heavy loads is another practical modification.5PubMed. Ruptures of the pectoralis major muscle. An anatomic and clinical analysis
For non-athletes, the usual culprit is unfamiliar exertion. Spending a Saturday doing overhead work or yard labor when your muscles aren’t conditioned for it is a common setup. Building in breaks during sustained overhead or pushing tasks, and stretching before and after, goes a long way. If you’re recovering from a respiratory illness with a persistent cough, supporting your chest with a pillow while coughing can reduce the mechanical stress on the intercostals. These are small measures, but intercostal strains from coughing are surprisingly common and surprisingly painful, and a little cushioning helps more than most people expect.