The abdomen (simply known as “the belly”) is the body space between the thorax (chest) and pelvis. The diaphragm forms the upper surface of the abdomen. At the level of the pelvic bones, the abdomen ends, and the pelvis begins. The abdomen contains a complex list of digestive organs, which includes:
- The stomach
- Small and large intestines
These organs mentioned above are held together loosely by connecting tissues that allow them to expand and slide against each other. The abdomen also contains the kidneys and spleen. Furthermore, several important blood vessels travel through the abdomen, including the aorta, inferior vena cava, and dozens of their tinier branches. In the front, the abdomen is protected by a thin, tough layer of tissue called fascia. In the front of the fascia are the abdominal muscles and skin. In the rear of the abdomen are the back muscles and spine.
As for the muscles, the abdominal muscles are part of the musculoskeletal system. These muscles on the front of the body, between the pelvis and ribs, support the trunk, hold organs in place, and help you move. Overall, your abdominal muscles and your back muscles are core muscles that support and stabilize the spine. They work together to help you sit, stand, walk, exercise, and much more.
Many other groups of muscles that make up the abdominal muscles include:
- Oblique muscles – The oblique muscles contract to help rotate your body left and right.
- Rectus abdominus muscles – These muscles allow movement between the ribcage and pelvis.
- Transversus abdominus muscles – These types of muscles are the deepest abdominal muscles. They help stabilize the trunk and protect organs.
Pain in the abdomen area could potentially mean many possible conditions. In cases of an abdominal strain (pulled abdominal muscles) may generally occur during intense or excessive exercising. For that reason, strains are very common in athletes or highly active individuals. Strained muscles could also happen when you make sudden, fast movements like coughing, sneezing or lifting something heavy. If you went too hard, you may be at risk of putting excess strain on certain areas in your body leading to a tear or a pulled muscle.
Causes & Symptoms
A strain can vary in severity from a mild stretch to a full rupture. In an abdominal strain, any of the four muscles can be injured causing extreme discomfort with any trunk movements as well as with coughing, laughing, deep breathing, or sneezing. Therefore, below is a list of three separate degrees that indicate the severity of an abdominal strain:
First-degree abdominal strain
A mild stretching of muscle is classified as a first-degree abdominal strain and can result in localized pain, mild swelling, and pain with movement, coughing, laughing, deep breathing, or sneezing.
Second-degree abdominal strain
A more severe injury of an abdominal muscle is a partial tear. Depending on the number of fibers torn, this type of injury may be quite debilitating. You may experience sudden abdominal pain, marked tenderness, localized swelling, and discoloration.
Third-degree abdominal strain
A third-degree strain is the most severe injury and is diagnosed as a complete rupture either at its insertion, origin, or midsection. Along with the symptoms of a second-degree muscle strain, you may also experience symptoms, such as nausea, vomiting, pale skin, excess perspiration, difficulty breathing, and a shallow and rapid heart rate. If you suspect a full rupture muscle tear, it is recommended to seek immediate medical attention to safely remove the tear to avoid further life-threatening complications.
The most common causes of abdominal strains are sudden twisting (such as swinging a bat) or sudden hypertension of the spine. If the force of the movement is stronger than the fibers of the muscles can withstand, the muscles will begin to stretch. If the force continues, the fibers may begin to tear. Continued force could cause a complete rupture within the muscle or between the muscle and its fascial attachment.
Throughout symptoms linked to this condition, pain is the most common and obvious symptom of an abdominal strain, however, there are others to be aware of. Upper abdominal strain symptoms are usually the same as lower abdominal strain symptoms, differing only by location. The following symptoms of a strain in the abdominal area are:
- Bruising and swelling – Abdominal strains, which involve small tears or a full rupture, may result in swelling and bruising over the site of injury.
- Cramping or tightness – A sensation of cramping or tightness happens when the stomach muscles are stretched or contracted. You may even experience this while sneezing or coughing.
- Burning or stabbing sensation – A burning sensation typically occurs after the tear develops. The discomfort is often localized instead of diffuse. Also, pain is aggravated by any activity that causes stretching or direct use of the torn muscle.
- Trouble breathing or rapid heart rate – These symptoms can be due to internal bleeding, which may also cause vomiting, nausea, and cold sweats.
Who gets Abdominal Strain?
Anyone can pull a stomach muscle, but certain activities may increase your risk of straining the muscle. People who play the following sports below are more likely to develop an abdominal strain whether it is a partial or complete rupture:
How does it affect you? How serious is it?
In addition to abdominal strains, there is another condition with similar symptoms, known as a hernia. Hernias occur when an organ pushes through a weak spot in a muscle. They typically appear in the groin, the area between the abdomen and upper thigh. An abdominal muscle strain may increase your risk of getting a hernia.
A hernia and an abdominal strain can both cause abdominal pain. Hernias cause a lump or bulge at the hernia site, which may ache or burn. A hernia can also cause constipation or nausea and vomiting (abdominal strains do not cause these problems). A hernia won’t go away without treatment, but an abdominal strain can with enough rest.
Recommended Treatment & Rehabilitation
It is highly recommended to visit a healthcare provider for a clear diagnosis if you are experiencing any symptoms occurring in your abdominal area. Even if your condition does not seem severe, an accurate abdominal strain diagnosis is crucial to a rapid recovery. Here are a few effective diagnostic procedures your doctor will use:
- Medical history and physical examination – A comprehensive physical exam is the first step in diagnosing an abdominal strain. Your doctor will ask about your symptoms, medical history, and daily activities. They will then examine your belly and will likely ask you to do an exercise, such as a sit-up, to see if it causes discomfort.
- Magnetic Resonance Imaging (MRI) – In the location of the strain, there will be a number of symptoms, such as swelling, tenderness, and often weakness. If symptoms are severe, your doctor may order an MRI scan to determine the extent of the rupture. MRI scans may also rule out hernias.
Conservative treatment of abdominal injuries includes changes to your activities and physiotherapy. A physiotherapist will use a selective amount of treatments to precisely target the problems found during your evaluation.
They will design a personalized treatment program for you based on your condition that focuses on your goals to help you safely return to your sport or regular activities. Therefore, physiotherapy will focus on addressing the main problems discovered during your evaluation. These problems often include poor hip strength and flexibility, and a reduced ability to activate or turn the abdominal muscles to keep the pelvis stable during intense activity.
Physiotherapy treatments will address your condition without causing pain or making your pain worse. He or she will also teach you to modify sports or training activities that cause abdominal pain or hinder your recovery. Therefore, the following treatment plans below may include:
- Icing and compression – During the early phases of injury or when you have high levels of pain, applying ice and compression to the area may decrease your pain level.
- Stretching – Your physiotherapist may show you how to perform hip and low-back exercises to gently stretch your muscles. They will teach you how often and how long to do these exercises to match your condition to improve muscle flexibility and decrease pain.
- Muscle retraining – Your physiotherapist will teach you to target and move your abdominal and hip muscles. This is an important key part of your treatment, as certain muscles may not be working well due to your injury.
- Manual therapy – Your therapist may perform hands-on therapy to stretch and mobilize affected soft tissue and joints based on your evaluation. Manual therapy can improve your hip-joint mobility and range of motion, decrease muscle pain, and improve flexibility.
- Return to activities – Once you have recovered enough to progress without pain, your physiotherapist will slowly add movements specific to your activity to your treatment program. For instance, you may return to running and light sport-related drills to prepare your body for the full stress of participation in your sport.
Here are some exercise examples for you to try in your free time. The exercises may be suggested for your condition or for basic rehabilitation:
Lie on your back with your knees bent, then brace your stomach while you tighten your muscles by pulling in and imagining your belly button is moving toward your spine. Next, press your lower back into the floor. You should feel your hips and pelvis rock back. Hold for 6 seconds while breathing smoothly. Relax and allow your pelvis and hips to rock forward before repeating 8-12 times a day.
Lie down with your knees bent and your arms at your sides. Keep your feet flat on the floor. Afterward, lift your head and shoulders up to 8-10 centimeters. At the same time, raise your arms to about thigh level. Hold for 6 seconds, then repeat 8-12 times while relaxing through each set a day.
Begin by lying on your back with your knees bent. Place two fingers just inside your hip bones so you can feel your lower belly muscles. Take a deep breath in, then, as you breathe out, pull your belly button in toward your spine as if you are trying to zip up a tight pair of jeans. You should feel your lower belly muscles pull slightly away from your fingers as the muscles tighten. Hold for about 6 seconds, then repeat 8-12 times a day.
Begin on your hands and knees. Relax your bottom down towards your heels (your knees should be wider apart, feet closer together). Hold this stretch for 30 seconds, then rest your head on the floor before repeating 2-3 times a day.
Alternative & Homeopathic Treatment
There are several homeopathic treatments that you can use to help reduce symptoms linked to abdominal pain. Some of these include:
- Heat application – Heat is one of the best home remedies you can use to treat abdominal pain. Applying a heat pack or having a warm bath can relax the pelvic muscles, which can reduce cramping and pain.
- Non-steroidal anti-inflammatory drugs (NSAIDs) – Anti-inflammatory medications can offer fast relief from painful cramping caused by abdominal pain. These medications include ibuprofen and naproxen.
- Turmeric – Turmeric has useful anti-inflammatory properties that can be very beneficial to patients experiencing symptoms linked to abdominal strains. It can also be used to manage abdominal pain in the long term.
- Massage – Massaging the abdominal muscles can help relax them and reduce inflammation, reducing cramping. Using a few drops of lavender oil can help further relax the muscles.
- Ginger tea – Some patients with muscle pain experience nausea as a result of the condition. Ginger tea is a well-known home remedy for treating nausea.