An abdominal strain refers to injury caused by damage of the abdominal muscles, whether by tearing, stretching or rupturing. If the injury is caused by tearing of those muscle fibers, it is referred to as “pulled abdominal muscle”.
This type of injury is fairly widespread among athletes or those who play a sport intensively. This is a result of the important role played by the core muscles in many sporting movements.
We should note at the start that an abdominal muscle strain is different from a hernia. However, the two injuries are sometimes confused with each other. The confusion sometimes arises because the symptoms of a hernia can be very similar to those of an abdominal strain. However, one important difference between a hernia and muscle strain is that a hernia is often associated with a swelling or the presence of a lump. A muscle strain does not usually cause a lump.
Hernias occur when an internal organ or body part starts sticking through the abdominal wall of muscle or tissue that normally contains it. If the internal organ is the bowel (intestine), then it can become become squeezed in the opening in the abdominal wall. This, in turn, can cause a blockage and the patient can then develop, nausea, vomiting and/or constipation.
Anatomy Of The Abdomen
The abdomen has several layered muscle fibres running from superficial to deep in the abdominal cavity:
The transverse abdominis that run across the abdomen (left to right). These are the deepest muscle fibers and they help to keep the contents of the abdomen in place. They also play a key role in involuntary expiration, such as when coughing, laughing or sneezing;
Internal and external obliques, which cross the abdomen diagonally in opposite directions. They are the next deepest fibers and assist in trunk rotation, sideways movements and trunk flexion; and
The rectus abdominis, which are the closest to the skin and run vertically across the abdominal cavity. These muscle fibers play key roles in trunk flexion but are also involved in other trunk movements.
Possible Causes Of An Abdominal Strain
People may experience abdominal strains due to any of the following activities or circumstances:
Sudden twisting of the torso, possibly as part of a vigorous form of exercise;
Overusing the stomach muscles, for example during intense or excessive exercise;
Playing sports that require running, turning and jumping with an incorrect technique;
Lifting heavy objects, again with an improper technique;
Violently coughing, sneezing or even laughing;
Not properly resting overused muscles.
Types Of Strain & Their Symptoms
Most abdominal muscle strains will cause a sudden sharp abdominal pain when the injury occurs.
As with other types of muscle strain, abdominal muscle strains can be classified according to their severity:
A Grade 1 strain involves only mild stretching of the muscle fibers. Typical symptoms are localized pain, mild swelling and pain when trying to move, laugh, cough or sneeze;
A Grade 2 strain involves partial tearing of the abdominal muscle fibers. If sufficient fibers are torn, the affected individual may experience significantly more severe symptoms than with a Grade 1 strain. These may include significant abdominal tenderness, localized swelling and discoloration / bruising on the surface of the abdomen.
The ability of the patient to move without experiencing severe pain will be very limited. Muscle spasms may also be experienced.
Grade 3 strains are the most severe and involve complete rupture of one or more muscles. The rupture may be at the points of insertion, origin or midsection of the muscle. In addition to the Grade 2 symptoms, the patient may experience nausea, vomiting and difficulty breathing. A shallow and/or rapid heart beat may also be observed.
This injury requires emergency care. Anyone suspected of having experienced a Grade 3 abdominal strain should be kept as still as possible until emergency care arrives. Those in charge of his or her care should apply an ice pack and monitor his/her vital signs closely.
Along with these symptoms, people with all grades of abdominal strain may experience difficulty walking or standing up straight. Others may find it hard to bend forward or sideways. This is because these movements all engage the abdominal or core muscles to one extent or another.
Individuals experiencing some or all of the above symptoms should consult a healthcare professional for medical advice. This type of injury is frequently sustained in connection with sports or exercise. Consequently, the patient should see a doctor with sports medicine expertise.
How Do These Symptoms Compare With Those Of A Hernia?
Although some of these symptoms may also be experienced with a hernia, the latter may also present additional signs. These may include some of all of:
A bulge in the abdomen;
Nausea or vomiting.
Diagnosis of an abdominal strain should ideally be done by a sports medicine professional. The doctor making the diagnosis will likely need to palpate (examine by touch) the abdominal muscles. Muscle testing may then be carried out to determine which muscles have been damaged and the severity of the injury.
Treatment of an abdominal strain may require one or a combination of 6 options, depending on the severity of the injury:
This is probably the most important component of the treatment for an abdominal strain. The patient should avoid any activities that may place stress on the stomach muscles. The aim should be to give them a chance to repair themselves naturally. Rest alone will be sufficient to heal the majority of mild muscle strains. Most mild strains will heal within a few weeks.
Apply a cold compress or ice pack to the painful area (after wrapping it in a towel) for about 15-20 minutes. Repeat every 2-3 hours until the pain and swelling have improved.
Once the pain and swelling have largely disappeared, switch to using heat therapy using a hot compress. As with the cold therapy, wrap the compress in a towel before application. Apply for about 20 minutes at a time at intervals of 2-3 hours. Heat therapy helps to relax the muscle and relieve tension, thereby reducing pain. In addition, blood flow to the affected area is increased. The increased blood flow helps to promote healing and reduce inflammation.
Pain Killing Medication
Use non steroidal anti inflammatory drugs (NSAIDs) to reduce the pain and any inflammation that may be present. Examples of good options include ibuprofen (Advil) and naproxen (Aleve).
Pain killers such as acetaminophen (Tylenol) may also be considered. However, the patient should be aware that they will not reduce any inflammation that may be present.
Use a tensor bandage to apply compression to the injury. The pressure produced by the bandage helps to minimize movement and swelling. A compression top like the LP EmbioZ back support may also be useful in applying compression to the required area
This is another critical component of the recovery plan that is sometimes underestimated. A physical therapist can design an exercise program for abdomen and core strengthening. It will help to reduce the risk of another abdominal strain after returning to regular activities.
These exercises should not be undertaken until after the acute injury has healed. Strengthening exercises done before an injured muscle has healed can exacerbate the damage and lengthen the healing process.