What Causes Lower Rib Pain During Physical Activity

Lower rib pain during physical activity is often a clear sign that something is mechanically or structurally off in the way your body moves, supports your core, or transfers load between your upper and lower torso.

It is not just a “side stitch” or a random sharp jab; it usually involves deeper issues such as intercostal muscle strain, joint dysfunction, nerve compression, or, in some cases, misalignment or instability in the ribcage itself.

People most frequently report this type of discomfort during twisting movements, high-impact sports, deep breathing under exertion, or prolonged core engagement (like in planks, running, or rowing).

In many cases, the pain is localized to the 8th to 12th ribs, the so-called “floating” or “false” ribs, which are more flexible and less securely attached than upper ribs. These ribs rely heavily on muscular and connective tissue support.

When those supports are stressed, injured, or imbalanced, pain signals begin to fire during specific physical tasks.

Intercostal Muscle Strain

Cause	Overstretching or tearing of the muscles between the ribs
Common Triggers	Over-rotation, sudden twisting, lifting heavy weights
Pain Description	Sharp, stabbing, or pulling pain worsened by deep breathing or torso movement
Physical Signs	Local tenderness, swelling, or muscle tightness in the area

Intercostal muscles are responsible for supporting the ribcage and facilitating respiration. During activities involving rotation or lateral flexion (like tennis, golf, or even yoga), these muscles can become strained or micro-torn.

Unlike typical muscle soreness, intercostal strain often causes pain that intensifies with breathing or coughing, which makes it easy to mistake for a lung or digestive issue.

If untreated or if you continue high-intensity movement, the strain can worsen. The best course is rest, controlled stretching, and careful reintroduction to physical activity.

Costovertebral Joint Irritation or Dysfunction

Each rib connects to the thoracic spine through a costovertebral joint. These joints are small but essential to stability and movement. When these joints become compressed, irritated, or poorly aligned, it can create pain that mimics muscle strain.

This pain may feel dull and tight, but sharp when rotating the spine or lifting arms overhead.

Often, this issue is linked to sedentary posture (e.g., working at a desk) combined with a sudden return to physical activity without mobility prep. Manual therapy, thoracic mobility exercises, and postural correction can improve symptoms significantly.

Oblique or Rectus Abdominis Muscle Overload

The external obliques and rectus abdominis attach directly to the lower ribs. When these muscles are overloaded, either from overtraining or insufficient warm-up, they can create tension at their bony attachments.

This often results in insertional pain at the lower rib cage during intense core activity.

This is particularly common among athletes who overuse their rectus abdominis (six-pack muscle) without balancing it with deep core work. Reducing volume, adjusting technique, and including more transverse abdominis activation (e.g., dead bugs, bird dogs) can reduce rib-side strain.

Slipping Rib Syndrome

One of the most underdiagnosed and overlooked causes of lower rib pain during activity is Slipping Rib Syndrome. This occurs when the cartilage of the lower ribs (usually 8–10) becomes hypermobile or partially dislocates, resulting in irritation of surrounding nerves and tissues.

The condition is more common in young, active individuals and athletes, especially those involved in martial arts, rowing, or gymnastics. While not immediately dangerous, slipping ribs can significantly impair performance and quality of life.

In many patients, the slipping rib probability increases with repetitive lateral flexion and trunk extension, as these movements exploit the anatomical looseness of floating ribs. Diagnosis often involves physical palpation (hooking maneuver) and is confirmed via dynamic ultrasound.

Treatment ranges from conservative methods, like abdominal bracing and physical therapy, to surgical stabilization in more persistent cases.

Diaphragmatic or Breathing Pattern Dysfunction

The diaphragm anchors to the lower ribs and is a key player in core stability. When breathing becomes dysfunctional, such as during stress or while holding your breath through effort, it can strain the diaphragm’s rib attachments and even mimic lower rib pain.

This issue is common among novice lifters and endurance athletes who haven’t developed good respiratory-cordination under load. Diaphragmatic breathing, breath training, and core-integrated movement drills (like loaded carries or tempo squats) are often effective in correcting the pattern and reducing discomfort.

Final Thoughts

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Lower rib pain during exercise should never be brushed off as a random side effect. It is often your body’s way of alerting you to imbalance, instability, or muscular overuse, especially in the lower thoracic and upper abdominal regions.

Some people also report stomach pain alongside lower rib pain, especially when core tension is poorly distributed.

While occasional soreness is expected in training, recurrent pain that worsens with movement or breathing demands assessment. The key is not just to treat the symptom, but to identify the mechanical or structural cause, whether it’s a strained muscle, dysfunctional joint, or something more complex like slipping rib syndrome.