Pain guide · Back pain

Chest muscle pain: a strained muscle, the chest wall, the heart and lungs, and how to build back

Most chest pain that general practitioners (GPs) see comes from the chest wall: the muscles, the rib cartilages and the joints at the front of the chest. It is usually in one spot, sore to press, and worse when you move, twist or take a deep breath. It usually settles, though it can take weeks to months and often comes back.

But chest pain can also come from the heart, the lungs or a clot, and being sore to press doesn't rule those out. So this guide starts with the signs that need a 999 call, accident and emergency (A&E) or the National Health Service's 111 line (NHS 111), then maps the causes by where and when it hurts, and gives a plan from breathing and walking back to pushing, lifting and sport, once a clinician has checked your chest.

3-stage exercise plan When to get help 32 sourcesUpdated 25 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 (911 in the US) if you have chest pain that feels tight or like squeezing on your chest.
Call 999 (911 in the US) if you have chest pain that spreads to your arms, neck or jaw.
Call 999 (911 in the US) if you're having severe difficulty breathing: you're gasping, choking or not able to get words out.
Call 999 (911 in the US) if your lips or skin are pale, blue or grey. On brown or black skin, this may be easier to see on the palms of the hands.
Call 999 (911 in the US) if someone has passed out and is not responding normally.
Call 999: sudden pain or discomfort in your chest that does not go away (it can feel like squeezing or pressure, burning or indigestion); pain that spreads to your left or right arm, or your neck, jaw, shoulder, stomach or back; or chest pain and you feel sweaty, sick, light-headed or short of breath. It could be a heart attack. Don't drive yourself to A&E.
Call 999: chest pain that started suddenly, or spreads to your arm, neck or jaw, or your chest feels tight. This could be a heart attack. Do not drive yourself to A&E.
Call 999 for any of these signs even if your chest is sore to press: pain you can press on can still come from the heart or a clot (our suggestion, from the studies in this guide).
Call 999: chest pain with difficulty breathing, your heart beating fast, or coughing up blood. This could be a blood clot in the lungs (pulmonary embolism).
Call 999 or go to A&E: you have difficulty breathing which comes on suddenly, you feel pain in your chest or upper back, your heart is beating very fast, or someone has passed out. These could be signs of a pulmonary embolism (a blood clot in the lungs) or another serious condition. Don't drive yourself.
Call 999: sudden chest or back pain that can feel like something being torn inside, with shortness of breath and problems walking, seeing or speaking.
Call 999: sudden chest pain or discomfort, or chest pain with feeling sweaty, sick, light-headed or breathless. A collapsed lung (pneumothorax) causes a sudden, sharp, stabbing pain in the chest or shoulder that gets worse when you breathe in, with breathlessness; it is more common in people aged 15 to 34, people who smoke, and tall, thin people.
Call 999 or go to A&E: you have sudden chest pain that lasts for 15 minutes or more, sudden chest pain that spreads to your arms, back, neck or jaw, or difficulty breathing; you're coughing up more than just a few spots or streaks of blood; or you're coughing up blood and finding it hard to breathe, have a very fast heartbeat, or have pain in your chest or upper back.
Call 999 or go to A&E: a rib injury caused by a serious accident, such as a car accident. Don't drive yourself: ask someone to drive you or call 999.
Call 999 or go to A&E: with a broken or bruised rib, shortness of breath or chest pain that is getting worse, or coughing up blood. A broken rib may have damaged your lung.
Same day (NHS 111 or an urgent treatment centre): a pop or tearing at the front of the armpit or chest during a lift, a dip or a tackle, followed by bruising into the chest or upper arm, a change in the shape of the chest or armpit (a thinner or lost armpit fold, or a chest or nipple that looks uneven), or weakness pushing. Don't wait for it to settle: it can be a torn pec tendon, and repairs done within about 6 weeks did better than later ones.
Get help from NHS 111: you're suddenly more short of breath than usual; you have chest pain and you feel sick or are being sick; or you have chest pain and you feel like your heart is racing, going too slowly, skipping a beat or fluttering.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem.
Same day (urgent GP appointment or NHS 111): sharp or stabbing chest pain that gets worse when you take a deep breath in, swallow, cough or lie down, or sharp chest pain that only happens when you breathe or cough, or hasn't got better after a few days. These can be pericarditis or pleurisy.
Get help from NHS 111 if you think you have costochondritis. Chest pain needs checking to rule out other, more serious conditions, and costochondritis is diagnosed only once the heart and lungs have been considered.
Ask for an urgent GP appointment or get help from NHS 111: you have sharp chest pain that comes and goes, or only happens when breathing or coughing; sharp chest pain that has not got better after a few days; you've coughed up a few small spots, flecks or streaks of blood, or noticed blood in your phlegm; or you're feeling short of breath regularly. It can be pleurisy or a chest infection.
Ask for an urgent GP appointment or get help from NHS 111: breast pain with a very high temperature, or you feel hot, cold or shivery; any part of the breast is red, hot or swollen; a hard lump in the breast that doesn't move; nipple discharge, which may be streaked with blood; one or both breasts change shape; dimpled skin like orange peel; or a rash on or around the nipple, or a nipple that has sunk in.

See a doctor or physiotherapist if

See a GP if you have chest pain that comes and goes, or that goes away quickly but still worries you.
Very bad pain that isn't getting better over time: see a GP. A steroid injection or a local anaesthetic may be offered.
A swelling over a rib joint beside the breastbone: see a GP. It is usually Tietze syndrome, but rarely an infection or a growth, especially with a fever, after chest surgery or if you inject drugs.
Pain, swelling or grinding where the collarbone meets the breastbone, with no injury: see a GP. Arthritis and, rarely, infection can affect that joint; redness with a fever, chills or night sweats needs checking the same day.
A dip or change in the chest's shape that you only notice once the bruising fades, or weakness pushing that isn't getting better: get it checked promptly through your GP or NHS 111, and ask about a shoulder specialist. A tendon tear found late can often still be repaired, though the results are better early.
A burning, tingling or painful patch of skin on one side of your back or chest, with or without a rash: get advice from a pharmacist or NHS 111 as soon as possible. Shingles can cause pain a few days before the rash appears, and rarely without one. Try to see a pharmacist within 3 days of the rash appearing.
You smoke or used to, and have shoulder pain with a cough that will not go away, breathlessness or weight loss. See a GP if you've had a cough for longer than 3 weeks.
Heartburn most days, or heartburn that lifestyle changes and pharmacy medicines aren't helping: see a GP.
Panic attacks that keep happening, or worry about having more: see a GP. In England you can also refer yourself to an NHS talking therapies service.
Breast pain that isn't improving or painkillers aren't helping, with a family history of breast cancer, or with any signs of pregnancy: see a GP.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The front of the chest beside the breastbone, sharp or aching, worse moving your upper body, lying down, breathing deeply or pressing, with no swelling

Often costochondritis, once a clinician has thought about the heart and lungs.

Read: Costochondritis →A visible, tender swelling over one of the upper rib joints beside the breastbone

Usually Tietze syndrome: see a GP.

Read: Costochondritis →

The pec, across the upper chest towards the armpit, sore to press and worse pushing, reaching across or lifting, with no single injury

The chest wall muscles, which this guide covers once the heart and lungs have been considered.

A sudden pop or ripping feeling at the front of the chest or armpit during a press, a dip or a push-up, then bruising or a changed armpit fold

A possible torn pec: get it checked the same day.

Read: Pec strain or tear →A pulled chest muscle after a lift, a throw or a tackle, without a pop

Our pec strain guide covers strains as well as tears.

Read: Pec strain or tear →

Sore across both sides of the chest a day or two after a new or harder chest workout, easing each day

Delayed onset muscle soreness. Our muscle soreness guide covers what helps.

After a fall, a blow or a coughing fit: sharp pain when you breathe in or cough, and one tender spot over a rib

A bruised or broken rib, or a pulled muscle between the ribs.

Read: Rib injury →Pain over the ribs at the side or lower down

Our rib pain guide maps it.

Read: Rib pain →The back of the chest or between the shoulder blades, stiff and achy, easing as you move

The upper back.

Read: Upper and mid back pain →The top of the chest just below the collarbone, or where the collarbone meets the breastbone

Our collarbone pain guide maps the joints and glands there.

Read: Collarbone pain →The front of the shoulder or chest when you bench press, do dips or push-ups

Usually the rotator cuff, the joint at the end of the collarbone or a pec. Our bench press guide covers grip and range.

Read: Shoulder pain when benching →

A burning feeling in the middle of the chest after eating, or bringing up food or bitter-tasting fluid

Heartburn and acid reflux.

A sharp, continuous pain with a racing heart, sweating and dizziness, set off by worry or stress

Possibly anxiety or a panic attack, once a heart cause has been ruled out. Most panic attacks last 5 to 20 minutes.

A burning, tingling or painful band on one side, then a rash a few days later

Shingles: see a pharmacist within 3 days of the rash appearing.

Breast pain, often in both breasts in the 2 weeks before a period, sometimes spreading to the armpit

Usually linked to periods; neck, shoulder and back injuries can be felt as breast pain too. See the warning signs for a lump or skin changes.

Chest pain that feels tight, heavy, squeezing or like indigestion, or spreads to an arm, the neck, jaw, shoulder, stomach or back, with sweating, feeling sick, light-headedness or breathlessness

The heart: call 999, even if your chest is sore to press.

Chest discomfort that comes on with effort, stress or cold and eases within a few minutes of rest

Possibly angina: get help from NHS 111.

Sudden breathlessness with chest or upper back pain, a very fast heartbeat, or coughing up blood

A possible clot in the lungs: call 999.

A sudden, sharp, stabbing pain on one side of the chest or in the shoulder, worse when you breathe in, with breathlessness

A possible collapsed lung: call 999.

Sharp pain when you breathe in or cough, with a high temperature, a cough or yellow or green mucus

A chest infection or pleurisy: get help the same day.

Sharp, stabbing chest pain that is worse lying down and better leaning forward, often after a cold or flu

Possibly pericarditis, inflammation of the lining around the heart: get help the same day.

Chest or shoulder pain with a cough that won't go away, especially if you smoke or used to

See a GP: a cough lasting more than 3 weeks needs checking.

Understand it

The chest wall is the commonest cause of chest pain in general practiceStrong evidence

In 58 Swiss general practices, 300 of 672 people with chest pain (44.6%) had chest wall pain, about three times as many as had heart pain; in 74 German practices, GPs diagnosed it in 46.6% of 1,212 people aged 35 or over. It affected all ages, and men and women equally.

The emergency department is different. In one US study, 30% of 122 people with chest pain had costochondritis, and 6% of them were having a heart attack, against 28% of the others.

Sources 1, 2, 3

What it feels likeEmerging evidence

In the Swiss study the pain was usually moderate, in one spot you could point to, and lasted hours, days or weeks. In 71% it was made worse by a position or a movement, lying down or breathing, and a tender spot was found where it hurt in 214 of 300 people. It was more often on the left, and it spread to the left arm in 18 people and the right arm in 4. In the German study it was most often behind the breastbone or on the left.

Sources 1, 2

Where on the chest wallEmerging evidence

In one Swiss cohort, GPs could name a pattern in 195 people with pain in one place, though they diagnosed without set criteria: most often the cartilages where the ribs join the breastbone (costochondritis), then the pec muscle (a pectoral syndrome, in nearly 1 in 4, most of them on the left), then the breastbone itself.

A review of chest wall problems in athletes adds rib stress fractures, a slipping rib, Tietze syndrome (a swollen rib joint) and strains of the muscles between the ribs. The NHS says costochondritis has been linked to a chest injury, repetitive upper body movements like lifting, coughing a lot and infection.

Sources 1, 4, 5

A torn pec is differentStrong evidence

A pec tear usually happens on the lowering part of a bench press: a pop or ripping feeling, bruising on the chest or inside of the arm, weakness, and a chest, armpit or nipple line that looks uneven, mostly in men aged 30 to 60, the American Academy of Orthopaedic Surgeons (AAOS) says. Of 365 published cases, 83% came from indirect force and 48% happened during weight training. The AAOS says a repair works best soon after the injury; our pec strain guide covers strains and tears.

Sources 6, 7

Being sore to press doesn't rule out the heart or a clotStrong evidence

In reviews of people seen in emergency departments with a possible heart attack, pain that pressing reproduced, sharp or stabbing pain, pain that changed with position and pain on breathing in all made a heart attack less likely, but none ruled it out. The history, the examination and the first heart tracing could not confirm or exclude it; scores that added a blood test gave more information.

In general practice, a rule built to spot chest wall pain still let through 3 people with angina among its 41 false alarms, and its authors wrote that pain reproduced by pressing is not proof. Chest wall pain sat alongside heart disease in 19 of the 300 Swiss patients. And in 965 people with a suspected clot in the lungs, pressing reproduced the pain in 19.9% of those who had a clot and 23.8% of those who didn't.

Sources 8, 9, 10, 11, 1, 12, 3

What else can hurt in the chestStrong evidence

The NHS chest pain page (past its review date) lists a chest sprain or strain, which starts after a chest injury or chest exercise, may get worse when you breathe in and feels better when you rest the muscle; heartburn, which starts after eating; anxiety or a panic attack, an often sharp, continuous pain triggered by worry, with a racing heart; a chest infection, pneumonia or pleurisy, worse when you breathe in, with a cough and a high temperature; and shingles, a tingling feeling and then a rash.

Pericarditis causes sharp, stabbing pain that is worse lying down and better leaning forward. Breast pain is usually linked to periods, and neck, shoulder or back injuries can be felt as breast pain. A collapsed lung causes a sudden, sharp, stabbing chest or shoulder pain with breathlessness, a clot in the lungs causes sudden breathlessness with chest or upper back pain, and chest or shoulder pain with a cough that won't go away needs a GP.

Sources 13, 14, 15, 16, 17, 18, 19, 20, 21

When a scan or test helpsStrong evidence

New chest pain needs a clinician first: the NHS says always get medical advice for unexplained chest pain that doesn't go away, and sends suspected costochondritis to NHS 111. Suspected heart pain is checked with an electrocardiogram (ECG) and blood tests, and the National Institute for Health and Care Excellence (NICE) asks clinicians to explain when chest pain isn't from the heart. Lung causes are checked by listening to the chest and, if needed, blood tests, a chest X-ray, an ultrasound or a computed tomography (CT) scan.

A torn pec may need an ultrasound or a magnetic resonance imaging (MRI) scan of the chest, because a routine shoulder scan doesn't show the whole muscle. Chest wall pain itself has no test that confirms it: it is usually diagnosed once other causes have been considered.

Sources 5, 22, 23, 24, 6, 11

How it usually goesEmerging evidence

The NHS says costochondritis usually gets better on its own and can last a few weeks to several months, and most sprains and strains feel better after 2 weeks. In the Swiss study, the outcome at a year was good, but 57% had chest wall pain more than once; in the German study, 55.4% still had chest pain after 6 months; and of 21 people followed after costochondritis in a US emergency department, 11 still had chest pain at a year, though only a third still had definite costochondritis. In a Danish trial, the pain eased in both groups over the year. No one can promise a date.

Sources 5, 25, 1, 2, 3, 26

What helps, and how strong the evidence is

Get it checked, then be reassuredStrong evidence

NICE asks clinicians to discuss people's worries, including anxiety when the cause of chest pain is unknown, to explain when chest pain isn't from the heart, and to give advice about getting help for any further chest pain. The Swiss authors note that a clear diagnosis of chest wall pain is more reassuring than just being told a serious disease has been ruled out.

The NHS says painkillers that help with inflammation, like ibuprofen, may be recommended for costochondritis, and very bad pain that isn't getting better may be offered a steroid injection or a local anaesthetic.

Sources 23, 1, 5

A fresh strain: protect it briefly, then keep movingStrong evidence

For the first 2 to 3 days after a strain, the NHS advises rest from the activity, ice for up to 20 minutes every 2 to 3 hours, and no heat, alcohol or massage for the first couple of days; then keep the muscle moving, and avoid strenuous exercise for up to 8 weeks. NHS inform says too much rest can slow your recovery and that you don't need to be pain-free to move, keeping pain at 5 out of 10 or less.

Sources 25, 27

Hands-on treatment: no better than self-management by a yearEmerging evidence

In one Danish trial of 115 people with acute musculoskeletal chest pain, first seen at a hospital heart unit, 4 weeks of chiropractic treatment did better than self-management on some measures at 4 and 12 weeks, but by a year there was no difference. The trial wasn't blinded, and it is the only trial of treatment for chest wall pain this guide found.

Sources 28, 26

Exercise for chest wall pain hasn't been tested

No trial of an exercise programme for chest wall pain, chest muscle pain or costochondritis was found. The plan below borrows breathing, walking and gentle stretching from our costochondritis guide, chest holds and the pressing progression from our pec strain guide, and doses from the move pages, each labelled.

A torn pec: repair usually does betterStrong evidence

The AAOS says studies suggest surgical repair gives more satisfaction than non-surgical care, which is usually for older, less active people or incomplete tears. Without repair the pain can improve, but the change in the chest's shape won't go away and some weakness stays.

Source 6

How much pain is OK while you exercise?

Mild, familiar and in the spot you can press: about 3 out of 10, and chest discomfort with effort is never a pain-rule questionEmerging evidence

Start only once a clinician has checked your chest pain. During breathing, stretching and strength work, a mild ache up to about 3 out of 10 is fine if it is in the same spot you can press on, settles within an hour and leaves you no worse the next morning; if it is worse, do less next time, not nothing. For a strained pec, our pec strain guide allows about 3 to 4 out of 10.

These limits are editorial: borrowed from the site's pain-monitoring guides (our costochondritis and pec strain guides) and untested for chest wall pain. They are lower than the 5 out of 10 used elsewhere so that a different kind of chest pain stands out. In trials of long-lasting muscle and joint pain, exercise that allowed some pain did no worse than pain-free exercise.

Stop any exercise that brings on sharp pain at the breastbone or a new pop, and leave out the stretched, arms-wide position (a deep fly, a wide bench press, a deep dip) until pressing is comfortable.

Chest discomfort that comes on with effort, such as brisk walking or stairs, and eases within a few minutes of rest, or feels tight, squeezing or heavy, or comes with breathlessness, sweating or feeling sick, is not a pain-rule question: that is how angina and heart attacks behave. Stop, and follow the warning signs.

Sources 5, 29, 23, 30

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: breathe, walk and keep moving, once your chest pain has been checked

About the first 1 to 2 weeks. Take painkillers if they suit you; for a fresh strain, ice for up to 20 minutes every 2 to 3 hours and no heat, alcohol or massage for the first couple of days, as the NHS advises. Ease off whatever brings it on, such as heavy lifting, pressing or a lot of reaching, but keep walking and moving. No exercise programme has been trialled for chest wall pain, so the doses are the move pages' or editorial.

Slow breathing (6 breaths a minute) demonstrated on the 3D figure

3D demoSlow breathing (6 breaths a minute)Beginner · No equipment

At least 5 minutes, once or twice a day · The move page's dose (the NHS breathing exercise for stress; once or twice a day is its editorial suggestion). Small, quiet breaths, as our costochondritis guide says

Easier: Breath reach · Harder: Crocodile breathing (prone diaphragmatic breathing)

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

10 to 30 min most days, at a pace you can talk at · As in our costochondritis guide (editorial); or walk outdoors. Stop for chest discomfort that comes on with the effort

Harder: Treadmill jogging

Shoulder rolls demonstrated on the 3D figure

3D demoShoulder rollsBeginner · No equipment

10 to 15 slow circles each way, once or twice through · The move page's dose, an editorial starting point

Harder: Shoulder CARs (controlled articular rotations)

Thoracic rotation demonstrated on the 3D figure

3D demoThoracic rotationBeginner · No equipment

6 rotations each side, moving with the breath · The move page's dose

Easier: Side-lying open book · Harder: World's greatest stretch

3D demoCat-cowBeginner · No equipment

8 waves, slower than feels natural · The move page's dose

Harder: Half lord of the fishes (Ardha Matsyendrasana)

Move on when: Pressing on the sore spot hurts less, a deep breath and turning are easier, and walking brings on no chest discomfort.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Restore: wake the chest muscles up and open the upper back

About weeks 1 to 6: gentle holds for the chest muscles with the arms close to the body, pulling to balance the pressing, and movement for the upper back. Mobility daily, strength moves 3 days a week (editorial).

Isometric chest squeeze (palm press) demonstrated on the 3D figure

3D demoIsometric chest squeeze (palm press)Beginner · No equipment

6 to 10 holds of 5 to 10 s, building from gentle to firm over the stage · The move page's dose (editorial); elbows close to the body, as our pec strain guide says

Harder: Machine chest fly (pec deck)

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

2 to 3 sets of 10 to 15, a short range at first · As in our costochondritis guide (editorial)

Harder: Push-up

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15, stopping 2 to 3 reps short of failure · The move page's dose, an editorial starting point

Harder: Supported single-arm dumbbell row

Side-lying open book demonstrated on the 3D figure

3D demoSide-lying open bookBeginner · No equipment

8 to 10 slow openings each side, pausing 2 s at the end · The move page's dose (editorial); lie on the less sore side, as our costochondritis guide says

Harder: Thoracic rotation

Doorway chest opener demonstrated on the 3D figure

3D demoDoorway chest openerBeginner · A wall

Late in the stage: 2 to 3 gentle holds of 20 to 30 s, elbows low · As in our costochondritis and pec strain guides (editorial); not for a fresh strain

Easier: Elbows back · Harder: Fish pose (Matsyasana)

Foam roller thoracic extension demonstrated on the 3D figure

3D demoFoam roller thoracic extensionBeginner · A foam roller

5 to 8 slow breaths at each of 3 or 4 spots along the upper back · The move page's dose (editorial); skip it with osteoporosis, as the page says

Harder: Fish pose (Matsyasana)

Move on when: These feel comfortable, reaching, carrying shopping and a normal day don't flare it, and the wall push-ups stay within the pain rule.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Rebuild pressing, then lifting and sport

From about week 6, or once it has settled, 2 or 3 days a week, one change at a time; go back a step if pressing flares the breastbone, as our costochondritis guide says. Pressing, lifting and sport come back by the written steps below.

Incline push-up demonstrated on the 3D figure

3D demoIncline push-upBeginner · A bench or box

3 sets of 8 to 12, lowering the surface over the weeks · As in our costochondritis and pec strain guides (editorial)

Easier: Wall push-up · Harder: Push-up

Dumbbell floor press demonstrated on the 3D figure

3D demoDumbbell floor pressIntermediate · A dumbbell

2 to 3 sets of 8 to 12, stopping with 2 or 3 reps in reserve · The move page's dose (editorial); the floor stops the elbows at about shoulder level

Easier: Chest press machine · Harder: Bench press with chains

Chest press machine demonstrated on the 3D figure

3D demoChest press machineBeginner · Strength machine

2 to 3 sets of 10 to 15 · As in our pec strain guide (editorial); the move page says set the range limiter so the bottom of the rep is a comfortable stretch, and our pec strain guide keeps it short of a stretch at first

Harder: Barbell bench press

Band pull-apart demonstrated on the 3D figure

3D demoBand pull-apartIntermediate · A band

2 to 3 sets of 15 · As in our costochondritis guide (editorial)

Easier: Prone Y-T-W raises · Harder: Tuck back lever

3D demoDead bugBeginner · No equipment

8 slow reps each side · As in our costochondritis guide (editorial)

Easier: Dead bug heel taps · Harder: Forearm plank

3D demoPush-upIntermediate · No equipment

3 sets, building back to your usual numbers · As in our pec strain guide; with heart failure, the move page says use a wall push-up instead

Easier: Wall push-up · Harder: Close-grip push-up (close triceps position)

Move on when: Our suggestion: your usual pressing, lifting and sport stay within the pain rule, and your chest is no worse the next morning. If it flares, drop back a stage for a few days rather than stopping.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

What to change for now (written steps)

Our 3D figure can't show these changes. They come from the NHS unless marked as a guide's or our suggestion.

1. Get new chest pain checked first; once a clinician has said it's the chest wall, keep moving.
2. A fresh strain: for the first 2 to 3 days, ice for up to 20 minutes every 2 to 3 hours, and no heat, alcohol or massage; then keep it moving, and leave strenuous exercise for up to 8 weeks (the NHS).
3. Painkillers: ibuprofen may help, if it suits you (the NHS).
4. Pressing: shorten the range, bring your grip in, and leave flys, deep dips and wide-grip bench pressing until pressing is comfortable (our pec strain guide's suggestion).
5. Lifting: breathe out as you lift or press rather than holding your breath (our suggestion; our guide to breathing when lifting covers it).
6. Sleeping: lie on your back or on the less sore side (our suggestion).
7. If it burns after meals or at night: raising the head of your bed by about 10 to 20 cm can help heartburn (the NHS).
8. If worry or panic sets it off: the NHS suggests breathing exercises and regular exercise for panic attacks, and seeing a GP.

Sources 5, 25, 14, 15

Pressing, lifting and sport come back (written steps)

No trial has tested how to bring these back after chest wall pain. These steps are our suggestion unless a guide is named.

1. Wall, then incline, then knee and full push-ups, adding range before load.
2. Bench pressing at about half your old working weight, adding about 5% to 10% a week within the pain rule, as our pec strain guide suggests.
3. Flys, deep dips and heavy wide-grip pressing come back last.
4. Contact and throwing sports once pressing and push-ups are comfortable and your chest is no worse the next morning.

Positions to swap, and why

Habit or position	Why it matters	Instead
Chest flys while it's sore	The stretched, arms-wide position loads the pec most, and pec tears happen on the lowering part of a press, the AAOS says.	A press with a shorter range, such as the floor press.Try: Dumbbell floor press
Deep dips	The move page says going deeper than upper arms parallel loads the front of the shoulder heavily.	Incline push-ups.Try: Incline push-up
Pressing hard on the sore spot with a massage ball	The move page says there are no trials of it, and to skip it after a recent rib injury or over implants, a pacemaker or a port.	Slow breathing and gentle upper back movement.Try: Slow breathing (6 breaths a minute)
Testing your chest pain with hard exercise to see if it's the heart	Chest discomfort that comes on with effort and eases with rest is how angina behaves: it needs a check, not a test.	Walking at a pace you can talk at, once your chest has been checked.Try: Treadmill walking
Strapping or binding the chest	No source we read supports it, and it restricts your breathing (our reasoning).	Easy, full breaths, such as lateral breathing.Try: Lateral breathing (Pilates breathing)

Routines to follow

Breathing exercises to relax

A 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.

6 minBeginner5 movesNo equipment

Spine mobility routine: neck to pelvis, every direction

A 15-minute routine that moves your neck, upper back and lower back through bending, arching, side bending and twisting, then holds the spine steady.

15 minBeginner12 movesNo equipment

Easy cardio workout

A steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.

40 minBeginner3 movesCardio machine, A wall

Upper back mobility routine

A 12-minute routine for a stiff upper back and rounded shoulders: chin tucks, wall angels, Y-T-W raises and open books.

12 minBeginner8 movesA foam roller, A wall

Push-up progression workout

Work up to full push-ups: wall, incline and knee push-ups, then the floor push-up and harder variations.

15 minBeginner8 movesA wall, A bench or box

Chest workout at home: push-ups, floor presses and flys

A 30-minute chest workout at home with a pair of dumbbells or a band: push-ups, dumbbell floor presses, flys and a squeeze press, with no bench needed.

30 minBeginner8 movesA band, A dumbbell

More moves for this area

Questions people ask

How can I tell if chest pain is a muscle or my heart?

Chest wall pain is usually in one spot you can point to, sharp or aching, and changes when you move, twist or breathe deeply. But no single clue rules out the heart, so new chest pain needs checking. Chest pain that feels tight or heavy, spreads to an arm, the neck, jaw or back, or comes with sweating, feeling sick or breathlessness is a 999 call.

If my chest hurts when I press on it, is it a muscle?

It makes a muscle or joint more likely, but it doesn't rule out the heart or a clot. Pressing reproduced the pain about as often in people with a clot in the lungs as in those without one, and chest wall pain can exist alongside heart disease.

Why does my chest muscle hurt when I breathe?

Chest wall pain is often worse with a deep breath, lying down or moving. Sharp pain on breathing with a fever, a cough or coloured mucus can be pleurisy or a chest infection, and sudden sharp pain with breathlessness can be a collapsed lung or a clot. Those need checking the same day, or a 999 call.

How long does chest muscle pain last?

Most strains feel better after about 2 weeks, while costochondritis can last a few weeks to several months. It often comes back: in one study, more than half had it again within a year. No one can promise a date.

Why is my chest muscle pain on the left side?

Chest wall pain is more often on the left, so left-sided pain is common and usually harmless. But the heart is on that side too, so the warning signs still apply.

Can anxiety cause chest pain?

Yes. Anxiety and panic can cause a sharp, continuous chest pain with a racing heart, sweating and dizziness, and most panic attacks last 5 to 20 minutes. Get chest pain checked the first time; after that, breathing exercises and regular exercise help.

What helps chest muscle pain?

For a fresh strain, ice for up to 20 minutes every 2 to 3 hours for the first couple of days, then keep moving; painkillers such as ibuprofen can help. Ease off what brings it on, then build back gradually with the plan on this page.

Can I work out with chest muscle pain?

Yes, once it has been checked: walking, breathing and gentle moves first, then pressing, building back gradually. Leave flys, deep dips and wide-grip bench pressing until pressing is comfortable, and stop for chest discomfort that comes on with the effort.

Is chest muscle pain the same as costochondritis?

Costochondritis is one cause: inflammation where the ribs join the breastbone, sore to press and worse with moving or a deep breath. The chest muscles themselves, the ribs and the upper back are others.

What does a torn pec feel like?

A pop or ripping feeling at the front of the chest or armpit, usually on the lowering part of a bench press, then bruising, weakness and an uneven armpit or nipple line. Get it checked the same day, because a repair works best soon after the injury.

Why does my chest hurt after coughing?

A lot of coughing can strain the muscles between the ribs or set off costochondritis. A cough with a high temperature or coloured mucus, sharp pain on breathing, or coughing up blood needs checking the same day, and a 999 call with breathlessness.

Related exercise guides

Spine guide

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.